Question

Mrs. Yaa Aboagyewaa reported to your ward with history of adrenal insufficiency and chronic use of diuretics, which resulted in loss of gastrointestinal fluids and high urinary salt wasting. she was diagnosed as an electrolyte imbalance that resulted from an imbalance of water rather than the electrolyte itself. She complained of headache, nausea, vomiting, anorexia, muscle cramps and weakness. Her laboratory values indicated a decreased urine specific gravity and osmolality. Her vital signs on admission recorded as follows: T: 36.7℃, P: 110pbm, BP: 83/50mmHg RR: 25cpm.

What is her diagnosis?

Explain how you would manage Mrs. Yaa Aboagyewaa as a nurse.

Explain the role of the nurse in preventing Mrs. Yaa Aboagyewaa’s condition.

Answer 1

1)What is her diagnosis?

The diagnosis could be an adrenal crisis where the adrenal gland produces insufficient cortisol which results in electrolyte imbalances and water retention.

2)Explain how you would manage Mrs. Yaa Aboagyewaa as a nurse.

*Monitor vital signs to observe for hypotension and fever.

*Monitor EKG for hyperkalemia

*Encourage oral fluids to maintain fluid and electrolyte levels.

*Minimizes stress by reducing activities.

*Encourage high protein low carbohydrate diet as tolerated.

*Maintain intake and output,

*Watch for dehydration by checking skin turgor and mucus membranes.

*Administer medications as ordered by the physician.

3)Explain the role of the nurse in preventing Mrs. Yaa Aboagyewaa’s condition.

In order to prevent an acute adrenal crisis, the patient should be taught about avoiding stress, the importance of taking the medication regularly as advised, and importance of wearing medical alert bracelets. The nurse should explain the patient about signs and symptoms of adrenal crisis and seek medical attention.