A nurse has just been assigned to care for three p 1. Which patient needs to...

A nurse has just been assigned to care for three p 1. Which patient needs to be assessed first based on the information above? Why? 2. What could be some possible causes of the hyperkalemia? 3. Patient B is also complaining of numbness and tingling, especially around the mouth. What are the other two electrolyte imbalances in this patient that could be causing these symptoms? 4. Discuss the possible etiology associated with each electrolyte imbalance identified in question number 3. 5. What manifestations are associated with the three electrolyte imbalances in Patient B? 6. How would you interpret Patient B’s arterial blood gases? 7. What body system will attempt to compensate?

Expert Solution

2. Hyperkalemia is the medical term that describes a potassium level in your blood that's higher than normal. Potassium is a chemical that is critical to the function of nerve and muscle cells, including those in your heart. Your blood potassium level is normally 3.6 to 5.2 millimoles per liter . The major causes of hyperkalemia are kidney dysfunction, diseases of the adrenal gland, potassium sifting out of cells into the blood circulation, and medications.

3. Hypocalcemia and hypomagnesimia could be the other two electrolyte imbalance that the patient B is having.

As hypocalcemia progresses, muscle cramps are common, and people may become confused, depressed, and forgetful and have tingling in their lips, fingers, and feet as well as stiff, achy muscles.

4. Hypocalcemia most commonly results when too much calcium is lost in urine or when not enough calcium is moved from bones into the blood. Causes of hypocalcemia include the following:

5. If levels of calcium are low for long periods, people may develop dry scaly skin, brittle nails, and coarse hair. Muscle cramps involving the back and legs are common. Over time, hypocalcemia can affect the brain and cause neurologic or psychologic symptoms, such as confusion, memory loss, delirium, depression, and hallucinations. These symptoms disappear if the calcium level is restored.

A low level of parathyroid hormone (hypoparathyroidism), as can occur when the parathyroid glands are damaged during thyroid gland surgery
Lack of response to a normal level of parathyroid hormone (pseudohypoparathyroidism)
No parathyroid glands at birth (for example, in DiGeorge syndrome)
A low level of magnesium (hypomagnesemia), which reduces the activity of parathyroid hormone
Vitamin D deficiency (due to inadequate consumption or inadequate exposure to sunlight)
Kidney dysfunction, which results in more calcium excreted in urine and makes the kidneys less able to activate vitamin D
Inadequate consumption of calcium
Disorders that decrease calcium absorption
Pancreatitis
Certain drugs, including rifampin (an antibiotic), anticonvulsants (such as phenytoinand phenobarbital), bisphosphonates (such as alendronate, ibandronate, risedronate, and zoledronic acid), calcitonin, chloroquine, corticosteroids, and plicamycin.

** Hypomagnesemia can result from decreased intake, redistribution of magnesium from the extracellular to the intracellular space, or increased renal or gastrointestinal loss. In some cases, more than one of these may be present.

Causes of hypomagnesemia related to decreased magnesium intake include the following
Starvation
Alcohol dependence
Total parenteral nutrition

An extremely low calcium level may cause tingling (often in the lips, tongue, fingers, and feet), muscle aches, spasms of the muscles in the throat (leading to difficulty breathing), stiffening and spasms of muscles (tetany), seizures, and abnormal heart rhythms.

Deficiency of magnesium can cause tiredness, generalized weakness, muscle cramps, abnormal heart rhythms, increased irritability of the nervous system with tremors, paresthesias, palpitations, hypokalemia, hypoparathyroidism which might result in hypocalcemia, chondrocalcinosis, spasticityand tetany, epileptic seizures, basal ganglia calcifications and in extreme and prolonged cases coma, intellectual disability or death.^[3]Other symptoms that have been suggested to be associated with hypomagnesemia are athetosis, jerking, nystagmus, and an extensor plantar reflex, confusion, disorientation, hallucinations, depression, hypertension and fast heart rate

Nightingale answered 2 years ago

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