Respiratory and Fluid and Electrolyte Case Studies CASE 1. C
Respiratory and Fluid and Electrolyte Case Studies CASE 1. Clara… Respiratory and Fluid and Electrolyte Case StudiesCASE 1. Clara Bidalchi is an 86-year-old female with hypertension who has become increasingly weak and confused. Clara’s daughter tells the nurse that her mother takes a “water pill” for her blood pressure. Clara is admitted with fluid volume deficit. The nurse assesses Clara for orthostatic vital sign changes and recognizes the need to assess skin turgor. The nurse calculates Clara’s recent weight loss, converting kilograms to pounds, and estimates her fluid loss. The nurse is aware of age-related factors such as protein binding and hepatic blood flow that may impact the effect of medications. The nurse s a new prescription for IV push potassium chloride and monitors lab values related to the administration of furosemide. Mrs. Bidalchi’s labs on admission: ABGNormalPt ValuepH 7.34PaCo2 47HCO3 24O2 Saturation 93%Electrolytes Na 147K 3.2Cl 98Total Ca 8.4Mg 1.5Phos 2.7What clinical manifestations does the patient have?What would be the priority Nursing Diagnosis (choose one).Interpretation of Electrolyte abnormality (which electrolyte is most concerning)?What symptoms does the patient have specific to the electrolyte abnormality?What treatment would you expect based on the problem?What nursing interventions would you expect? CASE 2. Jared, a 47-year-old male, is admitted to the emergency center complaining of severe abdominal and back pain. He has been vomiting for the last 24 hours. Jared was diagnosed with chronic pancreatitis two years ago, and this is his fourth admission for an acute exacerbation of pancreatitis. The nurse’s initial assessment includes asking about a history of alcohol use and a review of Jared’s lab results. The nurse administers IV morphine for pain, maintains NPO status and inserts a nasogastric tube before he is transferred to the medical unit. The nurse on the medical unit positions Jared to help relieve his pain and administers oxygen. Four days later, TPN is initiated. The nurse assists with central line insertion and plans to weigh Jared daily. ABGNormalPt ValuepH 7.47PaCo2 45HCO3 28O2 Saturation 96%Electrolytes Na 145K 3.3Cl 98Total Ca 8.0Mg 1.5Phos 2.8What clinical manifestations does the patient have?What would be the priority Nursing Diagnosis (choose one).Interpretation of Electrolyte abnormality (which electrolyte is most concerning)?What symptoms does the patient have specific to the electrolyte abnormality?What treatment would you expect based on the problem?What nursing interventions would you expect?Health Science Science Nursing NSG 252
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