Mrs. T has just been admitted to your telemetry unit. She is 82 years old and reports that she has been home

Mrs. T has just been admitted to your telemetry unit. She is 82 years old and reports that she has been home-bound for about a week with “the flu.” She also reports that she had several days of nausea and vomiting and has not been eating or drinking much since she got sick. She informs you that she has a long history of “heart problems” and is taking a drug for heart disease and a diuretic daily but has not been able to take either because of her nausea. Mrs. T had a complete lab panel drawn on admission, and you have just been informed that her serum potassium level is 2.8 mEq/L. You go to her room to reassess her.

1. List at least two clinical findings consistent with hypokalemia for each of the assessments below:
2. Neurologic:
3. Cardiovascular:
4. ECG changes:
5. Gastrointestinal:
6. Musculoskeletal:

1. Is Mrs. T at risk for cardiac emergency? Why or why not?
2. Should you be concerned about her potassium level because she has a history of coronary artery disease and is taking a drug for heart disease? Why or why not?
3. From her recent history, what are the most likely causes of her hypokalemia?
4. If Mrs. T is experiencing fluid volume deficit (FVD) from her vomiting, what would you anticipate her serum sodium level would be?
5. It is determined that Mrs. T is experiencing FVD. The provider orders a moderate fluid challenge. What type of IV fluid would the provider likely order?

D5W

0.9% normal saline

Hypertonic saline

0.225% saline