Patient Profile: Frances, a 78 years old that lives alone, is admitted to the hospital because of weakness and confusion. She has a history atrial fibrillation and chronic heart failure (HF). On admission it is noted that her at home medications include Digoxin (Lanoxin), Furosemide (Lasix), Metoprolol, Diltiazem and Levothyroxine. Objective Data: Neurologic: Confused; slow to questioning; generalized weakness; states she has trouble focusing his vision- people look green with halo's RR 100/50: HR 55 im OHR alu ECC indi

Curren'S Math For Meds: Dosages & Sol
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Fluid and Electrolytes Case Study
Patient Profile:
Frances, a 78 years old that lives alone, is admitted to the hospital because of weakness and
confusion. She has a history atrial fibrillation and chronic heart failure (HF). On admission it is
noted that her at home medications include Digoxin (Lanoxin), Furosemide (Lasix), Metoprolol,
Diltiazem and Levothyroxine.
Objective Data:
Neurologic: Confused; slow to questioning; generalized weakness; states she has trouble
focusing his vision- people look green with halo's
Cardiovascular: BP 100/59; HR 55 irregular; peripheral pulses weak; ECG indicates Atrial
fibrillation with controlled ventricular response
Pulmonary: Respirations at 12/min; shallow
Skin: decreased turgor; dry mucous membranes
Laboratory Results:
Digoxin level
Electrolytes
●
• Mag+
CI-
BUN
CBC
Na+
K+
ABG
● RBC
● WBC
●
Creatinine
Glucose
CO2
Hemoglobin
Hematocrit
Platelets
pH
PaO2
PaCO2
HCO3-
1.0 ng/ml
134 mEq/L
2.5 mEq/L
1.2 mEq/L
88 mEq/L
42 mg/dL
0.9 mg/dL
122 mg/dL (random)
31 mEq/L
5 x 106uL
7,000/uL
14 g/dL
50%
250,000/uL
1
7.55
88 mm/Hg
45 mm/Hg
42 mEq/L
Adapted from: Maltas, J.L. (2011). Study guide for medical-surgical nursing: Assessment and management of clinical problems (8.ed.). Omaha,
NE: Elsevier Mosby.
Transcribed Image Text:Fluid and Electrolytes Case Study Patient Profile: Frances, a 78 years old that lives alone, is admitted to the hospital because of weakness and confusion. She has a history atrial fibrillation and chronic heart failure (HF). On admission it is noted that her at home medications include Digoxin (Lanoxin), Furosemide (Lasix), Metoprolol, Diltiazem and Levothyroxine. Objective Data: Neurologic: Confused; slow to questioning; generalized weakness; states she has trouble focusing his vision- people look green with halo's Cardiovascular: BP 100/59; HR 55 irregular; peripheral pulses weak; ECG indicates Atrial fibrillation with controlled ventricular response Pulmonary: Respirations at 12/min; shallow Skin: decreased turgor; dry mucous membranes Laboratory Results: Digoxin level Electrolytes ● • Mag+ CI- BUN CBC Na+ K+ ABG ● RBC ● WBC ● Creatinine Glucose CO2 Hemoglobin Hematocrit Platelets pH PaO2 PaCO2 HCO3- 1.0 ng/ml 134 mEq/L 2.5 mEq/L 1.2 mEq/L 88 mEq/L 42 mg/dL 0.9 mg/dL 122 mg/dL (random) 31 mEq/L 5 x 106uL 7,000/uL 14 g/dL 50% 250,000/uL 1 7.55 88 mm/Hg 45 mm/Hg 42 mEq/L Adapted from: Maltas, J.L. (2011). Study guide for medical-surgical nursing: Assessment and management of clinical problems (8.ed.). Omaha, NE: Elsevier Mosby.
Fluid and Electrolytes Case Study
Critical thinking questions:
1. Evaluate Frances' fluid volume and electrolyte status. Which physiological assessment
findings support your analysis? Which lab results support your analysis? What is the
most likely etiology of these imbalances?
2. Explain the reasons for Frances' ECG changes?
3. Analyze the ABG results. What is the etiology of the primary imbalance? Is the body
compensating for this imbalance?
4. What has Frances' advanced age placed her at risk for fluid imbalance?
5. Discuss the role of aldosterone in the regulation of fluid and electrolyte balance. How
will changes in aldosterone affect Frances' fluid and electrolyte imbalances?
6. What are the primary daily assessments that the nurse will complete?
7. What would be the priority nursing problem (s)?
8. What burning questions does the astute nurse have for Frances?
9. Which collaborative team members might you contact to ensure safe discharge?
2
Adapted from: Maltas, J.L. (2011). Study guide for medical-surgical nursing: Assessment and management of clinical problems (8.ed.). Omaha,
NE: Elsevier Mosby.
||
Transcribed Image Text:Fluid and Electrolytes Case Study Critical thinking questions: 1. Evaluate Frances' fluid volume and electrolyte status. Which physiological assessment findings support your analysis? Which lab results support your analysis? What is the most likely etiology of these imbalances? 2. Explain the reasons for Frances' ECG changes? 3. Analyze the ABG results. What is the etiology of the primary imbalance? Is the body compensating for this imbalance? 4. What has Frances' advanced age placed her at risk for fluid imbalance? 5. Discuss the role of aldosterone in the regulation of fluid and electrolyte balance. How will changes in aldosterone affect Frances' fluid and electrolyte imbalances? 6. What are the primary daily assessments that the nurse will complete? 7. What would be the priority nursing problem (s)? 8. What burning questions does the astute nurse have for Frances? 9. Which collaborative team members might you contact to ensure safe discharge? 2 Adapted from: Maltas, J.L. (2011). Study guide for medical-surgical nursing: Assessment and management of clinical problems (8.ed.). Omaha, NE: Elsevier Mosby. ||
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