Fluid and Electrolytes: Balance and Disturbance

Case Study, Fluid and Electrolytes: Balance and Disturbance

Fluid and Electrolytes: Balance and Disturbance Case Study Assignment

Mrs. Dean is 75-year-old woman admitted to the hospital for a small bowel obstruction. Her medical history includes hypertension. Mrs. Dean is NPO. She has a nasogastric (NG) tube to low continuous suction. She has an IV of 0.9% NS at 83 mL/hr. Current medications include furosemide 20 mg daily and hydromorphone 0.2 mg every 4 hours, as needed for pain. The morning electrolytes reveal serum potassium of 3.2 mEq/L. (Learning Objective 4)

  1. What are possible causes of a low potassium level?
  2. What action should the nurse take in relation to the serum potassium level?
  3. What clinical manifestations might the nurse assess in Mrs. Dean?


Conrad Jackson is a 28-year-old man who presents to the emergency department with severe fatigue and dehydration secondary to a 4-day history of vomiting. During the interview, he describes attending a family reunion and states that perhaps he “ate something bad.” Upon admission his vital signs are a temperature of 102.7°F, heart rate of 116 bpm, respiratory rate of 18 breaths/min, and blood pressure of 86/54 mm Hg. The nurse also notes the patient has dry mucous membranes and tenting of skin. The physician orders an IV to be started with 0.45% normal saline, and orders a serum electrolytes and an arterial blood gas. (Learning Objective 7)

The following results are returned from the laboratory:

Sodium (Na+) 150

Potassium (K+) 5.5

Chloride (Cl¯) 110

BUN 42

Creatinine 0.8

Glucose 86

pH 7.32

PaCO2 35

HCO3¯ 20

PaO2 90

O2 Sat 98%


  1. What is your interpretation of this arterial blood gas sample?
  2. Explain the high potassium in this patient.
  3. Calculate the patient’s anion gap:
  4. What is the interpretation of this anion gap?



Write a 1000-1500-word essay addressing each of the following points. Be sure to completely answer all the questions for each bullet point. There should be two main sections, one for each bullet below. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper.

Support your ideas with at least three (3) sources using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment.

Length: 1000-1500 words; answers must thoroughly address the prompts in a clear, concise manner.

Evaluation Criteria for Paper

(10%) Resources used as rationale for approaches and as sources of content

_____ 5. (20%) write paper in a scholarly manner
(4%) Format includes title page, body of paper, & reference page, with pages numbered

_____ 5. (20%) Write the Paper in a scholarly manner
(4%) Format includes title page, body of paper, & reference page, with pages numbered


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