All This Fluid!

All This Fluid!

1. emesis at home

   • when did she vomit last?
   • How much?
   • what did it look like?
   • possible causes?

2. K = 2.9, Na = 130, creat & BUN are up

   • what is normal?
     • Serum Potassium, K = 3.5-5.0  mEq/L  Serum Sodium, Na  135-147 mEq/LBUN - blood urea nitrogen 7-20 mg/dLBUN: Cr - creatinine ratio 10-20:1
   • what do these results mean?
     • Inc. BUN: Cr may indicate dehydration, GI bleeding, increased catabolism Inc. BUN may indicate acute glomerulonephritis, ahminoglycosides, burns, chronic nephritis, dehydration, GI bleeding, renal failure, shock, stress K is low but no critical (< 2.5 would be critical) could indicate alkalosis, ascites, burns, chronic pyelonephritis, bushings syndrome, diarrhea, low potassium intake, RTA type I II, VOMITTING, drugs: diuretics, salicylate, insulin Na is low which could indicate AIDS, adrenal insufficiency, CHF, cirrhosis, cyclophosphamide, exercise, heavy sweating, nephrotic syndrome, NG suctioning, SIADH, VOMITING, water intoxication, Drugs: ACE inhibitors, D5W, diuretics, hypotonic saline, thiazides
     • do these labs diagnose her pain?
     • any immediate danger?
     • care for person with E& F imbalance

3. ER inserted an NG tube

   • why?

4. IV running

   • Why?

5. still in pain

   • call Dr?
     • what else do I need to know before I call?
       • SBAR
   • has anything been prescribed for her pain?
     • how long ago did she have it?
       • when's next dose?
   • pain score?
   • assessment & intervention PQRST
     • AS WELL AS BOWEL OBSTRUCTION AND PAIN

6. is she on any medications?

7. reason for going to the hospital?

8. Admitting diagnosis?

   • plan of treatment
   • diagnostic tests

9. age

10. More about her

    • family, social support,
      • power flower for interviewing & integrating family
    • health history