Complex Fluid & Electrolytes

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N.H., a 65-year-old female is admitted to your unit with a chief complaint of nausea, vomiting, and diarrhea for the past 3 days. Her medical history reveals that she is being treated for hypertension with hydrochlorothiazide. N.H. states that she is exhausted and has been experiencing leg cramps that keep her from being able to sleep.

You assess the patient.

Vital Signs
Temperature 38.8 degrees Celcius
Heart Rate 102 and irregular
Blood Pressure 90/50

The patient has absent bowel sounds upon assessment. You also note poor muscle tone and skin turgor.

Noteworthy labs:
Potassium 2.9 mEq/L
Sodium 137 mEq/L
Chloride 97 mEq/L
WBC 20,000/ul

Physician Orders:
IV D5/0.9% NaCl with 20 mEq KCl/L to infuse at 90 mL/hr
40 mEq of KCl IV over the next 2 hours
Repeat potassium level 30 minutes after 40 mEq KCl has infused
NPO

Hammond, J. (2005, September 5). RN reentry F&E, acid-base & shock case studies. Retrieved from https://www.pcc.edu/staff/pdf/892/f&ecasestudies.pdf

Which of the above orders would you question? *

1 point

IV D5/0.9% NaCl with 20 mEq KCl/L to infuse at 90 mL/hr

40 mEq of KCl IV over the next 2 hours

Both 1 and 2

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