NURS 3300 Nursing Care of Persons With Health Challenges

Electrolyte Imbalance

Patient Profile E.G. is a 73-year-old woman whose daughter brings her to see the health care provider because she has had a case of the “stomach flu,” with vomiting and diarrhea for the past three to four days and is now experiencing occasional light-headedness and dizziness. Her past medical history includes hypertension, hypercholesterolemia, and mild heart failure. She is taking:

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Digoxin 0.125 mg po daily.

Captopril 25 mg po BID F

urosemide 40 mg po daily.

Potassium chloride 20 mEq po daily

Atorvastatin 20 mg po at bedtime.

Subjective Data

Has been following a low sodium diet

States her abdomen feels bloated and she has been constipated since the onset of the lu”

Has been taking her medications except for the potassium chloride pill because it upsets her stomach.

Occasionally takes an extra “water pill” when her ankles are swollen

Objective Data

Physical Examination

Temperature 98.20 F, pulse 88, respirations 20, BP 138/86

Lungs clear to auscultation, breathing regular and unlabored +1 edema bilaterally in ankles

Muscle strength in upper e xtremities normal and equal and in lower extremities weak

Sensation to all extremities normal

Abdomen distended with hypoactive bowel sounds

Diagnostic Studies

Lab values Sodium 139.0mEq/L

Potassium 3.0mEq/L

НСО 25.4mEq/L

Chloride 99.5 mEq/L 1.

1. What is a possible pathophysiologic cause of E.G.’s muscle weakness and dizziness? What other symptom does E.G.

2. What factors contributed to the development of this

3. What should you be on an alert for in a patient who is on

4. What additional signs and symptoms should you assess have that may be related to this problem? electrolyte imbalance? furosemide and digoxin and why? E.G. for?

5. What diagnostic test is indicated and why?

6. Write three nursing diagnoses that are appropriate for E.G.

7. What interprofessional care would you anticipate for E.G.?

8. What instructions should you give E.G. regarding the signs and symptoms of this electrolyte imbalance and how to prevent it?

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