Question

3456 Case Study, Chapter 8, Disorders of Fluid, Electrolyte, and Acid-Base Balance A nurse has just been assigned to care for three patients: A, B, and C. Selected lab work for each patient is listed below. Patient A Na+ 138 mEq/L K+ 5.1 mEq/L Ca+ 8.9 mg/dL Mg+ 1.3 mg/dL pH 7.40 7.32 PCO2 42 mm Hg PO2 95% 98% HCO3 22 28 Patient B 142 mEq/L 6.1 mEq/L 7.5 mg/dL 0.9 mg/dL 7.42 48 mm Hg 99% 26 Patient C 148 mEq/L 3.8 mEq/L 9.5 mg/dL 2.1 mg/dL 40 mm Hg 4. Discuss the possible etiology associated with each electrolyte imbalance identified in question number 3. What manifestations are associated with the three electrolyte imbalances in Patient 5. B? 6. How would you interpret Patient B's arterial blood gases? 7. What body system will attempt to compensate?

Answer 1

4.The possible etiology are

Hypernatremia	Hyperkalemia	Hypocalcemia	Hypomagnesimia
Decreased fluid intake Dehydration or fluid loss via diarrhea or vomiting Uncontrolled diabetes Increased sodium intake Diet high in sodium Fever Medication	Increased dietary intake of potassium Medication Kidney problems	Inadequate dietary supplements Vitamin D deficiency Decreased absorption Bone destruction Medical conditions Womens Age	Inadequate dietary intake Decreased absorption Renal function problems

5.The manifestation are

Hypernatremia	Hyperkalemia	Hypomagcalcemia	Hypomagnesimia
Increased thirst Confusion Disorientation Tiredness or fatigue Restless Tachycardia Oliguria Nausea, vomiting, diarrhea	Tingling sensation Muscle cramps and weakness Fatigue Bradycardia Weak pulse	Tingling sensation around oral cavity ,hands ,feet Muscle cramps,weakness Brittle hair and nails Feeling depressed Fracture	Weakness Nausea, vomiting Tremor Constipation Trousseau sign positive

6.The decreased pH level indicates it is acidic and increased carbon dioxide indicates problems with respiratory system and increased bicarbonate

It is Respiratory acidosis

7.The renal mb system is responsible for the compensatory mechanism. It absorbs the increased level of bicarbonate levels.This simultaneously decreases the acidic nature of blood after normalising the carbon dioxide level.