Question

A 73-year-old man is seeking treatment following 3 days of recurrent diarrhea. He has not had an appetite and is afraid to drink due to the diarrhea. He states he feels weak all over, his heart rate is elevated at 112 bpm, his oral mucous membranes are dry, and his skin turgor is poor. The physician orders a bolus of IVF (intravenous fluid) for the patient. (20 points each)

·        Identify the fluid and electrolyte imbalance(s) you suspect and why.

·        Define three priority nursing concerns for this patient who has fluid and electrolyte imbalances.

·        Anticipate what the patient's urine will look like when he provides a sample. What do you anticipate the urine specific gravity results will show, either elevated or decreased?

·        Describe the type of fluid you anticipate would be ordered (hypotonic, isotonic, hypertonic)?

·        Discuss what the most likely pH imbalance that this patient would have if an ABG was drawn and why

Answer 1

Patient suffer with dehydration when there is loss of fluid occur from his body.It may end up with hypovolemia and hypovolemic shock. In this case patient have tachycardia, hypotension,dryness of skin etc.The total volume of fluid inside our body reduces and patient suffer with these symptoms.

Three priority nursing concern includes Risk for deficient fluid volume,risk for electrolyte imbalance and deficient supply of blood to vital organs due to deficient blood volume.

There will be high coloured urine will be there or oliguria will be there.Urine specific gravity will be elivated.

Usually doctors advice to give colloids and crystalloids for these patients . Isotonic solutions like ringer lactate will be advisable for patients suffering with dehydration.

Commonly metabolic acidosis will be present in patients with diarrhoea. During diarrhoea lot of bicarbonate ions loss from our body and results in metabolic acidosis. pH and bicarbonate level will be low in case of metabolic acidosis.