Question

WEEK 3 ASSIGNMENT # 1 Discussion Topics, Chapter 8, Disorders of Fluid, Electrolyte, and Acid-Base Balance Discussion Topics Learning Objective(s) 1. An 82-year-old female client lives in a residential 8, 9, 12 elder care home. Her family has noticed the following gradually occurring over the past week: headache, agitation, restlessness, and confusion; she complains of being thirsty all the time even after drinking. They have noticed that her urinary catheter bag does not have as much fluid in it and she looks flushed at times. She has had frequent episodes of diarrhea. The nursing staff drew blood for CBC, serum osmolarity, and electrolytes and has been monitoring her BP and heart rate every 4 hours. Her BP has ranged from 86/60 to 88/66 and her pulse range is 105 to 118 and regular. They also reviewed her medication profile and discovered she received two extra dosages of lactulose that were not ordered. Based on the client's presenting symptoms and a. the nurse's knowledge of fluid volume and balance, what does the nurse suspect is happening with this client? b. What treatment options for the client will need to be discussed with the family? 2. Recent research has indicated that Northern 17, 18, 19 hemisphere populations, especially aboriginal groups, have decreased serum vitamin D levels. What aspects of integrative body functions a. would the nurse examine with this health issue? Why should the nurse be concerned for this b.

Please give me a good Rationale

Answer 1

1.a.The nurse can suspect the patient is having lactulose overdose .The common symptoms of lactulose overdose are diarrhea, irregular heart rat,polydypsia,confusion, agitation, restlessness,decreased urination. The patient is simultaneously experiencing a fluid volume deficit due to diarrhea.This medication in overdose leads to increased sodium level causing headache and confusion, decreased potassium levels leading to cardiac function abnormalities like irregular heart beats. In addition diarrhea leads to loss of fluid volume and lowering the blood pressure.

b.The following treatment has to be suggested for the patient

• Stop the lactulose medication
• Fluid replacement to increase the blood pressure
• Monitor serum electrolyte level to assess the underlying cause and great it
• Maintain intake and output to assess fluid volume replacement or loss
• correction of tachycardia

2.a.The nurse has to examine the following

• Physical appearance (brittle hairs,nails)
• Muscle for weakness and pain
• Associated skeletal problems
• Symptoms associated with body pain ,extreme fatigue.

b.The nurse should be concerned because low levels oof vitamin D can lead to

• Osteoporosis
• Osteomalacia
• Rickets especially in childrens
• It can also contribute to cancers like ovarian cancer in female, prostate cancer in men.