Fluid and Electrolyte Imbalance Case Essay

Fluid and Electrolyte Imbalance Case

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Patient Profile
S.S., a 63-year-old white woman with lung cancer,
has been receiving chemotherapy on an outpatient
basis. She completed her third treatment 5 days ago
and has been experiencing nausea and vomiting for
2 days even though she has been using ondansetron
(Zofran). S.S.’s daughter brings her to the hospital,
where she is admitted to the medical unit. As the
admitting nurse, you perform a thorough assessment.
Subjective Data
• Complains of lethargy, weakness, dizziness, and dry mouth
• States she has been too nauseated to eat or drink anything for 2 days
Objective Data
• Heart rate 110 beats/min, pulse thready
• BP 100/65
• Weight loss of 5 lb since she received her chemotherapy treatment 5
days ago
• Dry oral mucous membranes
Discussion Questions
1. Based on her clinical manifestations, what fluid imbalance does S.S.
have?
2. What additional assessment data should you obtain?
3. What are her risk factors for fluid and electrolyte imbalances?
4. You draw blood for a serum chemistry evaluation. What electrolyte
imbalances are likely and why?
5. S.S. is at risk for which acid-base imbalance? Describe the changes that
would occur in S.S.’s ABGs with this acid-base imbalance. How would
the body compensate?
6. The physician orders dextrose 5% in 0.45% saline to infuse at 100 mL/
hr. What type of solution is this, and how will it help S.S.’s fluid
imbalance?
7. Priority Decision: What are the priority nursing interventions for S.S.?
8. Evidence-Based Practice: S.S. has a double-lumen PICC in her left
arm. One lumen is connected to the IV infusion; the other is unused.
What is the recommended practice for maintaining the patency of the
unused lumen?

Grading Rubrics

Critical Elements

Distinguished

(100%)

Proficient

(85%)

Basic

(70%)

Below Expectations

(50%)

Non-Performance

(0%)

Thesis Statement

Raises the strongest objection to the thesis presented in the assignment. The objection is strongly grounded in research and logical reasoning.

Raises a plausible objection to the thesis presented in the assignment. The objection is mostly grounded in research and logical reasoning.

Raises an objection to the thesis presented in the assignment. The objection is somewhat grounded in research and logical reasoning.

Attempts to raise an objection to the thesis presented in the assignment. The objection is minimally grounded in research and logical reasoning.

The objection to the thesis is either nonexistent or lacks the components described in the assignment instructions.

Counter Argument

Provides a strong, thorough rebuttal to the objection. The rebuttal effectively demonstrates that the thesis can withstand the objection and applies the principles of charity and accuracy.

Provides a rebuttal to the objection. The rebuttal mostly demonstrates that the thesis can withstand the objection and mostly applies the principles of charity and accuracy.

Provides a limited rebuttal to the objection. The rebuttal somewhat demonstrates that the thesis can withstand the objection and somewhat applies the principles of charity and accuracy.

Attempts to provide a rebuttal to the objection; however, the rebuttal minimally demonstrates that the thesis can withstand the objection and does not apply the principles of charity and accuracy.

The rebuttal is either nonexistent or lacks the components described in the assignment instructions.

Conclusion

– Provides clear and concise closing remarks that comprehensively summarize the essay. The remarks consider the broader controversy and/or further research that could offer additional insight into the moral solution of the business problem.

Provides closing remarks that summarize the essay. The remarks mostly consider the broader controversy and/or further research that could offer additional insight into the moral solution of the business problem. The closing remarks are somewhat unclear.

Provides closing remarks that minimally summarizes the essay. The remarks minimally consider the broader controversy and/or further research that could offer additional insight into the moral solution of the business problems. The closing remarks are unclear and/or vague.

Attempts to provide closing remarks that summarize the essay, however, the remarks do not consider the broader controversy and/or further research that could offer additional insight into the moral solution of the business problem. The closing remarks are unclear and vague.

The closing remarks are either nonexistent or lack the components described in the assignment instructions.

Written Communication: Context of and Purpose for Writing

Demonstrates methodical application of organization and presentation of content. The purpose of the writing is evident and easy to understand. Summaries, quotes, and/or paraphrases fit naturally into the sentences and paragraphs. Paper flows smoothly.

Demonstrates sufficient application of organization and presentation of content. The purpose of the writing is, for the most part, clear and easy to understand. There are some problems with the blending of summaries, paraphrases, and quotes. Paper flows somewhat smoothly.

Demonstrates a limited understanding of organization and presentation of content in written work. The purpose of the writing is somewhat evident but may not be integrated throughout the assignment. There are many problems with the blending of summaries, paraphrases, and quotes. Paper does not flow smoothly in all sections.

Organization and presentation of content are extremely limited. The purpose of the writing is unclear. There is little or no blending of summaries, paraphrases, and quotes. Paper does not flow smoothly when read.