Case Study Question Question & Answer Guide (With Explanation)

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Original Question

Case Study Question 1 of 6 The nurse cares for a 72-year-old female admitted to the medical unit with dehydration and secondary diagnosis of mid-stage Alzheimer’s disease. Phase Sheet Name Theresa Peters Gender F Age 72 Weight (Ibs/kg) 122 lb (55 kg) Allergies NKA Nurses’ Notes DAY 1 1800: Client admitted from ED to medical unit for dehydration after several days of poor PO intake where she appeared to briefly lose consciousness this am after breakfast. Retired for several years as seamstress and husband passed away last year. Now lives with daughter/family due to recent diagnosis of middle stage Alzheimer’s disease, history of mild hypertension & gastroesophageal reflux. Daughter notes appetite has diminished in past 2-3 weeks, and it is hard to get her to drink enough fluids even in the warmer weather. She has been more “down in the dumps” the past few weeks. Client has been unsteady on her feet due to dizziness and increasingly weak. P: 104 and B/P 102/62 (sitting) & 94/55 (standing). Skin & mucous membranes dry; tenting noted. Admission BUN & creatinine elevated. Foley inserted and draining concentrated amber urine. Provider notified; ordered fluid challenge of 500 ml normal saline. Alert/oriented to name only, answers questions, pleasant, cooperative, asking for daughter. Vital Signs Time 1800 T F / C 97.8 F /36.5 C P 104 RR 20 fat saline OF B/P 102/62 Pulse oximeter 97 Oxygen Room air Laboratory Report Lab Results @ 1400 (ED) Reference Range Sodium 146 135 to 145 mEq/L Potassium 5.0 3.5 to 5.0 mEq/L Glucose (fasting) 72 Normal < 99 mg/dL BUN 32 10-20 mg/dL Creatinine 1.5 0.9 to 1.4 mg/dL Hematocrit 49 Males: 42-52%; Females: 35-47% WBC 6.6 4.5 -10.5 x 10' cells/mm Which 4 findings are most urgent? Blood pressure Sodium Potassium BUN Creatinine Mucous membranes Pulse oximeter Hematocrit Tenting CJCST Version 2.2 designed by Desiree Hensel, 2022. Permission granted to use and modify template for educational purpose

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