Arginine Vasopressin

The patient in “The Red Hat Hikers” scenario is suffering from hyponatremia. Hyponatremia is defined as a serum sodium level of less than 136mEq/L. Sodium is an electrolyte that is found predominately in the extracellular fluid, and it is the chief regulator of water in the body. Sodium is also important for muscle contraction, nerve impulses, acid-base balance and chemical reactions that occur inside the cell (McCance & Huether, 2014). Normal sodium levels in the body are maintained by the kidneys and the hormone aldosterone. Aldosterone is secreted by the adrenal cortex at the completion of the renin-angiotensin-aldosterone system, and it helps stimulate the proximal tubules of the kidneys to reabsorb sodium and water. The anti-diuretic hormone (ADH) also indirectly affects sodium levels because it regulates water balance in the body (McCance & Huether, 2014).

Dosages of the drug vary from one extreme to another based upon the patients needs.

One of these symptoms is jaundice, which is characterized by yellowish skin and eyes because of an inability of the liver to remove bilirubin from the blood. Patient with cirrhosis also suffering from itching, due to deposited bile's products in the skin. This patient also suffers from accumulation of fluid in legs that is called edema. As a result of the blockage of blood flow via the liver, fluid accumulation in abdomen which is worsen by the decrease in protein production. Other symptoms include fatigue, weakness, loss of appetite, weight loss and nausea. As the disease progress, complications may develop ,such as varices that happens with cirrhosis patient when the blood flow through the liver slows, so the blood from intestine go back to the vessels of the stomach and esophagus, these vessels are not meant to carry this much of blood so they dilate (varices), with increasing

In patients stabilised on diuretic therapy, the recommended initial dose is 1.25 mg daily. The dose should be doubled every 1-2 weeks up to a maximum dosage of 10 mg with two administrations daily.

A nurse should maintain doses administration as per repeated cycle of frequencies every 4 hours or 3 hours per day. Guidelines that facilitate the administration of time-critical

a. -in both hepatic functions are not functioning well hence requires calculation adjustments of drugs to suit the patient needs

4. Is it possible to know the percentage of liver cirrhosis? In other words is the organ completely affected and it's not functioning?

CBC lab results can look normal or they can reflected hydration as polycythemia (shown as a high hematocrit level). A lack of insulin is present. This deficit in insulin causes glucose not to be taken into the cells of the body leaving glucose floating free in the blood stream. The increase in glucose can be determined on a CBC panel as well. Biochemical panels will most likely show liver abnormalities if the underlying cause if hepatic Lipidosis, pancreatitis, or extrahepatic biliary obstruction with severe pancreatitis. ALT and ALP levels become elevated in these cases. An increased BUN and creatinine m be high with either primary renal disease or pre-renal azotemia. Caused by dehydration or hypovolemia. Hyperlipidemia may also

More rapid administration can result in respiratory depression, apnea, and an enhanced pressor response. Usual induction doses are 1 - 2 mg/kg IV and will produce 5 - 10 minutes of surgical anesthesia.

The ideal time for taking this drug is morning and splitting the dose is not necessary which may induce insomnia among some people.

- Patients who present “early” (within 8 hours of ingestion) only require a serum acetaminophen determination. In those patients who require acetylcysteine treatment, liver enzymes, serum electrolytes, and renal function should be monitored.

The therapy ordered by the doctor for the patient includes 1000 mL of Dextrose 5% in 0.90% sodium chloride (normal saline), or D5NS, with 30 mEq of potassium chloride, KCl, at 125 ml/hr, which is a hypertonic tonicity. The D5NS restores fluid balance in the body due to fluid loss caused by hypernatremia or the elevation of sodium levels in the body. The potassium chloride will be used to manage hypokalemia. The dilution of the drug must be checked and rechecked due to the high concentration. The nurse should assess the patient hourly for symptoms of excessive losses of fluid, sodium, or potassium as well asks the patient if there is any burning or pain at the IV site. The order of 100 mL of albumin 25% draws fluid from the interstitial

The finished dosage form is a pre-filled syringe, which contains the liquid dosage. The drug should be administered subcutaneously by injection, after a period of 60 minutes, prior to consuming morning and afternoon meals. These dosage times are critical for maintaining efficacy and clinical significance as the drug slows the rate of gastric emptying, reducing the rate of meal derived glucose (Bond 2006).

Consider a fluid restriction to prevent possible fluid overloading due to his decreased renal function (Vera, 2011).

Clarify the order with the Physician involved. Refer to the drug guide or any reliable source if necessary.