Question

PN 200 Fundamentals of Nursing II Concept Map - Hyponatremia Ms. Rose Durham, a 54-year-old female, has been admitted to your unit with the diagnosis of hyponatremia. Her presenting symptoms include mental confusion, headache, and altered level of consciousness, anxiety, nausea, vomiting and a low-grade fever of 100.6. She has informed the physician that she has been out working in her garden for the past three days and it has been 97 degrees daily for the past 4 days. She does not recall drinking many fluids but has had her coffee in the moming. Her vital signs on admission are T100.6, P 104 weak and easily obliterated, R, 24 and regular, B/P 96/58. Height 5'7", weight 182 pounds. She states she follows a low sodium diet that she was given after being diagnosed with CHF. Additional history includes; appendectomy at 17; mitral valve prolapse, mild CHF with sodium restricted diet, and hysterectomy at 35 years of age. Labs & Diagnostic tests Свс Hemoglobin and hematocrit Electrolytes Chest X-ray Urinalysis Medications: Baby aspirin 81mg by mouth every day Plavix 75mg one tab by mouth daily Lasix 10 mg daily Digoxin 0.25 mg daily Physician Orders IV #18-20 Jelco 1000 mL NACL 0.9% IV every 8 hours Intake and output X 3 days Convulsion precautions Liberal sodium diet In addition to completing the care plan, answer the following questions:

Answer 1

Hyponatremia

●Nursing diagnosis

Altered sensorium related to decrease in serum sodium level as evidenced by confusion, headaches ,altered consciousness ,decrease sodium intske

Intervention

• Administer hypertonic solution (3 % NS )to correct sodium level
• Assess the GCS ,to know the baseline data and plan for care
• Administer intravenous fluids and oral fluids if capable to drink to correct fluid volume deficit
• Provide normal salt rich diet as per advice to correct hyponatremia
• Monitor vital signal

Outcome

• Positive:the patient will maintain normal sodium level
• Negative:excess fluid volume due to fluid overload in correction therapy as patient is a case of CHF

Evaluation

The patient is responsive ,alert, conscious orient to surrounding

●Rusk for impaired cardiac output related to disturbances in homeostasis as evidence by decreased blood pressure, tachycardia

Intervention

• Monitor vital signs to plan for care as it is the baseline indicator
• Administer IVF to increase blood plasma volume and hence blood pressure
• Administer vasoconstrictor as per order to elevate blood pressure
• Provide a head low position to increase cardiac circulation on gravitational force

Outcome

Positive:to maintain a normal blood pressure

Negative:risk for cardiac overload

Evaluation:the patient maintains a normal blood pressure.