Fundamentals of Nursing, 9e
9th Edition
ISBN: 9780323327404
Author: Patricia A. Potter RN MSN PhD FAAN, Anne Griffin Perry RN EdD FAAN, Patricia Stockert RN BSN MS PhD, Amy Hall RN BSN MS PhD CNE
Publisher: Elsevier Science
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Chapter 30, Problem 8RQ
Summary Introduction
Tachycardia is also referred to as tachyarrhythmia. It is a condition in which the heart rate exceeds than the normal resting rate. Normal heartbeat rate is of 75 beats/minute. If the resting rate is above 100 beats per minute, this condition can be considered as tachycardia in the case of adults.
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DaVita Dietitian Reference Manual
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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
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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.…
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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…
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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…
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