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note kindly answer QUESTION number 8 which is the last question using NANDA

NAME: ____________________________________   DATE: ___________________

 

CRITICAL THINKING EXERCISE CASE STUDY Fluid and Electrolyte Imbalance Patient Profile.

Sarah Smith, a 73-year-old white female with lung cancer, has been receiving chemotherapy on an outpatient basis. She completed her third treatment 5 days ago and has been experiencing nausea and vomiting for 2 days even though she has been using ondansetron (Zofran) orally as directed. Ms. Smith’s daughter brings her to the hospital, where she is admitted to the medical unit. The admitting nurse performs a thorough assessment.

Subjective Data: Complains of lethargy, weakness, dizziness, and a dry mouth. States she has been too nauseated to eat or drink anything for 2 days

Objective Data: Heart rate 110 beats/min, pulse thread, blood pressure 100/65: weight loss of 5 pounds since she received her chemotherapy treatment 5 days ago: dry oral mucous membranes

 

 

 

 

Critical Thinking Questions

1. Based on her clinical manifestations, what fluid imbalance does Ms. Smith have?

Ans- Hypovolemia

2. What additional assessment data should the nurse obtain?

Ans- The additional assessment is to check for orthostatic hypotension, respiratory rate, level of consciousness, pupils, voluntary movement, capillary refill, skin turgor, temperature, edema and feel temperature of skin.

3. What are the patient’s risk factors for fluid and electrolyte imbalances?

Ans- Nausea, vomiting, not drinking fluids, and old age

4. The nurse draws blood for a serum chemistry evaluation. What electrolyte imbalances are likely and why?

Ans-

5. The physician orders dextrose 5% in 0.45% saline to infuse at 100 ml/hr. What type of solution is this and how will it help Ms. Smith’s fluid imbalance?

Ans- Hypertonic solution, it will raise the osmolarity of the ECF and then the free water will expand the ECF and ICF.

6. What are the priority nursing interventions for Mrs. Smith?

ANS- Monitor intake and output, monitor cardiac changes and respiratory status, perform skin assessment and daily weight.

7. Because of the nature of her disease process, Ms. Smith is at risk for the development of SIADH. How would the nurse recognize this complication and what is the anticipated treatment?

Through an assessment i.e. blood and urine test, the nurse will recognize the medical condition by realizing an imbalance of electrolytes such as sodium, the patient will have impaired judgement, suffer from stupor, seizures and irritability.

Explanation: The treatment will include fluid and water intake restriction, administer vasopressin or even a surgical operation to remove the tumor producing ADH hormone.

8. Based on the assessment data presented, write one or more appropriate nursing diagnoses. Are there any collaborative problems?

SCIENCE
HEALTH SCIENCE
NURSING

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