Question

Please help

S.S a 63 years old white women with acute lymphocytic leukerimina, has been receiving chemotherapy on an out patient basics. She complain her third treatment 5 days ago and has been experiencing nausea and vomiting for 2 days despite using ondansentron (Zofran) S.S’s daughter bring her to the hospital, where she is admitted to the medical unit. As the admitting nurse, you perform a thorough assessment

Subjective data

. Complain of lethargy, weakness, dizziness, and dry mouth

. States she has been too nauseated to eat or drink anything for 2 days

Objective data

. Heart rate 110 beats/min, pulse thready

. BP 100/65

. Weight lass of 5 lb since she received her chemotherapy treatment 5 days ago

. Dry oral mucous membranes

Question

1. Base on her clinical manifestations, what fluid imbalance does S.S have?

2. What addition assessment data should you obtain?

3. What are her risk factors for fluid and electrolyte imbalances?

4.You draw blood for a serum chemistry evaluation. What electrolyte imbalances are likely and why?

5. S.S is at risk for which acid-base imbalances? Describe the changes that would occur in S.S ’s ABGs with this acid-base imbalance. How would the body compensate?

6. Teamwork and Collaboration. What is the interprofessional team’s priority at this time for S.S?

7. The physical orders dextrose 5% in 0.45% saline to infuse at 100 mL/hr. What type of solution is this, and how will it help S.S’s fluid imbalance?

8. Priority Decision : What are the priority nursing interventions for S.S?

9. Evidence- Based Practice: S.S have a double-lumen PICC in her left arm. One lumen is connected to the IV infusion; the other is unused. What is the recommended practice for maintaining the patency of unused lumen?

10. Quality Improvement : what outcomes will indicate that interprofessional care was affective?

Answer 1

1.The patient is experiencing Hyponatremia,as the clinical conditions prescribed in the situation suggests hyponatremia.

2 other findings which needs to be assessed are Respiratory findings whether the respiration was shallow and should also check renal findings by checking the urine output.Serum sodium level and urine specific gravity needs to be assessed to understand the exact cause.

3 The central nervous system is frequently a site for leukemic cells,thus the patient may experience headache and vomiting because of meningeal involvement.

4 The most possible electrolyte imbalance would be hyponatraemia.So serum electrolytes needs to be checked..As the clinical findings indicate the presence of hyponatraemia.

5 S.S is at risk for Metabolic Alkalosis,which occurs as a result from a dysfunction of metabolism that causes an increased amount of available base solution in the blood.Excessive vomiting leads to an excessive loss of hydrochloric acid.