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.