Question

PN 200 Fundamentals of Nursing II Concept Map - Hyponatremia Ms. Rose Durham, a 54-year-old female, has been admitted to your unit with the diagnosis of hvonatremia. Her presenting symptoms include mental confusion, headache, and altered level of consciousness, anxiety, nausea, vomiting and a low-grade fever of 100.6. She has informed the physician that she has been out working in her garden for the past three days and it has been 97 degrees daily for the past 4 days. She does not recall drinking many fluids but has had her coffee in the momine Her vital signs on admission are T100.6, P 104 weak and easily obliterated. R. 24 and regular. B/P 06:58 Height 5'7", weight 182 pounds. She states she follows a low sodium diet that she was given after being diagnosed with CHF. Additional history includes; appendectomy at 17: mitral valve prolapse: mild CHF with sodium restricted diet, and hysterectomy at 35 years of age. Labs & Diagnostic tests CBC Hemoglobin and hematocrit Electrolytes Chest X-ray Urinalysis Medications: Baby aspirin 81mg by mouth every day Plavix 75mg one tab by mouth daily Lasix 10 mg daily Digoxin 0.25 mg daily Physician Orders IV # 18-20 Jelco 1000 mL NACL 0.9% IV every 8 hours Intake and output X 3 days Convulsion precautions Liberal sodium diet In addition to completing the care plan, answer the following questions:

Answer 1

1.The coffee has a content called caffeine which is a diuretic and natriuretic. Consuming coffee has increased the renal function to excrete the urine contributing to hyponatremia

2.A continuous low diet of sodium can lead to shortage of sodium in the body.It means the patient is taking 2 to 3 g of sodium per day.Her continuous activity in sun, drinking coffee, lack of fluid intake has lead to depletion of the sodium in the body causing hyponatremia.

3.The current activity like

• 3 days working in the garden at a temperature of 97° has lead to increased perspiration and loss of sodium through sweat.In simple it is because of the exposure to extreme temperature.
• In addition the diet low in sodium was not altered or changed to meet the loss of sodium due to activity.
• Lack of adequate fluid intake leading to fluid deficiency and acid base abnormalities

4.The more deficiency of sodium affects the central nervous system directly. It affects the functions of brain leading to mental confusion, seizure,irreversible brain damage,cerebral edema,hallucinations, coma ,death.Hence placingbthe patient at convulsion precautions is necessary to save the life.

5.The list of electrolytes are

• Sodium:135_145mEq/l
• Potassium:3.5 _5mEq/L
• Chloride:98_108mEq/L
• Bicarbonate:22_30mmol/L
• Others
  • Magnesium :1.5 _2.5mEq/L
  • Calcium :8.5_10.5mg/dl
  • Phosphate :2.5_4.5mg/dl