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DOESN’T NEED TO ANSWER ALL QUESTIONS. Just as much as possible. CASE STUDY THE PATIENT WITH HYPOVOLEMIA AND ACID-BASE IMBALANCE LM is a 70-year-old man admitted to your unit for severe dehydration and hypovolemia. He has been experiencing diarrhea and vomiting for the past 3 days. He is lethargic weak and disoriented. LM’s usual weight is 175 lbs. He now weighs 167 lbs. LM’s vital signs are BP 98/58, P110. R 24 and T 100.8. Lactated Ringers IV solution is infusing at 100cc/hr. Your assessment reveals pale dry skin, cracked lips, and poor skin turgor. 1. What is hypovolemia? Discuss and describe some of the pathophysiological causes of hypovolemia. 2. Identify clinical manifestations related to fluid volume loss. 3. What assessments will the nurse perform when monitoring LM’s fluid balance? 4. Discuss the primary differences between Isotonic, Hypotonic, and Hypertonic IV solutions. Give an example of each. LM’s admission lab data is K 2.9mEq/L, BUN 40 mg/dl, creatine 1.6 Na 127, and Cl 90. 5. Are you concerned with the K level and if so why? Are the other values normal or abnormal? 6. What clinical manifestations are associated with any abnormal lab findings? 7. Why do you think the BUN and Creatinine levels are elevated? 8. What are the laboratory values for Calcium and Magnesium? Discuss the primary function of Calcium and Magnesium. 9. Identify mechanisms that take place in response to hypo and hypercalcemia. 10. If LM begins to display Chvostek’s sign or Trousseau’s sign, what will the nurse expect to observe and what do these findings signify? LM’s has arterial blood gases drawn. The ABG results are : pH = 7.5 pO2 = 88, PCO2 = 44, HCO3 = 35 11.What acid-base imbalance is LM experiencing? How did you determine this disorder? 12. What are some common causes of Respiratory Acidosis / Alkalosis? What are the common causes of Metabolic Acidosis / Alkalosis? 13. Identify the clinical manifestations associated with the above acid-base imbalances. 14. What nursing and medical interventions will take place to correct LM’s disorder.
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