A middle-age male patient arrived at the Emergency Department with a one-week hi

Question

A middle-age male patient arrived at the Emergency Department with a one-week history of a “stomach bug” characterized by extreme fatigue, persistent nausea and frequent, watery diarrhea. His only medications were metoprolol 50 mg b.i.d. and hydrochlorothiazide 25 mg daily for hypertension. Until this episode, the patient had been in relatively good health. Evaluation in the Emergency Department revealed the patient to have a pulse of 130, B/P of 78/50, respirations of 26, creatinine of 8, potassium of 2.8 and sodium of 150. Arterial blood gases revealed a pH of 7.28, PCO2 of 45, and HCO3 of 20. He was admitted emergently to the Intensive Care Unit.

List two (2) suitable nursing diagnoses for this patient. Which specific nursing assessments and interventions will be needed for these diagnoses? Discuss factors that likely contributed to his altered vital signs and abnormal lab values. What specific acid-base imbalance is evident in this patient? What criteria would be used to determine if the therapy is successful? What type of IV therapy might be used to restore this patient’s fluid and electrolyte balance?

Explanation / Answer

Ans. Lets solve the problem step wise step firstly i would like to explain about "stomach bug": it is usually a sickness caused by virus which spreads from person to person or through food contamination.Symptoms are diarrehia, vomiting, fever, headache etc. and it should be cured by avoiding un-hygenic conditions and eating healthy food.

as, mention in the question drugs are some how up to mark as these are preffered for this but should be avoided by serious heart patient. The further examination is so down to the health in terms of the pulse rate and b.p is too low and it is probably caused by excessive diarrehia and vomiting due to inbalance in the gastric acid- base content as well as due to medicinal dose preferred and what you said about creatine is not understandable as it is too high value you are missing something in this value

.as of the diagonisis realated you have to under go IV fluid solution treatment as followed by the reverse osmosis and continue supply of salts solutions as it is quite impossible to gave exact solution to the problem on the basis of the prior information in the question.

Regarding therapy i would suggest the IV saline infusion and diuretics.

Hopefully you got something of it further i would suggest you to go through the below link i have shared

http://www.digestive.niddk.nih.gov/ddiseases/pubs/viralgastroenteritis/index.aspx

thank you

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