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Strayer,Devery,Harvard University
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I need help doing my case studies.
Case Study #2, Fluid and Electrolyte and Acid–Base ImbalancesConrad Jackson is a 28-year-old man who presents to the emergency department with severe fatigue and dehydration secondary to a 4-day history of vomiting. During the interview, he describes attending a family reunion and states that perhaps he “ate something bad.” Upon admission his vital signs are a temperature of 102.7°F, heart rate of 116 bpm, respiratory rate of 18 breaths/min, and blood pressure of 86/54 mm Hg. The nurse also notes the patient has dry mucous membranes and tenting of skin. The physician orders an IV to be started with 0.45% normal saline, and orders a serum electrolytes and an arterial blood gas.
The following results are returned from the laboratory:
Sodium (Na+) 150
Potassium (K+) 5.5
Chloride (Cl¯) 110
BUN 42
Creatinine 0.8
Glucose 86
pH 7.32
PaCO2 35
HCO3¯ 20
PaO2 90
O2 Sat 98%
Explain why the physician ordered 0.45% normal saline.
What other orders might you expect from the provider?
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