E.G. is a 70-year-old woman whose daughter

E.G. is a 70-year-old woman whose daughter brings her to see the doctor because she has had a case of the “stomach flu,” with vomiting and diarrhea for the past 3 to 4 days and is now experiencing occasional light-headedness and dizziness. Her medical history includes hypertension, hypercholesterolemia, and mild heart failure. She is taking: ï‚· Digoxin 0.125 mg po daily ï‚· Captopril 25 mg po twice daily ï‚· Furosemide 40 mg po daily ï‚· Potassium chloride 20 mEq po daily ï‚· Atorvastatin 20 mg po at bedtime Subjective Data ï‚· Has been following a low-sodium diet ï‚· States her abdomen feels bloated and she has been constipated since the onset of the “flu” ï‚· Has been taking her medications except for the potassium chloride pill because it upsets her stomach. ï‚· Occasionally takes an extra “water pill” when her ankles are swollen Objective Data ï‚· Temperature 98.2°F, pulse 88, respirations 20, BP 138/86 ï‚· Lungs clear to auscultation, breathing regular and unlabored ï‚· +1 edema bilaterally in ankles ï‚· Muscle strength in upper extremities normal and equal and in lower extremities weak ï‚· Sensation to all extremities normal ï‚· Abdomen distended with hypoactive bowel sounds Diagnostic Studies Na =139 K =3.0 Cl =99.5 Total Ca =8.4 Mg =1.5 Phos =2.7 BiCarb =25.4 Questions: Explain specifically how furosemide works in the kidney. How would you assess E.G., for fluid volume deficit? What IV fluids would you expect the physician to order? How would you expect to replenish the potassium? Explain the rationale and include nursing interventions. What symptoms does E.G., have that support hypokalemia?

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