Jared Swollen, suffering from chronic renal failure, was in the hospital in seri

Question

Jared Swollen, suffering from chronic renal failure, was in the hospital in serious condition recovering from a heart attack He had just undergone "balloon angioplasty" to redilate his left coronary artery, and was thus on an npo" diet (i.e. he was not allowed to have food or drink by mouth). He received fluid through an intravenous (TV) line. Late one night, a weary nurse who was on the 11th hour of a 12-hour shift came into the patient's room to replace the man's empty IV bag with a new one. Misreading the physician's orders, he hooked up a fresh bag of IV fluid that was "twice-normal" saline rather than "half-normal" saline (in other words, the patient starting receiving a fluid that was four times saltier than it should have been). This mistake was not noticed until the following morming. At that time, the man had marked pitting edema around the sacral region and had inspiratory rales (wet-sounding crackles) at the bases of the lungs on each side. He complained that it was difficult to breathe as well. a) Will the nurse's mistake increase or decrease the "saltiness" of the interstitial fluid? b) Given your knowledge of osmosis, will this cause the cells in the body to increase or decrease in size? c) Why does this patient have pitting edema? d) What symptoms might result from hypenatremia (high blood-sodium level)? e) How is this patient's interstitial edema in the lungs affected by his already-weakened heart? T TTArial 3(12pt)

Explanation / Answer

Answers

a) nurse mistake will have no effect on the saltiness of the intestinal fluid because fluid is given by IV route.

b) The condition given in the question will cause decrease in cell size due to osmosis. Because there is more saltiness or concentration outside the cell so fluid will move from cell to plasma. This will cause decrease in cell size.

c) Patient is having pitting edema because of high saltiness or concentration of the body fluid. This will cause more water retention and swelling.

d) Hypernatrimea or high blood sodium level causes dehydration, thirst, fatigue, restlessness, irritability, altered sensorium, dry mouth, fast heart rate,decrease in urine production etc.

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