Question

Electrolyte Imbalance Patient Profile E.G. is a 73-year-old woman whose daughter brings her to see the health care provider because she has had a case of the "stomach flu," with vomiting and diarrhea for the past three to four days and is now experiencing occasional light-headedness and dizziness. Her past medical history includes hypertension, hypercholesterolemia, and mild heart failure. She is taking: Digoxin 0.125 mg po daily. Captopril 25 mg po BID Furosemide 40 mg po daily. Potassium chloride 20 mEq po daily Atorvastatin 20 mg po at bedtime. Subjective Data Has been following a low sodium diet States her abdomen feels bloated and she has been constipated since the onset of the lu" Has been taking her medications except for the potassium chloride pill because it upsets her stomach. Occasionally takes an extra "water pill" when her ankles are swollen Objective Data Physical Examination Temperature 98.20 F, pulse 88, respirations 20, BP 138/86 Lungs clear to auscultation, breathing regular and unlabored +1 edema bilaterally in ankles Muscle strength in upper e xtremities normal and equal and in lower extremities weak Sensation to all extremities normal Abdomen distended with hypoactive bowel sounds Diagnostic Studies Lab values Sodium 139.0mEq/L Potassium 3.0mEq/L НСО 25.4mEq/L Chloride 99.5 mEq/L 1. What is a possible pathophysiologic cause of E.G.'s muscle weakness and dizziness? What other symptom does E.G. 2. What factors contributed to the development of this 3. What should you be on an alert for in a patient who is on 4. What additional signs and symptoms should you assess have that may be related to this problem? electrolyte imbalance? furosemide and digoxin and why? E.G. for? 5. What diagnostic test is indicated and why? 6. Write three nursing diagnoses that are appropriate for E.G. 7. What interprofessional care would you anticipate for E.G.? 8. What instructions should you give E.G. regarding the signs and symptoms of this electrolyte imbalance and how to prevent it?

Answer 1

1.The possibile reason for muscle weakness may be due to the reason that she stopped taking potassium chloride. The normal value of potassium is 3.5 to 4.5,but her Potassium value is 3.0.Muscle spasms, cramps are some of the symptoms associated with this condition. When blood potassium levels become low ,the brain cannot relase signals effectively. This contractions occur in the digestive system may become weaker and slow the movement of food and cause digestive problems like bloating and constipation. Patient may also develop numbness, palpitations and mood changes.

2Since the patient has vomiting and diarrhea, this further result in depletion of potassium resulting in hypokalemia.

3.Furosemide may reduce the potassium level in your blood. Therefore doctor may instruct you to add potassium rich foods to diet. Digoxjn can also cause electrolyte imbakance, by reducing potassium levels. While administering Digoxin health care providers should be aware of sinus bradycardia and assess renal function periodically.

4The patient should be observed for hypoventilation and hypo tension as these could indicate that patient is under severe hypokalemia.