Question

A 19-year-old female arrives at the Emergency Department (ED) after participating in a contest to drink the most water. She drank 5 liters of water in about 2 hours. 911 was called when the student reported a headache and was confused. Upon arrival to the ED, a nursing assessment was performed and laboratory tests ordered by the healthcare provider were obtained. The patient reports a headache, abdominal cramping, and has orthostatic hypotension. The following laboratory results are reported:

• Sodium: 122 mEq/L
• Potassium: 3.6 mEq/L
• Calcium: 10 mg/dL
• Magnesium: 2 mg/dL
• Chloride: 100 mEq/L
• Phosphate: 2 mEq/L

Initial Discussion Post:

• Cluster and analyze the data in the scenario.
  • Determine the electrolyte imbalance.
  • As the RN monitoring this patient, what assessments will you perform for early recognition of potential problems?
  • Identify a nursing diagnosis with related factors, and defining characteristics (if appropriate).
  • Describe the analysis used and rationale for your choice.

Answer 1

Ans:- the given case is a dilution hyponatraemia

Clicnal features:- muscle cramps

Weakness and fatigue

Mental confusion

Disorientation

Convulsions and coma

These features are appear step wise pattern as sodium level become low.

One should always looking for cause which are following :-

1.Syndrome of inappropriate sections of Adh (SIADH)

2.primary polydipsia

3.Chronic renal failure

Treatment :-

Never ever rapidly correct hyponatraemia it will cause central pontine myelinolysis

Rate of correction should be 0.6mEq/L/hour to 1mEq/L/hr but total correction in a day should be not exceed 8-10 mEq/L

1. Restrict the fluid or water

2 hypertonic saline with loop diuretic

3.V2 receptor antagonist