Case Study 1

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1. Background: Ms. C. is a 53 y/o female with admitted to 2A with complaints of severe right abdominal pain. She is a pleasant lady with a friendly demeanor and asks for very little assistance. Mrs. C is morbidly obese which makes it difficult to get out of bed without assistance but for the most part, she can ambulate and walk around on her own once she is out of the bed with the assistance of a walker. Because of her obesity, Ms. C has several skin folds throughout her body, which make a great medium for fungal infections. The area underneath her skin folds is red and irritated. Ms. C has had oliguria for the past several days and is outputting very little to no urine. A foley catheter has been placed in order to remove any…show more content…
o D5W 1000 mL with Sodium Bicarb 100 mEq IV: o Intravenous Sodium Bicarbonate therapy increases plasma bicarbonate, buffers excess hydrogen ion concentration, raises blood pH and reverses the clinical manifestations of acidosis. o Sodium Bicarbonate is indicated in the treatment of metabolic acidosis which may occur in severe renal disease, uncontrolled diabetes, circulatory insufficiency due to shock or severe dehydration, extracorporeal circulation of blood, cardiac arrest and severe primary lactic acidosis. Sodium Bicarbonate is further indicated in the treatment of certain drug intoxications, including barbiturates (where dissociation of the barbiturate-protein complex is desired), in poisoning by salicylates or methyl alcohol and in hemolytic reactions requiring alkalinization of the urine to diminish nephrotoxicity of hemoglobin and its breakdown products. Sodium Bicarbonate also is indicated in severe diarrhea which is often accompanied by a significant loss of bicarbonate. o Side Effects: Frequent urge to urinate, headache (continuing), loss of appetite (continuing), mood or mental changes, muscle pain or twitching, nausea or vomiting, nervousness or restlessness, slow breathing, swelling of feet or lower legs, unpleasant taste, unusual tiredness or weakness o o Furosemide (Lasix) o Furosemide, a 'water pill,' is used to reduce the swelling and fluid retention caused by various

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