Question

PN 200 Fundamentals of Nursing II Case Study; Heart Failure – Potassium/Digoxin Shirley Trent, a 64-year-old paient ,has heart failure which is being controlled with diagoxin (Lanoxin), furosemide (Lasiz), and a low sodium diet. She is taking potassium chloride (KCL) 20 mEq per day orally. Three days ago,Shirley had flu-like symptoms such as anorexia,lethargy, and diarrhea. Her fluid and food intake was diminished; she refused to take KCL an stated that drug make her sick. She has been taking the digoxin and furosemide daily The nurse’s assessment during the home visit includes poor skin turgor,poor muscle tone,irregular pulse rate, and decreased bowel sounds. Obtained a blood sample for serum electrolytes: results indicated: K (Potassium) 2.9 mEq/L Na (Sodium) 137 mEq/L Cl (chloride) 96mEq/L 1. List reference values for serum potassium,serum, and serum chloride,Are Shirley’s electrolyte levels within normal range? Explain your answers 2. Match Shirley’s physical findings with the corresponding electrolyte imbalance 3. What are three (3) reasons for the electrolyte imbalance? 4. Shirely said she was not taking the KCL because the drug makes her sick. What information would you give her concerning the administration of potassium? 5. What is the effect of furosemide on digoin when there is a potassium deficit? Explain your answer 6. Why should the nurse assess Shirley for digitalis toxicity? List the signs and symptoms of digitatalis toxicity. What is the normal blood therapeutic range of the digitalis? Shirley was referred to the health care provider because of her serum potassium deficitis and its effects on digitalis. A repeat potassium was completed, and the result was 2.8 mEq/L. A liter of 5% Dextrose in water with KCL 40 mEq wa administered over four hours. 7. How many milliequivalents of KCL per hour would the patient receive? Does this amount constitute an acceptable dosage? 8. Why is it important for the nurse to monitor the rate of intravenous fluids containing potassium, the hourly urine output, and the vital signs? 9. Because of the low serum potassium level, What other electrolytes values should be checked? Explain your answer. After shirley’s serum electrolytes returned to normal, the health care provider instructed her to continue taking the prescribed KCL dosage daily with her other medications. 10. Shirley asks why she has to continue taking these drugs. What is the nurse’s best response? 11. The nurse instructs Shirley to eat foods rich in potassium. Prepare a list of foods that are richest in potassium.

Answer 1

Question 1

Reference level

Potassium: 3.5 to 5.1meq/lit

Sodium: 135-145 meq/lit

Chloride : 95-105 meq/lit

Here patient is having hypokalemia.

Question 2:

Flu like symptoms

Anorexia

Lethargy

Diarrhea

Decreased food and fluids.

Question 3

Cardiac failure

Digoxin toxicity

Excess use of diuretics.

Question 4

1. Explain her about the need of potassium

2. Hypokalemia causes cardiac arrhythmias.

3. Hypo kalemia index digoxin toxicity.

Question 5

1. Frusemide is a loop diarrhea that causes hypokalemia.

2. Hypo kalemia increases the potassium toxicity.

Question 6

Signs and symptoms of digoxin toxicity:

Nausea

Vomiting

Abdominal pain

Visual distances.

Normal therapeutic range of digoxin: 0.5-2ng/ml.

As perfect Chevy rule answered 4 questions