Question

PN 200 Fundamentals of Nursing II Hypokalemia

PN 200 Fundamentals of Nursing II Concept Map - Hypokalemia Mr. Sam Downs is admitted to your unit from the emergency room. He is 71 y/o 7:30AM male. Weight upon admission 156; Ht 5" 11"; T 97.2; R 22 and shallow; P 102 and easily obliterated; B/P 102/76. NKA. Primary admitting diagnosis is altered mental status. He is lethargic and has difficulty responding to question rapidly but given time he can answer all questions. He is also very somnolent. He denies pain and can move all extremities freely with no limited range of motion. On assessment you note that the heart rate is irregular and bowel sounds are diminished. You notice a Heparin lock in his left hand. His admission orders are as follows: СМР UA СВС ЕKG Start an IV of 09 % NS ; 1000 ce to run over 12 hours. The drop rate is 15 gtts per ce. Insert retention catheter. Strict I& O Regular diet Metropolol 25 mgm by mouth twice daily Lasix 20mgm one tablet by mouth daily Potassium Chloride 10mEq one tablet by mouth daily. Lipitor 20mgm one tablet by mouth at bedtime. 1. Which of the above medications would you question when verifying orders? You receive the laboratory results and note the following as abnormal values: BUN 45 K 3.2 Hgb 22

Answer 1

1.The patient's antihypertensive medication (metoprolol twice a day) has to questioned when verifying the orders because the patient has a blood pressure of 102/76 (hypotensive) cane further decreased if antihypertensive are taken and if taken twice can lead to severe hypotension

2.The normal values are

BUN:7 to 20mg/dl (an elevated level occurs when there is a problem associated with the renal function, increased bowel movements.

K:3.5 to 5mEq/l (a low level can help to identify the problem associated with gastrointestinal tract like severe vomiting ,diarrhea ,renal tubular problems, use of diuretics ,cardiac conduction)

Hgb:13 to 16.5 (an elevated level is often a serious problem can be due to diarrhea

Hct:45 to 52%(is elevated in polycythemia and dehydration)

Specific gravity 1.020 to1.030 (elevation occurs in dehydration)

The information which has to be had before calling the physician is whether it is hypo or hyper (increased or decreased) to be reported and to initiate the treatment.

1.The danger of GI suction in a patient with hypokalemia are

• A further decrease in potassium levels while suctioning because the stomach has few potassium in it which can be lost when applying a continuous low suctioning.

2.The important decision which the physician failed to do is to treat the nausea and vomiting. This is important to be asked by a nurse because this can lead to fluid loss resulting in dehydration and hypokalemia

3.The nurse failed to report the vitals of shallow breath ,tachycardia, hypotension,GCS of the patient which can be helpful in diagnosis.