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Concept explainers
To explain:
The approaches that Mrs. K’s health care providers will use to reverse her delirium. Give some examples of these approaches.
Case summary:
Mrs. K is an 81-year-old active and independent retired bookkeeper admitted to the hospital for an emergency hip pinning surgery for her hip fracture followed by a fall at her home. She also had other medical problems such as hypothyroidism, hypertension, and anxiety disorders for which she is also taking medications. In the past, she had bilateral knee replacements. She drives, plays cards with her friends, and also participates in the church activities. She wears glasses and uses a cane.
Mrs. K’s postoperative medical report showed that she is been receiving opioids for pain and has intravenous fluids for hydration. She has an indwelling urinary catheter. The nurse reported that Mrs. K was restless and slept only a little all night. Her pain medications did not help her to sleep. The nurse while entering Mrs. K’s room found that she is picking at the air as she was trying to eat the breakfast and she is founded to be self-orienting. During the shift assessment, the nurse recognizes the signs of delirium in Mrs. K.
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Chapter 14 Solutions
Fundamentals of Nursing, 9e
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- As a nursing student with a smart goal of being able to identify common sources of fear and anxiety in school age patients, describe how this influence future growth in reflective practice with detailed and/or relevant insights.arrow_forwardAs a nursing student trying to implement strategies on how to alleviate anxiety and fear in school age children, what are some roadblocks and how would you overcome it? (Example not having the opportunity to care for a school age patient with anxiety)arrow_forwardProvides a thoughtful and relevant analysis of how identifying key sources of fear and anxiety and effective interventions in school age patients will impact nursing practice, supportedby specific examplesarrow_forward
- Organize a series of questions that you will ask to our virtual patient Sara Bellum, based on new guidelines. Find patient's medical charting separately.arrow_forwardMake a patient interview sheet for patients with Diabetes and CKD: Assessing symptoms Signs Biochemical data Nutrition focused physical exam key points.arrow_forwardModule 4 - Interpreting Labs.pd X CB CastleBranch Login Merged-TDL-Files--2024103012280X pl Dietetic Practitic 6uo8tbjf.cloudfront.net/68f85c32-16e5-11ef-925e-aaa4f1cd8999?response-content-disposition-inline DaVita Dietitian Reference Manual - + 90% Module 4-Evaluating Laboratory Values Case 3 Ray dialyzes three times a week on 2 K+ bath. His appetite is fair and he takes ReGen (4 oz. TID) to supplement his intake. His medications include: Nephrovite RX, PhosLo (1 at breakfast, 1 at lunch, 2 at supper) Prilosec, Imdur, Zemplar and Epogen. He says he's been feeling weak and tired and has SOB (shortness of breath). He reports having diarrhea for 2 days. His blood pressure is low Date PreBUN PostBUN URR KUV Creat Alb CO2 K+ Ca PO4 PTH- Hgb intact 5.3 9.0 4.9 160 11.5 5.4 8.9 5.4 6.5 9.3 6.1 01/01 02/01 03/01 37 8 40 9 104 missed 78% 1.6 7.7 3.2 25 78% 1.6 3.5 22 3.0 21 7.5 7.6 10.8 8.4 What do you suspect is the reason for his change in lab values? Case 4 Margaret is a 78-year-old woman…arrow_forward
- Module 4 - Interpreting Labs.pd X CB CastleBranch Login Merged-TDL-Files--2024103012280X 1k6uo8tbjf.cloudfront.net/68f85c32-16e5-11ef-925e-aaa4f1cd8999?response-content-disposition=inline DaVita Dietitian Reference Manual + 90% Module 4-Evaluating Laboratory Values CASE STUDIES Case 1 Steve has been on hemodialysis for 3 years. His medications include Nephrocaps, PhosLo (3 at breakfast, 2 at lunch, 3 at supper), Lisinopril, EPO and Venofer. Patient reports he has had the flu and not eaten much for the past 4-5 days, but has continued to take all medications as prescribed. Date PreBUN PostBUN URR KWV Creat Alb CO2 K+ Ca PO4 PTH- Hgb intact 12/01 54 01/02 55 02/02 40 18 17 12 68% 1.33 12.3 3.9 24 4.7 11.0 5.9 69% 1.39 12.2 4.0 23 4.8 11.0 5.2 70% 1.45 12.5 4.0 26 4.1 12.5 4.5 96 12.3 12.1 11.9 What are possible reasons for increasing hypercalcemia in February? Case 2 Barb has been on hemodialysis for 1½ years. She has diabetes, but is not currently taking an antiglycemic agent.…arrow_forwardzm Module 4 - Interpreting Labs.pd X CB CastleBranch Login X Merged-TDL-Files--2024103012280X marks Tools Window Help 100% E pl Dietetic Practitioners s://d3da1k6uo8tbjf.cloudfront.net/68f85c32-16e5-11ef-925e-aaa4f1cd8999?response-content-disposition=inline + 90% DaVita Dietitian Reference Manual Module 4-Evaluating Laboratory Values REVIEW QUESTIONS 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. True False A patient who has a low bicarbonate level will also have a low potassium level. Causes of low albumin include low protein intake, infection, proteinuria and severe liver disease. Inaccurate handling of the blood specimen can result in a falsely low PTH. In a patient on hemodialysis, a potassium level of 6.0 is acceptable. An excessive intake of meat will result in higher levels of BUN, phosphorus and potassium. In a patient without kidney function, hyperglycemia will be accompanied by hypokalemia. A patient with access problems is likely to have increased levels of potassium, BUN, creatinine…arrow_forwardTools Window Help zm Module 4 - Interpreting Labs.pd X CB CastleBranch Login x Merged-TDL-Files--2024103012280X pl Dietetic Prac Halk6uo8tbjf.cloudfront.net/68f85c32-16e5-11ef-925e-aaa4f1cd8999?response-content-disposition=inlin - + 90% CASE STUDIES-DISCUSSION Case 1 His lower BUN, K+ and phosphorus are consistent with his reported decrease in intake due to the flu. His high calcium level is a consequence of taking his prescribed amount of PhosLo while eating less food. Thus, he absorbed more calcium from his phosphate binder. In this patient, with adynamic bone disease (low PTH without IV vitamin D therapy), he is unable to deposit calcium in his bones, so serum level rose quickly. PhosLo was held and the next week his calcium was 11.0 and phosphorus 5.8. Other possibilities for a rise in calcium might be that patient took Tums (or another calcium-containing antacid) because of the flu or heartburn; took phosphate binders between meals rather than with meals; was consuming…arrow_forward
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