Problem
You are a registered nurse working on an acute care medical-surgical unit. You receive a call from the emergency department (ED) that you will be receiving Adele Long, an 82 y.o. woman with a 3-day history of intermittent abdominal pain, abdominal bloating, nausea, and vomiting. The patient's medical history includes a colectomy for colon cancer 6 years ago, ventral hernia repair 2 years ago, and mild arthritis. She has no history of coronary artery disease, diabetes mellitus, or pulmonary disease. She takes only Tylenol occasionally for the arthritis. Allergies include shellfish, sulfa drugs, and meperidine. The admitting diagnosis is gastroenteritis. She is admitted to your unit for diagnostic workup. Her VS are BP 92/60, P 90, R 16. She has an I.V. started with a 22 over-the-needle catheter in her right hand, infusing D5/1/2 NS with 20 mEq KCl at 100 mL/hr and has 2 L O2/nc.
The results of the laboratory orders include:
Hgb: 12.5 Urine specific gravity: 1.035
Hct: 47 BUN: 20 mg/dL
Potassium: 3 mEq/L Creatinine: 0.8
Sodium: 133 mEq/L
Calcium: 9.1 mEq/L
Magnesium: 1.6 mg/L
Chloride: 92 mEq/L
Serum osmolality: 295
Task
I. Based on information from the ED and the presenting picture, what orders would you anticipate?
II. What problems might you anticipate with her I.V. placed in the ED?
III. Review laboratory test results in the textbook and identify which laboratory values indicate possible fluid and electrolyte imbalances. Are any values of concern to you?