(Answered) NUR 321 VCE #5 Fluid and Electrolyte Balance | Piya Jordan, Medical-Surgical Floor, Room 403 • Patricia Newman, Medical-Surgical Floor, Room 406

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NUR 321 VCE #5: Fluid and Electrolyte Balance Reading Assignment: • Oxygenation (Chapter 40) • Fluid, Electrolyte, and Acid-Base Balance (Chapter 41) • Care of Surgical Patients (Chapter 5... 0) Patients: • Piya Jordan, Medical-Surgical Floor, Room 403 • Patricia Newman, Medical-Surgical Floor, Room 406 Objectives: • Identify disturbances in fluid and electrolyte balances in two patients. • Describe variables that affect fluid and electrolyte balance. • Describe the factors to include in the assessment of a peripheral intravenous (PIV) site. • Calculate an intravenous (IV) flow rate. Exercise 1 Writing This exercise will take approximately 15 minutes to complete. 1. Identify the three processes at play in fluid homeostasis. 2. A nurse is reviewing the results of a patient's electrolyte panel. The documentation indicates the patient's potassium level is 5.2 mEq/L, a level that is indicative of: Indicate whether the following statement is true or false. 3. When the nurse is providing fluid maintenance to an adult, the use of a peripheral 18-gauge cannula is appropriate. 4. Which of the following patient populations are at an increased risk for developing fluid, electrolyte, and acid-base imbalances? Select all that apply. A. Older adults B. Infants C. Males D. Patients with burn injuries E. Patients using oral contraceptives Exercise 2 Online This exercise will take approximately 30 minutes to complete. Sign in to work at Pacific View Regional Hospital on the Medical-Surgical Floor for Period of Care 1. (Note: If you are already in the virtual hospital from a previous exercise, click on Leave the Floor and then on Restart the Program to get to the sign- in window.) From the Patient List, select Piya Jordan (Room 403). Click on Get Report; read the report and then click on Go to Nurses' Station. Click on Chart and then on 403. Click on and then review the Nursing Admission. 5. Identify three factors in Piya Jordan's Nursing Admission data that indicate a risk for fluid and electrolyte imbalances even before surgery. 6. Consider the data you received from the change-of-shift report. From the following list, identify the risks Piya Jordan has for fluid and electrolyte imbalance during the postoperative period. Select all that apply. A. Taking digoxin at home B. Nasogastric (NG) tube draining a moderate amount of brown fluid C. IV infusion of D5NS with 20 mEq KCl D. Receiving meperidine via patient-controlled analgesia (PCA) E. Nothing by mouth (NPO) status F. Telemetry shows atrial fibrillation Click on Laboratory Reports and review findings. 7. Using the chart below, record Piya Jordan's chemistry results. In the last column, indicate whether values demonstrate an abnormal or normal trend. Lab Value Mon 2200 Tues 0630 Wed 0630 Is Trend Normal or Abnormal? Sodium (Na) Potassium (K+) Chloride (Cl) Carbon dioxide (CO2) Blood urea nitrogen (BUN) 8. The condition indicated by Piya Jordan's potassium levels is known as 9. Clinical manifestations of the condition identified in the preceding question would include which of the following? Select all that apply. A. Confusion B. Abnormal ventricular arrhythmias C. Flushed skin D. Weakness E. Thirst F. Decreased bowel sounds G. Diarrhea Click on and then review the History and Physical. 10. Piya Jordan's BUN level is elevated. What is BUN used to measure? What can BUN help to determine? (Hint: Refer to your nursing drug guide as needed.) 11. What factors might explain her elevated BUN level that resulted during the preoperative period? 12. What treatment was given that would aid in reversing this condition? Click on Return to Nurses' Station. Click on 403 at the bottom of the screen. Review the Initial Observations. Piya Jordan has IV fluids of running at 100 mL/hour. 13. Piya Jordan's IV solution can best be described as: A. isotonic. B. hypertonic. C. hypotonic. 14. Piya Jordan's IV is running at 100 mL/hour. Assume the IV is being delivered by way of macrodrip tubing. Calculate the drop rate for an IV drop factor of 10 gtt/mL. 15. Which of the following statements best describes an IV site without complications? A. IV infusing at 75 mL/hour, site warm with redness, nontender B. IV infusing at 100 mL/hour, site nontender, without redness or swelling C. IV infusing at keep-vein-open rate, swelling less than 1 inch around site, cool to touch D. IV infusing at 100 mL/hour, pain on palpation over site, skin blanched and cool to touch Click on Patient Care and then on Physical Assessment. Complete an assessment of the areas pertaining to Piya Jordan's fluid and electrolyte status by clicking on the body system categories (yellow buttons) and subcategories (green buttons). Indicate whether the following statement is true or false. 16. The findings from the assessment of Piya Jordan's oral mucosa and skin indicate normal hydration and good integrity. Click on EPR and then on Login. Select 403 from the Patient drop-down menu and Intake and Output from the Category drop-down menu. Review the Intake and Output values for Piya Jordan from 2300 on Tuesday to 0700 Wednesday. 18. Which of the following interventions would be appropriate to manage Piya Jordan's fluid imbalance? A. Give oral fluids. B. Increase IV infusion rate. C. Initiate tube feeding. D. Discontinue NG decompression. [Show More]

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