Question

You are working in the ICU of an acute care hospital and assume the care of Edith Bunker, a 78 year-old woman who is 3 days post inferior wall MI. Mrs. Bunker had been healthy before admission except for a longstanding history of arthritis treated with rofecoxib (Vioxx) 50mgm daily and longstanding hypertension treated with atenolol (Tenormin) On admission to the emergency room the patent had a blood pressure of 210/122 mm Hg, therefore thrombolytics were contraindicated. An IV was started with D5/ W at keep open rate and was taken directly to the cardiac catheterization lab for acute PTCA Her angioplasty was successful, and she has been pain free since her PTCA. You are reviewing her lab work and note the following values: NA Cl CO2 BUN Creatinine 3.8 Glucose 158 142 4.6 100 26 60

Answer 1

Q. No 7. : Answer :

Lab values changed over the past 24 hours

* sodium(Na) is normal that is 142 to 140.

* potassium (k) levels are increased from 4.6 to 5.0 near to hyperkalemia.

* chlorine levels also increased from 100 to 104. But normal. Co2 levels changed from 26 to 24.

* blood urea nitrogen levels increased from 60 to 68. Abnormal.

* Creatinine also increased from 3.8 to 4.0 . It is abnormal.

* Glucose decreased from 158 to 104 it is also normal.

Q. No 8. Answer :

* Urine output is very important to all human beings.

* Because to excreat over fluids from body and wastage from body.

* here the creatinine level was high so the urine out put was less because the high creatinine may cause less glomerular filtration rate, so that low urine output.

* Normal urine output may indicates good kidneys functioning.

* otherwise we can know the kidneys are not functioning well.

* by the urine out put we can estimate the active level of clients.

Q. No 9. Answer :

Nursing action:

* as a nurse we have to assess the input levels of the client.

* maintaining input and output put chart is very necessary in cardiac patients.

* if input also good but not maintaining adequate out put, record the positive balance and show to the consultant doctor.

* They may decide whether clients need dialysis or not ,or some other diuretic medications to be given.

Q. No 10. Answer :

Anuria : absence of urine output due to kidney failure is called anuria.

Oliguria :

The production of abnormally small or less amount of urine that is less than 400 - 500 ml per 24 hours. In adults.

Here the client is having "oliguria" because the urine out put is 160 ml in 24 hours.