Question

In: Nursing

nursing diagnosis for a patient with hypernatremia and a secondary diagnosis of Leukocytosis

Expert Solution

Hypernatremia :-

Hypernatremia is a condition in which the serum sodium concentration is greater than 145 mEq/l ( normal level is 135 -145mEq/l) . Sodium is the most abundant cation in the body .

- inquire about the daily intake of fluid and salt by the client. Patient with hypernatremia often report a decrease in fluid intake and high salt intake.

- polyuria moving to oliguria is the early sign of the hypernatreamia.

-ask about daily urine output and concentrated urine or not.

Nursing diagnosis for the patient with hypernatremia :-

?-Fluid volume deficit related to fluid loss , inadequate fluid intake or fluid shift to the extravascular space.

?- Hypernatremia related to decreased thirst or excessive administration of salt solutions or impaired secretion of sodium and water .

?imbalance nutrition less than body requirements related to hypermetabolic state, anorexia,nausea.

?anxiety due to knowledge deficit and uncertain about future.

?risk for spiritual distress.

Leukocytosis is the increase in the WBC count of the blood usually 50 thousands to 0.1 millions ( normal count is 4 to 11 thousands.

Diagnosis of lukocytosis :-

?-Risk for infection and bleeding.

?-imbalance nutrition less than body requirements related to hypermetabolic state, anorexia, mucositis, pain and nausea.

? - deficit knowledge about disease process, treatment, complication management and self care measures.

?- acute pain and discomfort related to mucositis, leukocyte infiltration of systemic tissues, fever and infection.

?Fatigue and activity intolerance related to anemia, infection, inadequate nutrition and deconditioning.

?risk for excess fluid volume related to renal dysfunction, hyperproteinemia and need for multiple intravenous medications and blood products.

Other diagnostic methods mainly laboratory diagnosis are as followings :-

Complete and differential blood count -

This test is always almost done when your wbc count is higher then normal for unknown reason. For this test blood drawn from your veins is run through a machine that identifies the percentage of each type of WBC. Knowing which type have higher percentage than normal percentage can help your doctor narrow down the possible cause of your high WBC count.

Peripheral blood smear (PBF) -

This test is done when nutrophilia or lymphocytosis is found because your doctor can see if there are too many of the different type of leukocytes. For this test a thin layer of patient blood sample is smeared on a slide . A microscope is used to look the cells.

Bone marrow biopsy -

WBC are formed in bone marrow and then they release from bone marrow . When a high number of certain type of nutrophills are found on the peripheral smear your doctor can perform this test

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