Question

A 19-year-old female college student who is pledging a sorority arrives at the Emergency Department (ED) after participating in a contest to drink the most water. She drank 5 liters of water in about 2 hours. The sorority sisters called 911 when the student reported a headache and was confused. Upon arrival to the ED, a nursing assessment was performed and laboratory tests ordered by the MD were obtained. The patient reports a headache, abdominal cramping, and has orthostatic hypotension. The following laboratory results are reported: Sodium: 122 mEq/L Potassium: 3.6 mEq/L Calcium: 10 mg/dL Magnesium: 2 mg/dL Chloride: 100 mEq/L Phosphate: 2 mEq/L Initial Discussion Post: Cluster and analyze the data in the scenario. Determine the electrolyte imbalance. As the RN monitoring this patient, what assessments will you perform for early recognition of potential problems? Identify a nursing diagnosis with related factors, and defining characteristics (if appropriate). Describe the analysis used and rationale for your choice.

Answer 1

Cluster and analyzing data:

Sodium - 122mEq/L, we find that this values are slight lower than the normal which is 135-147mEq/L.

Potassium 3.6mEq/L,3.5-5.5 mEq/L, ranges among the normal values.

Calcium 10mg/dl, Magnesium 2mg/dl, 1.8-3.6 mg/magnesium levels are also within the normal ranges.

Chloride 100mEq/L,98-106 mEq/Phosphate 2mEq/L.1.8-2.3 mEq/L Phosphate levels are also within the normal range based on the Investigations operations manual.

Electrolyte imbalance

It is only the level of sodium that is low, this indicates hyponatremia, it is as a result of excessive fluid intake due to dilution of the electrolytes in the body. Assessments to be performed for early recognition for potential problems, first the memory and personality assessment will be important since in cases of low sodium there are tendencies for confusion andsluggishness.

Nursing diagnosis:

Hyponatremia is related to excessive consumption of fluid over a short duration which ends up replacing sodium in the body. The main characteristics of hyponatremia is headache, confusion and quickly complicates to seizures and finally coma. All these symptoms are correlated with the laboratory findings.clinical evaluation should focus on the fluid volume and blood pressure,this parameters will effectively guide on the severity of the condition. Postural deficit and blood pressure should be monitored closely. The chief complain which is excessive intake of fluid and later the patient had associated symptoms of headache, gives a significant clue to the processes that have occurred in the body to lead to the symptoms, and with examinations it is therefore confirmed with the laboratory findings of reduction in the levels of sodium.

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