A 39 year-old woman is brought to the emergency department by her husband

Discussion 1.1 – Case Study One

A 39 year-old woman is brought to the emergency department by her husband. She is conscious but confused and keeps repeating that her head hurts so much she feels it might “explode.” The husband tells you that she has no health problems and takes no medications other than aspirin for occasional pain. He also tells you that she entered a contest earlier today to try and drink the most water in 1 hour. She drank 10 glasses but did not win the contest and came home. Her confusion and headache started about an hour later.

What type of fluid or electrolyte imbalance is she likely to have and from what cause? Explain your answer.

What physical assessment data are the priority to obtain? Explain.

What laboratory data would you expect to be ordered?

Is this patient at risk for heart failure or pulmonary edema? Why or why not?

For details regarding grading criteria and posting requirements, please see the grading rubric. Contact your instructor if you have issues or concerns.

Discussion 1.2 – Case Study Two

The patient is a 29 year old woman admitted 20 hours ago for an acute exacerbation of Crohn’s disease with intense abdominal pain. She is NPO and receiving normal saline intravenously at 175 mL per minute. She was last given hydromorphone (Dilaudid) 4 mg IV 30 minutes ago. Because she did have an episode of hypotension earlier after Dilaudid, you now take her vital signs. On inflating the blood pressure cuff, she develops palmar flexion. The flexion remains after the cuff is deflated.

What is most likely the cause of this problem?

What electrolytes are most likely to be out of balance and why?

What is your best first action?Should the Rapid Response Team be called? Why or why not?

What additional assessment data are most important to collect? Explain your answer.

For details regarding grading criteria and posting requirements, please see the grading rubric. Contact your instructor if you have issues or concerns.