Qu.1 1) fluid intake/output recording
Qu.2 1) hyperaldosteronism: electrolyte imbalance caused = hypernatremia; hypokalemia; hypomagnesemia (Hyperaldosteronism, 2004).
2) chronic renal failure: electrolyte imbalance caused = inability to compensate for extreme solute loading or deprivation; hyperkalemia; hyponatremia; hyperphosphatemia (Rajavel and Kao, 2004).
3) loop and thiazide diuretics: electrolyte imbalance caused = hyponatremia; hypokalemia, hypomagnesemia (Electrolyte, 2004; Nicholls, 1990).
Qu.4 Kathleen B. Is suffering from dehydration. Her blood pressure is low, peripheral pulses are weak, her heart rate is rapid and irregular, she is in metabolic alkalosis because she has a blood pH of 7.52, and a HCO3 level of 43 mEq/L, with a raised pCO2 level of 55 mmHG. Since she is taking diuretics for chronic heart failure, she has possibly overdosed on them, or has taken in insufficient fluids, which is a common problem with the elderly. Other causes of metabolic alkalosis are an excessive intake of alkaline substances, or repeated vomiting, which is the most common cause of metabolic alkalosis (Applegate, 2000, 390). The generalized weakness and mental confusion, decreased skin turgor and dryness of the mucous membranes are a result of the severe dehydration, which is borne out by blood values: decreased Na, K and Cl, and by the abnormal heart rhythm on ECG.
Qu.5 Kathleen B needs immediate intravenous fluid replacement with balanced electrolytes to restore her blood values to normal. Her fluid intake/output needs to be monitored carefully, and her weight should be checked daily. She should be placed on a cardiac monitor until her heart rhythm returns to normal and is stabilized. Her ECG should be checked regularly until it is consistently free of abnormalities (Monitoring, 1004). Ka
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