Question
this is a case study,answers each question separately with the question number.
174 UNIT III Maintenance of Homeostasis meat. Phosphorus deficiency can result from decreased intes absorption, malnutrition, alcoholism, vomiting, diarrhea, deficits. Potassium phosphate is an Institute f r Safe Practices (SMP) high alert medication used for v trated glucose solutions, respiratory alkalosis, gly replacement. Potassium phosphate must be diluted use of cor bypokalemia, hypomagnesemia, or use of thiazide diuret and must be infused slowly using an infusion-cont sphatemia may lead to hemolytic anemia, platelet rapid an infusion may cause potassium toxicity in patients pump Tau uced oxygen transport. Hyperphosphatemia severe renal or adrenal insufficiency. The IV insertion site n related to chronic kidney disease. Increased intake monitored for infiltration: potassium phosphate may cause must be table e form of tives may also increase serum levels e may cause tiss eament of phosphorus imbalance is aimed at eliminat- sium, and calcium levels and renal function should be may necrosis and sloughing if infiltration occurs. Phosphorus Thirs nary ing or reducing the cause. Monitoring monitore c. phosphorus, calcium, and during and after infusion. Use of potassium phosphate is contra Is and assessing the patient for signs of electrolyte Phosphorus replacement is guided by the degree of deficit, onset, indicated in patients with hyperkalemia or hypocalcemia d. Head an ance are important nursing interventions. Hyperphosphatemia in patients with chronic kidney diseae is treated with restriction of dietary phosphorus, phosphorus an and patient presentation. Oral intake is the preferred route of binding medications such as calcium acetate, or dialysis. Hyper pa replacement. IV phosphorus is available for treatment of patients who are unable to tolerate oral replacements or those with severe phosphatemia can lead to seconda osteodystrophy. ry hyperparathyroidism and a. Meas b. Knov CRITICAL THINKING CASE STUDY Mr. K.W. is 72 years of age and has had vomiting and for 2 days. He takes digoxin 0.25 mg and hydrochlorothiazide d. Avoi e. Mon 6. A patie diarrhea Mr. K.VV. is ordered IV infusions of i L of 5% dextrose with 50 mg daily. His serum potassium level is 3.2 mEq/L. He com 30 mEq of potassium chloride (KCl) and i L of 5% dextrose in 0.45% sodium chloride (NaCl). He is also prescribed PO plains of being dizzy, and his blood pressure is slightly lower KCI 15 mEq/10mL thr ee times per day for 2 days e given intramuscularly, subcutaneously, or as an than usual. The nurse assesses his physiologic status and notes correct 5. Can KCl b 6. What instructions should the nurse give Mr. K.W. for taking 7. What happens if Mr. K. Ws urine output decreases while he approx lus (push)? Explain your answer. and peristalsis is diminished. 1. What signs and symptoms indicate that Mr. K.W. is in potas. oral potassium supplements? b. 2 L C. d. 8 sium imbalance? imbalance? potassium imbalance? Mr. K.Ws serum potassium by 1 mEq? 2. What contributing factors caused Mr. K.Ws potassium receiving IV and oral potassium? Explain the responsibilities of the nurse? 3. What interventions should be performed for allviating this 8. Because Mi: K.VW 4. How much potassium chloride would be needed to elevate examples. should the nurse include with patient teaching? Give NCLEX STUDY QUESTIONS 3. A patient is receiving 10 mEq of potassis y and ileostomy,
Explanation / Answer
Ans 1: The signs and symptoms which indicate that Mr. K W is in potassium imbalance are as follows:
- weak and flappy muscle
- diminished peristaltic movements
- dizziness
Ans 2: Vomiting and diarrhea caused potassium imbalance in Mr. K W.
Ans 3: Mr. K W potassium imbalance can be corrected by intravenous supplementation. Oral syrups are also available but since the client has a vomiting it will cause further vomiting, therefore, the intravenous correction will be preferred.
Ans 4: by general rule, each 10 meq potassium given to the client will raise serum potassium level by 0.1 meq/L
0.1 meq/L raise= 10 meq K+ given
1 meq raise = 10 X 10 = 100 meq K+ required.
Therefore total potassium ordered for Mr. K W is 30 meq IV + (15 x 3) orally
=20 + 45
= 65 meq /day X 2 days
= 130meq total correction over two days.
Potassium should be corrected slowly.
Ans 5: No, KCL cannot be given intramuscularly, subcutaneously or as a bolus dose because of following reasons.
intramuscularly or subcutaneously: can cause burn to the underline tissue which can cause necrosis of tissue.
Bolus dose: it can cause cardiac arrhythmia and sudden cardiac arrest eventually death of the client.
