Case Study: Fluid and Electrolyte Imbalances- Chapter 39
Mr. Abdul is a 76-year-old male who has been admitted to the hospital with a diagnosis of congestive heart failure (CHF). He complains of being tired all the time and barely having enough energy to sit up sometimes. “I think I've put on some weight. My waistband and shoes seem to be tighter and more uncomfortable to wear.” He has a history of coronary artery disease. He has smoked one pack of cigarettes per day for 56 years. He has no known drug allergies (NKDA) and has full code status.
Mr. Abdul's vital signs on admission are T 36.5° C (97.7° F), P 118 regular and bounding, R 32 and labored, BP 160/100, with a pulse oximetry reading of 90% on room air. He denies pain and is alert and oriented to person, place, time, and event. He can move all extremities easily but requires assistance with activities of daily living (ADLs) such as bathing and dressing, He becomes short of breath on exertion. He has fine crackles throughout all lung fields and has a moist, nonproductive cough. Bowel sounds are active in all four quadrants. The last bowel movement, a formed brown stool, was yesterday. His skin is warm, dry, and slightly pale. He has +3 pitting edema in both ankles and +1 bilateral dorsalis pedis and posterior tibial pulses. Admission laboratory test results are as follows:
• Electrolytes: sodium 142 mEq/L; potassium 3.3 mEq/L; chloride 100 mEq/L; bicarbonate 29 mEq/L; blood urea nitrogen 18 mg/dL; creatinine 0.8 mg/dL; glucose 140 mg/dL
Complete blood count: hemoglobin 15 g/dL; hematocrit 45%; white blood cells 8000 mm3; platelets 300,000 mm3
• Arterial blood gases: pH 7.34; PCO2 56 mm Hg; bicarbonate 32 mEq/L; PO2 80 mm Hg; O2 saturation 90%.
Medications are as follows:
• Digoxin 0.125 mg PO q A.M.
• Furosemide 80 mg IV now, then Lasix 40 mg PO q A.M. beginning tomorrow
Treatment orders are as
• O2 2 L/min per nasal cannula
• Vital signs q 4 hr. with pulse oximetry
• Daily weight
• Strict intake and output
• Diet: no added salt
• Activity: bed rest
• Saline lock
a. For each medication, discuss the action, two common side effects and nursing interventions for each side effect
Case Study: Fluid and Electrolyte Imbalances- Chapter 39 Mr. Abdul is a 76-year-old male who has...
Case Study: Fluid and Electrolyte Imbalances- Chapter 39 Mr. Abdul is a 76-year-old male who has been admitted to the hospital with a diagnosis of congestive heart failure (CHF). He complains of being tired all the time and barely having enough energy to sit up sometimes. “I think I've put on some weight. My waistband and shoes seem to be tighter and more uncomfortable to wear.” He has a history of coronary artery disease. He has smoked one pack of...
Case Study: Fluid and Electrolyte Imbalances- Chapter 39 Mr. Abdul is a 76-year-old male who has been admitted to the hospital with a diagnosis of congestive heart failure (CHF). He complains of being tired all the time and barely having enough energy to sit up sometimes. “I think I've put on some weight. My waistband and shoes seem to be tighter and more uncomfortable to wear.” He has a history of coronary artery disease. He has smoked one pack of...
Case Study: Fluid and Electrolyte Imbalances- Chapter 39 Mr. Abdul is a 76-year-old male who has been admitted to the hospital with a diagnosis of congestive heart failure (CHF). He complains of being tired all the time and barely having enough energy to sit up sometimes. “I think I've put on some weight. My waistband and shoes seem to be tighter and more uncomfortable to wear.” He has a history of coronary artery disease. He has smoked one pack of...
On day 2 of his hospital stay, Mr. Abdul begins to complain of increased muscle weakness and cramping. Assessment findings include an irregular apical pulse and hypoactive bowel sounds. Provide a possible explanation for these findings and identify appropriate nursing action. Mr. Abdul is at risk for acid base imbalance. What are the four Acid-Base imbalances? Describe the underlying causes for each Describe the clinical manifestations (i.e. signs and symptoms) What are interventions for each acid-base imbalance What is the...
CASE STUDY: Fluid, Electrolytes, and Acid-Base Imbalances Patient Profile: Mr. T., a 73-year-old man who lives alone, is admitted to the hospital because of weakness and confusion. He has a history of chronic heart failure and chronic diuretic use. Objective Data: Neurologic: Confusion, slow to respond to questioning, generalized weakness Cardiovascular: BP 90/62, HR 112 and irregular, peripheral pulses weak; ECG indicates sinus tachycardia Pulmonary: Respirations 12/min and shallow Additional findings: Decreased skin turgor; dry mucous membranes Significant Lab Results:...
CASE STUDY: Fluid, Electrolytes, and Acid-Base Imbalances Patient Profile: Mr. T., a 73-year-old man who lives alone, is admitted to the hospital because of weakness and confusion. He has a history of chronic heart failure and chronic diuretic use. Objective Data: Neurologic: Confusion, slow to respond to questioning, generalized weakness Cardiovascular: BP 90/62, HR 112 and irregular, peripheral pulses weak; ECG indicates sinus tachycardia Pulmonary: Respirations 12/min and shallow Additional findings: Decreased skin turgor; dry mucous membranes Significant Lab Results:...
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 Patient B Patient C Na+ 138 mEq/L 142 mEq/L 148 mEq/L K+ 5.1 mEq/L 6.1 mEq/L 3.8 mEq/L Ca+ 8.9 mg/dL 7.5 mg/dL 9.5 mg/dL Mg+ 1.3 mg/dL 0.9 mg/dL 2.1 mg/dL pH 7.40 7.32 7.42 PCO2 42 mm Hg 48 mm Hg...
Need help with these 2. NSG 115 Case Study Week 15 Review the Case Study in Chapter 39 about Mr. Abdul and answer the following questions. Kathy, Mr. Abdul's nurse, was caring for Mr. Abdul and saw that the lab tests ordered for him were drawn earlier today. She is viewing the results now. 1. What lab result would Kathy want to communicate to Mr. Abdul's primary care provider (PCP) immediately so orders can be obtained to correct the imbalance?...
CASE STUDY FOR CARE PLAN Mr. W is an 83-year-old man who was brought to the hospital from a long term care facility by paramedics after reporting severe dyspnea and shortness of breath. He has been experiencing coldlike symptoms for the past 2 days. He has a productive cough with thick greenish sputum. When Mr. W awoke in the nursing home, it was found that he had difficulty breathing even after using his albuterol (Proventil) metered-dose inhaler (MDI). He...
ita ( t FLUID AND ELECTROLYTES CASE STUDIES D) Mr. Johnson, 68 years old, has been vomiting and has had diarrhea for 2 days. He complains of being dizzy. The nurse assesses his physiologic status and notes that his muscles are weak, his abdomen is distended, and bowel sounds are absent a) What electrolyte imbalance do you su What other symptoms can electrolyte im balance? c) Hallue rgt イhgl. fever, fatique, ter ot cordide function uSing E Mrs. Unger has...