Question. A 52-year-old turbel man was brought into emergency department by his wife with main complaints of increasing fatigue and weakness. According to his wife his weakness has progressively worsened over the past month. He was so weak that he almost passed out when walking from the entrance of the ed to the registration desk. His wife reported that he has an increased fluid intake and an increase in urinary output. When asked patient reported that there was no pain on urination of history it urinary tract infection. Patient denied chest pain, vision problems, nausea, diarrhoea and syncope. His wife was concerned that the patient was wobbly when he walked. Past medical history Nephrolithiasis Hypertension Benign prostate hypertrophy Medical history Lisinopril Potassium chloride allopurinol diazepam Social history denies alcohol and tobacco use. Vital signs. Blood pressure 107/56 mmhg. Heart rate 115 respiration rate 22 bpm. Temperature 36.9 celcius Physical examination Awake and responsive but confused to time Skin was dry with poor turgor Oral mucosa was also dry Abdominal examination revealed mid epigastric tenderness Neurological examination was non focal Lung and cardiac examination were normal Lab values Arterial blood gas patient’s result reference range Ph 7.01 7.35-7.45 pCo2 30 35-45 mmhg PO2 22.1 >80 mmhg HCO3 8 24-26 mmol/l Chemistry patient’s result reference range Sodium 130 135-145 Potassium k 5.5 3.5-5.2 mmol/l Chloride cl 95 95 to 110 mmol/l Cratitine cr 300 60 to 110 mumol/l Urea 10 2.5 to 7.2 mmol/l Glucose 28 4.0 to 7.8 mmol/l Hba1c 12.4 3.5 to 6% Haematology patient’s result reference range Haemoglobin hb 130 130 to 180 g/l Water blood cells 15.9 x 10 4 to 11 x 10 Platelets 400 x 10 150 to 450 x 10 Urine dipstick patient’s range reference range Glucose ++++++ negative Ketone negative negative Q1. Identify one most striking clinical presentation and one chemistry laboratory finding. Q2. Explain the findings that you have identified above q1 Q3. Discuss three priority nursing interventions you will be implementing for this patients.
Question.
A 52-year-old turbel man was brought into emergency department by his wife with main complaints of increasing fatigue and weakness. According to his wife his weakness has progressively worsened over the past month. He was so weak that he almost passed out when walking from the entrance of the ed to the registration desk. His wife reported that he has an increased fluid intake and an increase in urinary output. When asked patient reported that there was no pain on urination of history it urinary tract infection. Patient denied chest pain, vision problems, nausea, diarrhoea and syncope. His wife was concerned that the patient was wobbly when he walked.
Past medical history
Nephrolithiasis
Hypertension
Benign prostate hypertrophy
Medical history
Lisinopril
Potassium chloride allopurinol diazepam
Social history denies alcohol and tobacco use.
Vital signs. Blood pressure 107/56 mmhg. Heart rate 115 respiration rate 22 bpm. Temperature 36.9 celcius
Physical examination
Awake and responsive but confused to time
Skin was dry with poor turgor
Oral mucosa was also dry
Abdominal examination revealed mid epigastric tenderness
Neurological examination was non focal
Lung and cardiac examination were normal
Lab values
Arterial blood gas patient’s result reference range
Ph 7.01 7.35-7.45
pCo2 30 35-45 mmhg
PO2 22.1 >80 mmhg
HCO3 8 24-26 mmol/l
Chemistry patient’s result reference range
Sodium 130 135-145
Potassium k 5.5 3.5-5.2 mmol/l
Chloride cl 95 95 to 110 mmol/l
Cratitine cr 300 60 to 110 mumol/l
Urea 10 2.5 to 7.2 mmol/l
Glucose 28 4.0 to 7.8 mmol/l
Hba1c 12.4 3.5 to 6%
Haematology patient’s result reference range
Haemoglobin hb 130 130 to 180 g/l
Water blood cells 15.9 x 10 4 to 11 x 10
Platelets 400 x 10 150 to 450 x 10
Urine dipstick patient’s range reference range
Glucose ++++++ negative
Q1. Identify one most striking clinical presentation and one chemistry laboratory finding.
Q2. Explain the findings that you have identified above q1
Q3. Discuss three priority nursing interventions you will be implementing for this patients.
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