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Fundamentals of Nursing

Competency-Based Assessments

Fundamentals of NursingCompetency-Based Assessments

Competency-Based Assessments

1 .
Use the internet to research dietary practices to improve electrolyte abnormalities in patients with renal disease. Describe common dietary guidelines for patients with chronic kidney disease.

Marika, a 45-year-old patient, presents to the emergency department with complaints of persistent vomiting, diarrhea, and abdominal pain for the past 24 hours. She reports feeling weak and lightheaded.

Laboratory Results:

  • pH: 7.28
  • PaCO2: 32 mm Hg
  • HCO3: 18 mEq/L
  • sodium (Na+): 140 mEq/L
  • potassium (K+): 3.2 mEq/L
  • chloride (Cl): 96 mEq/L
2 .
Identify whether each lab is normal or abnormal.
3 .
Based on the lab results, does Marika’s pH suggest acidosis or alkalosis?
4 .
According to Marika’s labs, which acid-base balance is she experiencing?
5 .
Many patients with chronic obstructive pulmonary disease (COPD) have chronic respiratory acidosis. Spend fifteen minutes reviewing COPD signs and symptoms. What trends in acid-base imbalance would nursing expect in a patient with COPD who presents with a productive cough and fever?
6 .
A patient with chronic kidney disease presents to the emergency department with a decrease in urine output from baseline and evidence of fluid overload. An electrolyte panel is sent that shows the following: Na+ of 130 mEq/L, K+ of 5.4 mEq/L, Ca+ of 10.2 mg/dL, and a phosphate level of 4.3 mmol/L. Based on the laboratory values, what is the highest priority for this patient?
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