please answer questions 6,7,8. iunl Jeetate, or dialysis. Hyper phosphatemia can

Question

please answer questions 6,7,8.

iunl Jeetate, or dialysis. Hyper phosphatemia can lead to secondary hyperparathyroidism and lil Ul pabents U tBlerate oral replacements or those with severe osteodystrophy CRITICAL THINKING CASE STUDY Mr. K.W. is 72 years of age and has had vomiting and diarrhea for 2 days. He takes digoxin 0.25 mg and hydrochlorothiazide Mr. K.W. is ordered IV infusions of 1 L of 5% dextrose with tassium chloride (KCI) and 1 L of 5% dextrose 30 mEq of po is serum potassium level is 3.2 mEq/L He com- in045% sodium chloride (Nadi). He is also prescribe plains of being dizzy, and his blood pressure is slightly lower KCl 15 mEq/10n that his muscles are weak and flabby, his abdomen is distended,IV bolus (push)? Explain your answer. and peristalsis is diminished 1. What signs and symptoms indicate that Mt. K.W. in otas oral potassium supplements? 2. What contributing factors caused Mr. K.Ws PO than usual. The nurse assesses his physiologic status and notes 5. Can KCl be given intramuscularly, subcutaneously, or as an 6. What instructions should the nurse give Mr. K.W. for taking 7. What happens if Mr. K.W's urine output decreases while he is L three times per day for 2 days. sium imbalance? imbalance? potassium imbalance? receivir receiving IV and oral potassium? Explain the responsibilities potassium of the nurse? 3. What interventions should be performed for alleviating this 8. Because Mr. K.W. is taking a diuretic and digo xin, what should the nurse include with patient teaching? Give examples. 4. How much potassium chloride would be needed to elevate Mr. K.W's serum potassium by 1 mEq? NCLEX STUDY QUESTIONS Iralacto mr and ilrostemy, 3. A patient is receiving 10 mEq of

Explanation / Answer

so normal serum potassium level =5-5.3meq/ln Mr K.W has vomiting and diarhea for 2 days whcih has lead to fluid loss along with electrolyte imbalance .

Q1) signs and syptoms of potassium imbalance : muscle weakness , twictching , sometimes paralysis ,dizziness , change in heart beat .( mr.k.w has muscles flabby , weakness decreasein persitalsis , low bp )

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Q2) contributing factors to potassium level imbalance - vomiting and diarrhea -loss of fluid along with electroytes

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Q3)alleivate potassium imbalance - 1) treat fluid loss ( vomiting and diarrhea ) 2) replace fluids with electrolytes 3) in low level -orally (supplements -banana is rich in potassium ) 4) when its higher -I/V fluids with potassium supplements are given 5) in case of Mr.k .W -he is taking hydrochlorothiaide which is a diruetic and not a potassium sparing , which has to be reported to the physician (causes futher fluid loss and potassium loss )

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Q4)a general rule is that 10meq/l of ptassium is to increase 0.1meq/l

so to increase (0.1* 10= 1 meq/l) 1meq/l -10*10 will be 100meq/l

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Q)5 potassium is replaced by - orally food rich in potassium , orall supplement , i/v slow drip ,I/Vblous -sudden rush of potassium can cau se cardia arrhythmias and stops the heart .

not intramuscular as it can cause tissue damage

not subcutaneous s/c it will cause periheral vein damage

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Q)6 potassium pills has to be taken along with food to prevent stomach upset with a glass of water b) do not take skipped doses together C) watch for symotms of palpitaitons ,muscular weakness, bloody stools ,tingling , muscle weakness . -immediately stop medication and seek meicial help .

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Q7) decrease urine out put means increase potassium , check for concentration and dilution so it does not exceed stated parameters.

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Q8) as diuretic causes fluid loss to manage after load to maintain the bP, still it is advisable to eat potassium rich food so look for the signs (ofexcessive fluid loss with hypokalemia )- signs of muscle weakness ., dizziness or palpitations .

refularly check for digoxin serum level to prevent digoxin toxicity -looks for its signs nausea, vomiting , visual disturbances and arrhythmias ( palpitations sweating ) weigh loss .

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