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Homework answers / question archive / A nurse is taking care of an 85-year-old woman in a hospital-based skilled nursing facility
A nurse is taking care of an 85-year-old woman in a hospital-based skilled nursing facility. In the report, the nurse is told the patient has not been breathing well for the past 2 days. She has been lethargic, her skin is warm and dry, and she has a decr Paper details: A nurse is taking care of an 85-year-old woman in a hospital-based skilled nursing facility. In the report, the nurse is told the patient has not been breathing well for the past 2 days. She has been lethargic, her skin is warm and dry, and she has a decreased urine output. The following laboratory findings were returned from the laboratory immediately after morning report:
Na: 147 Cl 110 K 4.0 Blood Gases: pH 7.33 PCO2 48 HCO3 27 Po2 96 Urine: Urine Specific Gravity 1.040
Address the following:
1. dentify each of the abnormal laboratory findings in the above results.
2. Specify how they differ from a normal range and identify what condition each abnormality indicates.
3. What specific electrolyte disturbance does the patient have?
4. What clinical manifestations would the nurse expect to see with this electrolyte abnormality presented above?
5. What blood gas abnormality is seen in this patient? Discuss the rationale for your answer.
6. What are the three major mechanisms of pH regulation?
Answer :
Q. No. 1. And 2. Answer :
* Na (sodium) values are abnormal because normal value is 135 to 145 mmol per liter.
* But the patient is having 147 so, it indicates Hypernatremia.
* Cl ( Chloride) also abnormal because normal value is 95 to 105 mmol per liter.
* but here the patient is having 110 mmol per liter, it indicates hypercalcemia.
* Ph values are abnormal because normal value is 7.35 to 7.45.
* Here the patient is having 7.33, it includes Acidic.
* PaCo2 also abnormal because normal value is 35 to 45 mm of hy.
* but here the patient is having 48.
* HCo3 bicarbonate levels also high because normal value is 22 to 26 mEq per liter.
* so here the patient is having 27, it indicates high.
* if the pH is low, PCo2 high and HCo3 high indicates " "Respiratory acidosis "
These are the abnormal laboratory values .
* Urine specific gravity also abnormal, because normal range is 0.002 to 0.010.
* The patient is having above the normal range that is 0.040.
It indicates dehydration.
Q. No. 3. Answer :
Patient having Electrolyte disturbances like
1.Hypeenatremia,
2. Hypercalemia.
Q. No. 4. Answer :
Clinical manifestations expect from these electrolytes abnormalities.
1. hypernatremia :
* Restlessness,
* irritability,
* muscular twisting,
* Tachycardia
* hypotension
* dry mucosal
* reduced skin turgur
* seizures,
2. hypercalcemia :
* muscle weakness
* decreased deep tendon reflexes,
* polyuria,
* Anorexia,
* nausea,
* vomitings,
* arrhythmias
* Heart block,
* hypertension ect.
Q. No. 5. Answer :
The patient ABG values are abnormal because the pH is low and bicarbonates high and PCo2 high indicates Respiratory acidosis.
Q. No. 6. Answer :
Three major mechanisms of pH regulation.
1. Buffering agents,
2. Respiratory system,
3. And renal system maintainance.
