32-Year-Old Diabetic Male on a Diuretic
Let’s return to Kyle Boulard, whom we met in the previous chapter. Mr. Boulard has recovered from his acute diabetic crisis. The last update on his chart before he is discharged includes the following:
•BP 150/95, HR 75, temperature 37.2°C
•Urine: pH 6.9, negative for glucose and
Mr. Boulard is prescribed a thiazide diuretic and an angiotensin converting enzyme (ACE) inhibitor. He is counseled on the importance of taking his medications regularly and keeping his outpatient follow-up appointments.
3. Where and how do thiazide diuretics act in the kidneys and how does this reduce blood pressure? At his two-week appointment at the outpatient clinic, Mr. Boulard complains of fatigue, weakness, muscle cramps, and irregular heartbeats. A physical examination and lab tests produce the following observations:
BP 133/90, HR 75, temperature 37.3°C
Blood K+ 2.9 mEq/L (normal 3.5–5.5 mEq/L); blood Na+ 135 mEq/L (normal 135–145 mEq/L)
Urine K+ 55 mEq/L (normal <40 mEq/L); urine Na+ 21mEq/L (normal >20 mEq/L)
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HUMAN ANATOMY+PHYSIOLOGY-PKG.
- Give typed explanation of all three otherwise leave it Answer the following questions: 1) The client for whom you are caring had the following for breakfast: 4 fluid ounces of milk, 6 fluid ounces of coffee, scrambled eggs, and one piece of toast. The client voided 4 fluid ounces of urine this morning. What is the person's fluid intake in millilitres? What is the person's fluid output in millilitres? 2) You are assisting with a 24-hour urine collection on a client assigned to your care. The client is in the dining room and chooses not to return to his room to collect the specimen; instead he voids in the nearest bathroom. Is it okay to just collect one extra sample and continue the collection? 3.You are caring for a client with Clostridium difficile.What precautions should you follow?arrow_forwardprovide handwritten solutionarrow_forwardRECORD THE HOURLY INTAKE AND OUTPUT USING THE TABLE PROVIDED. SHOW COMPLETE COMPUTATION IN THE TABLE- LABEL/ NAME ALL THE INATAKE PER You admitted a patient with hypotensive crisis; with the following data and doctor’s order Patient Juan Dela Cruz, 45 y/o, the patient NGT for gavage feeding every 4 hours. With Indwelling Foley Catheter for urine output monitoring 6:30am Clients VS BP=70/40 RR=15 PR=59 O2 Sat=98% monitor I &O every hour Doctor’s Order: Fluid Regimen: (R hand) Start IVF of D5LRS 1L to run for 8 hours using macroset with Side drip of Levophed: 2 ampules + 96 cc of PNSS x 15 ugtts/min stock dose of levophed (2ndline) L start IVF PNSS 1L x 10 gtts/min; To Start Blood transfusion of 2-unit PRBC once available properly typed and crossmatched You received the patient at exactly 7:00 AM and started the fluid regimen 8:00 AM – started gavage feeding of 1 glass osteorized feeding with 1/2 glass of plain water to dilute the feeding. 8: 30 AM -packed…arrow_forward
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