FLUID AND ELECTROLYTES CASE STUDIES

1) Mr. Johnson, 68-year-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 suspect?

b. What is the normal range for this electrolyte?

c. What other symptoms can this patient have exhibited with this type of electrolyte imbalance?

d. What treatment would be most appropriate for this patient?

2) Mrs. Unger has a high temperature and diaphoresis. She has been nauseated and has taken only ginger ale for the last several days. Her lab tests revealed a Sodium level of 129 mEq/L and Potassium level of 3.7 mEq/L.

a. What type of electrolyte imbalance do you suspect?

b. What is the normal range for this electrolyte?

c. What are some other clinical signs and symptoms might you observe with this type of imbalance?

d. When testing Mrs. Unger’s urine, what would you suspect her specific gravity to be?

e. What treatment would be most appropriate for this patient?

3) A patient has just received an administration of an intravenous potassium too rapidly.

a. What signs and symptoms would you assess for?

b. What lab values would you check for this patient?

c. What treatment would be prescribed for this patient?

4) An elderly patient has just been admitted to the Emergency Department with symptoms of confusion and muscle tremors. When taking his history, it is revealed he had been discharged from the hospital 2 days ago. He has been on IV therapy for a stomach virus, but could not keep down fluids after he was discharged.

a. What electrolyte imbalance do you suspect for this patient?

b. What other signs and symptoms might you need to assess for?

c. What type of treatment would be appropriate for this patient?

5) Develop one care plan for each case study from above. It should contain a NANDA nursing diagnosis, one goal, and at least four nursing interventions. Nursing interventions are not doctor’s orders.