case study for pathophysiology nursing course
Case Study #3 Jane Fonda Is a 74 year-old female who lives alone, and has been admitted to the hospital because of weakness and confusion. She has a history of chronic heart failure and chronic diuretic use. Objective Data: Neurologic: confusion, slow to respond to questioning, generalized weakness Cardiovascular: blood pressure90/62, heart rate112 and irregular, peripheral pulse is weak, EKG indicates sinus tachycardia Pulmonary respiration 12 per minute and shallow Additional findings: decreased skin turgor and dry mucous membranes Significant Laboratory Results: Serum Electrolytes: Sodium 141mEq/L Potassium 2.5 mEq/L Chloride 85mEq/L HC)3 43mEq/L BUN 42 mg/dl (15mmol/L) Arterial blood gas (ph 7.52, PaCO2 55mmHg PaO2 88mmHg HC)3 42mEq/L
1. Evaluate Jane’s fluid volume and electrolyte status. Which physical assessment findings support your analysis? Which laboratory results support your analysis? What is the most likely etiology of these imbalances?
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2. Explain the rational for Jane’s EKG changes.