Read the following case study and accompanying questions. On a Word doc, complete each question with explanations to support your answers. Designate the question number before each answer so the instructor can identify the answers. Accuracy and thoroughness in the answers will determine the points assigned. See the rubric.
Case Study
A client presents to the emergency department with fever, chills, abdominal cramping, and watery diarrhea with mucous and blood. After a CT of the abdomen, Ulcerative Colitis is diagnosed, and the patient is admitted to the hospital. The doctor orders IV antibiotics, pain medication, and IV fluids.
Sodium 139 mmol/L (Within normal limits)
Potassium 3.4 mmol/L (Low) Normal range 3.5 – 5 mmol/L
Chloride 97 mmol/L (Within normal limits)
White Blood Cells 19,280 (High) Normal range 4,500 to 11,000
Red Blood Cells 4.79 10*6/uL (Within normal limits)
Day 2
The patient continues to experience fever, chills, abdominal cramping, and watery diarrhea x 15 episodes per day. A regular diet is ordered. The patient consumes 0-25% per meal. IV antibiotics and fluids continue. IV potassium is ordered three times daily. Medications for pain as needed continue.
Potassium 3.2 mmol/L (Low) Normal range 3.5 – 5 mmol/L
Day 3
The patient continues to experience abdominal cramping and watery diarrhea x 15 episodes per day. Fever and chills are intermittent. Oral diet 0-25% consumed. IV antibiotics, fluids, and potassium continue. Pain medication as needed. Oral potassium was added.
Potassium 2.9 mmol/L (Low) Normal range 3.5 – 5 mmol/L
Answer Questions 1-4
Explain ulcerative colitis (etiology and symptoms) and which labs/symptoms are consistent with the diagnosis.
Why is a regular diet not appropriate for the diagnosis/symptoms? What is an appropriate diet order?
Why does the potassium continue to fall despite the patient receiving IV potassium? Explain your answer. (If you are struggling with this, look back in module 3 to determine why a person might be deficient and then look at the symptoms the patient is experiencing).
What concerns might the nurse have, and how would they address those?
Day 4
Pain with cramping continues. Diarrhea decreases to 8-10 episodes per day. New medications for colitis are ordered: Biaxin (antibiotic) and Bentyl (decreases GI cramping). Oral diet 25% consumed.
Potassium 3.9 mmol/L (within normal limits)
Later in the day, the patient developed large swelling on the lips and raised red blotches with itchiness on the extremities.
Answer Question 5
5. What are these new symptoms likely due to? How should the nurse respond?
I HAVE ATTACHED THE RUBRIC ALSO.
