Careers in Nursing Specialties by Institute for Career Research

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Fluid overload may lead to pulmonary congestion, impaired gas exchange, and ineffective breathing. Oliguria or anuria Tachycardia Bibasilar crackles Irritability, drowsiness, or confusion Altered level of consciousness Bleeding abnormalities Dry, pruritic skin Dry mucous membranes Uremic breath odor DIAGNOSTIC TEST RESULTS NEUROLOGIC SYSTEM ◆ Altered mental status and peripheral TREATMENT ◆ nine, and potassium levels are elevated. Hematocrit, blood pH, bicarbonate, and hemoglobin levels are decreased.

Serum potassium, sodium, lactate dehydrogenase, BUN, and creatinine levels are elevated. ◆ Urine specific gravity is increased. ◆ ABG analysis reveals respiratory acidosis. ◆ ◆ ◆ ◆ ◆ ◆ ◆ ◆ Administer vitamin K and folate. Institute safety precautions to minimize bleeding. Assess extent of fluid loss. Administer fluid and blood replacement immediately. Administer supplemental oxygen. Monitor respiratory status and pulse oximetry. Monitor vital signs continuously for changes. Anticipate the need for intubation and mechanical ventilation.

35. Partial pressure of arterial carbon dioxide (Paco2) may be normal or less than 34 mm Hg; bicarbonate level may be less than 22 mEq/L. 5 mEq/L. ◆ Anion gap is greater than 14 mEq/L. ◆ ◆ Correct the underlying cause. V. ◆ Frequently monitor vital signs, laboratory results, and level of consciousness (LOC) because changes can occur rapidly. ◆ Evaluate and correct electrolyte imbalances. ◆ Because metabolic acidosis commonly causes vomiting, position the patient to prevent aspiration. ◆ Record intake and output carefully to monitor renal function.

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