Question

A 36-year-old client was admitted with gastroenteritis. She has been vomiting and having severe diarrhea for 2 days. She is very weak. The current laboratory results are Na+ 128 mEq/L, K+ 3.0 mEq/L, Cl− 90 mEq/L. The physician orders IV of 0.9% normal saline solution at 100 mL/hr, NPO, and I & O.

1. Are the lab results normal or abnormal? If so, which ones?
2. What treatment and/or medication(s), if any, would be ordered?
3. What complication(s) if any is likely to develop if the symptoms persist? (Discuss one)
4. What education would you provide to the client to prevent this issue in the future?

Answer 1

1. Are the lab results normal or abnormal? If so, which ones?

The lab results are abnormal and results show hyponatremia or low blood Sodium levels and hypokalemia or low blood Potassium levels . Also serum chloride level are below normal

1. What treatment and/or medication(s), if any, would be ordered?

• Use of IV rehydration for dehydration like Normal Saline 0.9%
• Use antiemetic medications to stop vomiting.
• Recheck serum electrolytes and administer Potassium Chloride diluted in NS , if hypokalemia persists
• Advice to add tender coconut water to the diet to increase the potassium intake.
• Fast oral rehydration over 3 to 4 hours;
• Rapid re alimentation with normal feeding;
• Assess the hydration status and maintain intake output chart.

1. What complication(s) if any is likely to develop if the symptoms persist? (Discuss one)

If Hyponatremia persists, can lead to much more severe complications such as cerebral edema, brain disease, herniation of the brain, cardiopulmonary arrest, seizure, coma and even death.

1. What education would you provide to the client to prevent this issue in the future?

• Educate the patient on the problems of electrolyte imbalances and its complications.
• Advise the patient to consume plenty of fluids (non caffeinated) if GE occur in future.
• Advise to start ORS solution, if vomiting or diarrhea occurs.
• Fluids such as soups, cereal gruels, cereal-salt solutions, or home-made sugar-and-salt solutions may be more practical and nearly as effective against dehydration
• Keep a watch on the amount and color of the urine. In dehydration, the urine output will be less plus it will be concentrated or dark colored.