Difficulty: Medium
Average Score: 80%
Simulated
Passage / Scenario
History and physicalThe client is a 52-year-old female with a history of obesity, type 2 diabetes mellitus, and hypertension. She is in the hospital for treatment of cellulitis of the right leg. The client has a peripherally inserted central catheter (PICC) in her right antecubital vein. She is currently on day 4 of her antibiotic course.
Nurses notes :
The client had a large, loose stool.
Laboratory Results
Laboratory Test Result Reference Range
Blood Glucose 104 mg/dL (5.8 mmol/L) 74 to 106 mg/dL. (4.1 to 5.9 mmol/L)
Orders:
ÔÇó Vital signs every 4 hours
ÔÇó Regular diet
ÔÇó Cefazolin 1 g IV every 8 hours for 5 days
ÔÇó Metformin 1,000 mg PO every 12 hours
ÔÇó Point of care blood glucose check every 4 hours
Patient Data
Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.
Rationale
Condition:
Osmotic diarrhea
osmotic diarrhea. This type of diarrhea is often caused by an imbalance in the osmolality of the intestinal contents, which can be due to certain medications or dietary factors. In this case, the client's recent antibiotic therapy and diet might contribute to this condition.
Actions to Take:
Collect stool for culture ÔÇô This can help determine if there is an infectious or bacterial component contributing to the diarrhea.
Start a high fiber diet ÔÇô Increasing dietary fiber can help in managing diarrhea by increasing stool bulk and improving consistency.
Parameters to Monitor:
Serum potassium ÔÇô Osmotic diarrhea can lead to electrolyte imbalances, and monitoring potassium levels helps to detect potential deficiencies.
Serum ketones ÔÇô This can help to evaluate if the client is in a state of ketosis due to potential malabsorption or significant diarrhea.
Osmotic diarrhea
osmotic diarrhea. This type of diarrhea is often caused by an imbalance in the osmolality of the intestinal contents, which can be due to certain medications or dietary factors. In this case, the client's recent antibiotic therapy and diet might contribute to this condition.
Actions to Take:
Collect stool for culture ÔÇô This can help determine if there is an infectious or bacterial component contributing to the diarrhea.
Start a high fiber diet ÔÇô Increasing dietary fiber can help in managing diarrhea by increasing stool bulk and improving consistency.
Parameters to Monitor:
Serum potassium ÔÇô Osmotic diarrhea can lead to electrolyte imbalances, and monitoring potassium levels helps to detect potential deficiencies.
Serum ketones ÔÇô This can help to evaluate if the client is in a state of ketosis due to potential malabsorption or significant diarrhea.