NUR 641E Topic 3: Fluid, Electrolyte, And Acid-Base Pathophysiology

Objectives:

  1. Describe normal pathophysiology and alterations in electrolytes and their presentations.
  2. Differentiate between acid-base imbalances: metabolic acidosis or alkalosis and respiratory acidosis or alkalosis.
  3. Compare the role of the respiratory and renal systems in regulating acid-base balance.
  4. Describe a pharmacological intervention using an evidence-based treatment guideline.

Topic 3 DQ 1

Mar 17-19, 2022

Choose a medical condition from the fluid, electrolyte, or acid-base system and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder? Make sure that you select a different medical condition than your peers. Include the name of the medical condition in the subject line so that the medical conditions can be followed. Include your references in APA style.

REPLY TO DISCUSSION

NS

Nicole Santos

Posted Date

Mar 21, 2022, 8:06 PM

Read

Replies to Nicole Santos

Hypercalcemia is a condition where calcium level in the blood are elevated. Elevated calcium level in the blood can weaken the bones, form kidney stones, and affect the cardiac and brain function. Overactive parathyroid glands are typically the cause of hypercalcemia, other causes are cancer, other medical issues and medications, and taking too much calcium and vitamin D supplements.

Hypercalcemia can affect the following:

  • Kidneys: makes kidney work harder causing excessive thirst and frequent urination
  • GI system: stomach disturbances, nausea, vomiting, constipation
  • Bones and Muscles: weak and brittle bones, bone pain, muscle weakness
  • Brain: confusion, lethargy, fatigue, depression
  • Heart: palpitations, fainting, arrhythmia

Some patient education in patients would be to inform of signs and symptoms of hypercalcemia; inform for risk of kidney stones; drink plenty of water; avoid food high in dairy or calcium; discontinue calcium supplements; refrain from using antacids with calcium and opt for antacids with magnesium.

References

McCance, K. L., & Huether, S. E. (2018). Pathophysiology – e-book: The biologic basis for disease in adults and children (8th ed.). Mosby. https://bibliu.com/app/#/view/books/9780323413206/epub/OPS/xhtml/chp00007.html

Topic 3 DQ 2

Mar 17-21, 2022

Select a medication used in evidence-based treatment guidelines for the condition chosen in the first discussion question. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions of which one should be aware. Make sure that you select a different medication than your peers. Include the name of the medication in the subject line so that the medications can be followed. Include your references in APA style.

REPLY TO DISCUSSION

VB

Vanessa Brown

Posted Date

Mar 22, 2022, 9:36 PM

Read

Replies to Vanessa Brown

Magnesium sulfate

Magnesium sulfate is an evidence-based treatment used to treat hypomagnesemia. Depending on the severity of the hypomagnesemia and the stability of the patient, the administration can be oral, intravenous, intraosseous (if no other route is possible), or intramuscular. It can be combined with dextrose 5% or water to make intravenous solutions (Hicks & Tyagi, 2022). If given orally, it causes an osmotic shift in fluid; if given parenterally it will be broken down to elemental magnesium, and be used to replete and maintain circulating magnesium stores (Hicks & Tyagi, 2022). An increase in the serum concentration of magnesium occurs.When repleting magnesium in patients with abnormal kidney function, it is recommended that doses be reduced to prevent hypermagnesemia. After magnesium sulfate is administered parenterally, monitoring of the serum levels should be drawn every 6-8 hours (Hicks & Tyagi, 2022). Clinical assessment of patellar reflexes, urinary output, and possible signs and symptoms of hypermagnesemia should be monitored, too. Some of the common side effects of giving this parenterally within the therapeutic range are facial flushing and warmth (Hicks & Tyagi, 2022). If it is given parenterally and too quickly or in high doses, it can lead to hypotension absent reflexes, weakness, decreased respiratory drive, and abnormal cardiac conduction (Hicks & Tyagi, 2022). If a therapeutic dose is taken orally, nausea and loose stools can result. Several drug interactions may occur but vary greatly in severity. Some of the drugs to speak to your doctor about before taking magnesium are aminoglycoside antibiotics, such as amikacin and gentamicin, because if taken together respiratory depression may result (Magnesium sulfate interactions, n.d.). Taking medications that help with increasing calcium levels, such as calcium or Vitamin D medications, could increase the risk for hypermagnesemia (Magnesium sulfate interactions, n.d.).

References

Hicks, M., & Tyagi, A. (2022). Magnesium Sulfate. NCBI. https://www.ncbi.nlm.nih.gov/books/NBK554553/

Magnesium sulfate interactions. (n.d.). Drugs.com. https://www.drugs.com/drug-interactions/magnesium-sulfate.html