NURS 3380 CASE STUDY FLUID AND ELECTROLYTE
Fluid and Electrolyte Case Study
Breanna Lively, RN
Nursing 3380 Pathophysiology for
RN’s Austin Peay State University
School of Nursing
June 11, 2019
, FLUID AND ELECTROLYTE 2
Fluid and Electrolyte Case Study
L.S. is brought to the emergency department for management of acute acetaminophen
poisoning. Her respirations are slow and shallow, and she is nonresponsive. She is admitted to
the critical care unit to be closely monitored for the development of respiratory failure and renal
failure, which often accompany acetaminophen poisoning. Her urine output is decreased to about
20 mL/hr. Her laboratory values are serum K+ = 5.7 mEq/L; arterial blood gases (ABGs): pH =
7.13, PaCO2 = 56 mm Hg, PaO2 = 89 mm Hg, and HCO3- = 18 mEq/L. Answer the following
questions about LS’s situation.
1. What is the most likely cause of LS’s potassium imbalance? Explain the role of
the kidney in potassium excretion?
The most likely cause of LS’s hyperkalemia is probably acute kidney injury (AKI).
Usually the kidneys in normal function will excrete 90% of your daily potassium intake (Clegg
and Palmer, 2016). “Metabolic acidosis occurs with the retention of acidic waste products of
metabolism. It is also produced in association with hyperkalemia, when potassium ions in the
blood are exchanged for intracellular hydrogen ions, lowering the pH of the blood” (Copstead
and Banasik, 2018, p. 603).
Clegg, D. J., & Palmer B. F. (2016). Physiology and pathophysiology of potassium homeostasis.
Advances in Physiology Education, 40(4), 480-490.
doi:10.1152/advan.00121.2016 Copstead, L. E., & Banasik, J. L. (2018). Pathophysiology.
St. Louis, MO: Elsevier.
2. What is the relationship between acid-base balance and serum potassium level?
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