An older patient comes into the clinic complaining of watery ...

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An older patient comes into the clinic complaining of watery diarrhea for several days with abdominal and muscle cramping. The nurse realizes that this patient is demonstrating which imbalance?
 
  1. hypernatremia
  2. hyponatremia
  3. fluid volume excess
  4. hyperkalemia

Question 2

A patient is admitted with hypernatremia caused by being stranded on a boat in the Atlantic Ocean for five days without a fresh water source. What is this patient at risk for developing?
 
  1. pulmonary edema
  2. atrial dysrhythmias
  3. cerebral bleeding
  4. stress fractures

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Answer to Question 1

Correct Answer: 2
This elderly patient has watery diarrhea, which contributes to the loss of sodium. The abdominal and muscle cramps are manifestations of a low serum sodium level. Hypernatremia is associated with fluid retention and overload. Fluid volume excess is associated with hypernatremia. Hyperkalemia is associated with cardiac dysrhythmias.

Answer to Question 2

Correct Answer: 3

The brain experiences the most serious effects of cellular dehydration. As brain cells contract, the brain shrinks, which puts mechanical traction on cerebral vessels. These vessels may tear, bleed, and lead to cerebral vascular bleeding. The patient in question would face dehydration. Pulmonary edema is not associated with dehydration. Atrial dysrhythmias are not a factor for this patient. There have been no activities to support the development or occurrence of stress fractures.