Question

John is a 59-year-old man admitted to the emergency department with complaints of severe shortness of breath and a cough producing frothy, blood-tinged mucous. His history reveals a myocardial infarction 2 years ago. Since then, he has been on a low-salt diet, digoxin, and furosemide for control of congestive heart failure.

The client is admitted to the hospital for treatment of acute pulmonary edema secondary to congestive heart failure. On his fourth hospital day, the client complains of tingling and numbness of his fingers, muscle weakness, and palpitations. His electrocardiogram shows frequent premature ventricular contractions (PVCs). Four hours later, he is confused and restless.

The client’s diagnostic findings are as follows:

Arterial Blood Gases: pH 7.55, PaCO2 25 mm Hg, HCO3 34 mEq/L, PaO2 65 mm Hg, SaO2 91%

Hematology: K = 2.5 mEq/L

1. What is the relationship between the client’s arterial blood gas values and his serum potassium level?

A.Review factors that negatively alter serum potassium levels. Review the effects of acid-base imbalance on serum potassium levels.

B. Discuss the significance of a serum potassium of 2.5 mEq/L.

C. Identify possible consequences to the client if his hypokalemia is not addressed.

2. What are the priority nursing diagnoses for the client?

Group objective and subjective data into problem categories. Prioritize problems into those that need to be addressed immediately versus those that can wait. Use Maslow’s hierarchy of needs, life preservation, or other criteria to establish priorities.

Answer 1

1.

• when potassium level decrease in serum it causes decrease in PH value less than 7.35 known as acidosis. it manly happens during body fluid loss like dehydration, diarrhoea etc. in this condition the intra cellular potassium ions are moved to extra cellular .
• vomiting cause loss of hydrochloric acid , so it leads to a condition of alkalosis where ph is more than 7.35. so whenever ahydrogen ion excreted a biccarbonate ion is added with extra cellular fluid.
• sodium bicarbonate helps in moving the extra cellular potassium ions to intracellular. so during hypokalemia we should check ABG for soda bicarbonate level to maintain the balance. if it is low then we should administer it according to doctors advice.