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NUR 641E Topic 3: Fluid, Electrolyte, And Acid-Base Pathophysiology

NUR 641E Topic 3: Fluid, Electrolyte, And Acid-Base Pathophysiology

NUR 641E Topic 3: Fluid, Electrolyte, And Acid-Base Pathophysiology

Mar 17-23, 2022

Max Points:197

Objectives:

  1. Describe normal pathophysiology and alterations in electrolytes and their presentations.
  2. Differentiate between acid-base imbalances: metabolic acidosis or alkalosis and respiratory acidosis or alkalosis.
  3. Compare the role of the respiratory and renal systems in regulating acid-base balance.
  4. Describe a pharmacological intervention using an evidence-based treatment guideline.

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NUR 641E Topic 3: Fluid, Electrolyte, And Acid-Base Pathophysiology Topic 3 DQ 1

Mar 17-19, 2022

Choose a medical condition from the fluid, electrolyte, or acid-base system and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder? Make sure that you select a different medical condition than your peers. Include the name of the medical condition in the subject line so that the medical conditions can be followed. Include your references in APA style.

REPLY TO DISCUSSION

NS

Nicole Santos

Posted Date

Mar 21, 2022, 8:06 PM

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Replies to Nicole Santos

Hypercalcemia is a condition where calcium level in the blood are elevated. Elevated calcium level in the blood can weaken the bones, form kidney stones, and affect the cardiac and brain function. Overactive parathyroid glands are typically the cause of hypercalcemia, other causes are cancer, other medical issues and medications, and taking too much calcium and vitamin D supplements.

Hypercalcemia can affect the following:

  • Kidneys: makes kidney work harder causing excessive thirst and frequent urination
  • GI system: stomach disturbances, nausea, vomiting, constipation
  • Bones and Muscles: weak and brittle bones, bone pain, muscle weakness
  • Brain: confusion, lethargy, fatigue, depression
  • Heart: palpitations, fainting, arrhythmia

Some patient education in patients would be to inform of signs and symptoms of hypercalcemia; inform for risk of kidney stones; drink plenty of water; avoid food high in dairy or calcium; discontinue calcium supplements; refrain from using antacids with calcium and opt for antacids with magnesium.

References

McCance, K. L., & Huether, S. E. (2018). Pathophysiology – e-book: The biologic basis for disease in adults and children (8th ed.). Mosby. https://bibliu.com/app/#/view/books/9780323413206/epub/OPS/xhtml/chp00007.html

NUR 641E Topic 3: Fluid, Electrolyte, And Acid-Base Pathophysiology Topic 3 DQ 2

Mar 17-21, 2022

Select a medication used in evidence-based treatment guidelines for the condition chosen in the first discussion question. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions of which one should be aware. Make sure that you select a different medication than your peers. Include the name of the medication in the subject line so that the medications can be followed. Include your references in APA style.

REPLY TO DISCUSSION

VB

Vanessa Brown

Posted Date

Mar 22, 2022, 9:36 PM

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Replies to Vanessa

Magnesium sulfate

Magnesium sulfate is an evidence-based treatment used to treat hypomagnesemia. Depending on the severity of the hypomagnesemia and the stability of the patient, the administration can be oral, intravenous, intraosseous (if no other route is possible), or intramuscular. It can be combined with dextrose 5% or water to make intravenous solutions (Hicks & Tyagi, 2022). If given orally, it causes an osmotic shift in fluid; if given parenterally it will be broken down to elemental magnesium, and be used to replete and maintain circulating magnesium stores (Hicks & Tyagi, 2022). An increase in the serum concentration of magnesium occurs. When repleting magnesium in patients with abnormal kidney function, it is recommended that doses be reduced to prevent hypermagnesemia. After magnesium sulfate is administered parenterally, monitoring of the serum levels should be drawn every 6-8 hours (Hicks & Tyagi, 2022). Clinical assessment of patellar reflexes, urinary output, and possible signs and symptoms of hypermagnesemia should be monitored, too. Some of the common side effects of giving this parenterally within the therapeutic range are facial flushing and warmth (Hicks & Tyagi, 2022). If it is given parenterally and too quickly or in high doses, it can lead to hypotension absent reflexes, weakness, decreased respiratory drive, and abnormal cardiac conduction (Hicks & Tyagi, 2022). If a therapeutic dose is taken orally, nausea and loose stools can result. Several drug interactions may occur but vary greatly in severity. Some of the drugs to speak to your doctor about before taking magnesium are aminoglycoside antibiotics, such as amikacin and gentamicin, because if taken together respiratory depression may result (Magnesium sulfate interactions, n.d.). Taking medications that help with increasing calcium levels, such as calcium or Vitamin D medications, could increase the risk for hypermagnesemia (Magnesium sulfate interactions, n.d.).

References

Hicks, M., & Tyagi, A. (2022). Magnesium Sulfate. NCBI. https://www.ncbi.nlm.nih.gov/books/NBK554553/

Magnesium sulfate interactions. (n.d.). Drugs.com. https://www.drugs.com/drug-interactions/magnesium-sulfate.html

NUR 641E Topic 3: Fluid, Electrolyte, And Acid-Base Pathophysiology – Topic 3 Acid-Base and Electrolyte Case Study

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Points

167

Rubric

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Status

Published

Assessment Description

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:

Blood Chemistries

  • Na: 147
  • Cl: 110
  • K: 4.0

Arterial Blood Gases

  • pH: 7.33
  • PCO2: 48
  • HCO3: 27
  • PO2: 96

Urinalysis

  • Urine Specific Gravity: 1.040

Address the following:

  1. Identify each of the abnormal laboratory findings in the above results. Specify how they differ from a normal range and identify what condition each abnormality indicates.
  2. What specific electrolyte disturbance does the patient have?
  3. What clinical manifestations would the nurse expect to see with this electrolyte abnormality presented above?
  4. If the patient had an increase in her potassium level, for what clinical manifestations would the nurse monitor?
  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?

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

Topic 4: Respiratory System And HEENT: Selected Pathophysiology And Pharmacologic Therapy

Mar 24-30, 2022

Max Points:30

Objectives:

  1. Describe normal pathophysiology and alterations in the pulmonary system and HEENT.
  2. Integrate knowledge of pathophysiology and pharmacology into teaching and educational materials in diverse settings.
  3. Describe a pharmacological intervention using an evidence-based treatment guideline.
Topic 4 DQ 1

Mar 24-26, 2022

Choose a medical condition from the respiratory system or HEENT system and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder? Make sure that you select a different medical condition than your peers. Include the name of the medical condition in the subject line so that the medical condition can be followed. Include your references in APA style.

REPLY TO DISCUSSION

VB

Vanessa Brown

Posted Date

Mar 27, 2022, 4:49 PM(edited)

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Replies to Vanessa Brown

Acute otitis media

Acute otitis media is an infection of the middle ear that can affect both children and adults, and can have symptoms of ear pain, fever, irritability, inflamed tympanic membrane, and fluid in the middle ear (McCance & Huether, 2018). It is the most common infection in infants and children, and is also the leading reason for healthcare visits and prescriptions in the world (McCance & Huether, 2018). Acute otitis media is mostly caused by bacterial pathogens, but respiratory viruses and certain predisposing factors can also lead to acute otitis media. The pathophysiology changes that can be seen include erythema to the tympanic membrane that progresses to opaqueness, and is accompanied by membrane bulging caused by accumulating fluid (McCance & Huether, 2018).

Patient education that should be provided would be to seek medical attention for a definitive diagnosis and follow-up because treatment could include antimicrobial therapy, especially in children under the age of two (McCance & Huether, 2018). The other symptoms of pain and fever should be medicated accordingly for the patient’s comfort, as per physician order. Breastfeeding is a protective factor, and the widespread use of bacterial and viral vaccines in young children has accompanied a reduction of incidence of otitis media (McCance & Huether, 2018). Ongoing infections with certain types could possibly lead to conductive hearing loss (where there is interference in air conduction), eardrum perforation, or spread of infection (McCance & Huether, 2018). Placement of tympanostomy tubes in the ears would be a way to prevent permanent damage if the infections are reoccurring. This is why prevention of otitis media is key. Some additional things to help prevent acute otitis media would be to avoid cigarette smoke, control allergies, prevent colds, and bottle feed babies at an upright angle.

References

McCance, K. L., & Huether, S. E. (2018). Pathophysiology – e-book: The biologic basis for disease in adults and children (8th ed.). Mosby. https://bibliu.com/app/#/view/books/9780323413206/epub/OPS/xhtml/chp00007.html

Topic 4 DQ 2

Mar 24-28, 2022

Select a medication used in evidence-based treatment guidelines for the condition chosen in the first discussion question. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions of which one should be aware. Make sure that you select a different medication than your peers. Include the name of the medication in the subject line so that the medications can be followed. Include your references in APA style.

REPLY TO DISCUSSION

NS

Nicole Santos

Posted Date

Mar 29, 2022, 8:42 PM

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Replies to Nicole Santos

AUGMENTIN

Augmentin is a combination antibiotic that contains both amoxicillin and clavulanate potassium. Amoxicillin is a penicillin antibiotic that helps fight bacteria in the body by binding to proteins in the bacterial cell wall and inhibits the cell wall from synthesis , and clavulanate is a beta-lactamase inhibitor that helps prevent bacteria from becoming resistant to amoxicillin by being structurally related to penicillin, deactivating the potential of beta-lactamase enzymes.

Some common side effects of augmentin include nausea vomiting, diarrhea, rash, itching, vaginal itching or discharge, or diaper rash. It is recommended to notify your physician if you have severe stomach pain, watery or bloody diarrhea, loss of appetite, little to no urination, or easy bruising or bleeding.

Augmentin is contraindicated in patients with severe kidney disease, allergy to penicillin or cephalosporin antibiotics, breast feeding, or taking birth control. It is also advised to voice taking augmentin with a high-fat meal, as it makes it difficult for the body to absorb medications.

References

Evans J, Hannoodee M, Wittler M. Amoxicillin Clavulanate. [Updated 2021 Dec 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538164/

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