ST, a 64-year-old patient, has heart failure that is being controlled with digoxin, furosemide, and a low-sodium diet. She is taking potassium chloride (KCl) 20 mEq per day orally. Three days ago, ST had flulike symptoms that included anorexia, nausea, lethargy, and diarrhea. Her fluid and food intake was diminished, and she refused to take the KCl, stating that the drug makes her sick. She has been taking the digoxin and furosemide daily.
The nurse’s assessment during the home visit includes poor skin turgor, poor muscle tone, irregular pulse rate, and decreased bowel sounds. The nurse obtained a blood sample for serum electrolytes, and results indicated potassium (K) 2.9 mEq/L, sodium (Na) 137 mEq/L, and chloride (Cl) 96 mEq/L.
1.List reference values for serum potassium (K), serum sodium (Na), and serum chloride (Cl). Are ST’s electrolyte levels within normal range? Explain your answer.2.ST’s electrolyte levels within normal range? Explain your answer.
2.Match ST’s physical findings with the corresponding electrolyte imbalance.
3.What are the reasons for the electrolyte imbalance?
4. ST said she was not taking KCl because the drug makes her sick. What information can you give her concerning the administration of potassium?
5. What is the effect of furosemide on digoxin when there is a potassium deficit? Explain your answer.
6. Why should the nurse assess ST for digitalis toxicity? List the signs and symptoms of digitalis toxicity.
7. ST should be monitored and educated about digoxin. What is the normal therapeutic range?
8. What important skill should the nurse teach ST about home monitoring while taking digoxin?
9. The nurse instructs ST to eat foods rich in potassium. Which foods are the richest sources of potassium?
10. How would you incorporate the family?
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