Group 1

You are the R.Ncaring for a 65-year-old woman admitted last evening with a recenthistory of cellulitis and a 3-day history of persistent vomitingand diarrhea. She takes no medications at home, other than a dailymultivitamin. Her weight on admission was 153 pounds. The patientstates her original weight is 165 pounds (75 kg). The nurse notesthat the patient’s mucous membranes and skin are dry. Vital signsare temperature 99.8° F, pulse 112, respirations 32, and bloodpressure 100/76. Her urine output over the last 8 hours is125 mL. Labs reveal thefollowing:

K+ 3.5 mEq/L	Hematocrit 53%	Urine specific gravity1.033
Na+ 159 mEq/L	Hemoglobin 20 g/dL	Blood urea nitrogen (BUN) 28mg/dL
Cl- 120 mEq/ L	Serum glucose 163 mg/dl

ABGresults

pH	7.30
PaCO2	2 mm Hg
HCO3	17 mE/L
PaO2	88 mm Hg

1. Analyze the assessment andlaboratory findings and explain the patient’s fluid volume status.(USLO 1, 6)

2. This patient’s symptoms aremost likely a result of which acid-base imbalance? Explain therationale. (USLO 1)

3. The bicarbonate level of17 mEq/L is the result of whichfactor? Which ABG finding indicates a worsening acid-baseimbalance? (USLO 1)

4. What priority nursing andcollaborative interventions do you anticipate for this patient?(USLO 1,6, 7)

5. Describe what interventions canbe delegated to an unlicensed assistive personnel (UAP). Explainyour rationale. (USLO 8)

Group 2