Medical-surgical Nursing Demystified

(Sean Pound) #1

(^442) Medical-Surgical Nursing Demystified
HALLMARK SIGNS AND SYMPTOMS



  • Muscle weakness due to impairment in oxygen delivery to the tissues

  • Rhabdomyolysis with breakdown of muscle tissue

  • Paresthesia (tingling sensations)

  • Hemolytic anemia due to fragility of red blood cells

  • Encephalopathy (irritability, confusion, disorientation, seizures, coma)

  • Respiratory failure or trouble weaning from ventilator due to changes in oxy-
    gen delivery to cells

  • Weakening of bone structure seen in chronic, severe hypophosphatemia due
    to phosphate leaving bones

  • Petechiae due to poorly functioning platelets


INTERPRETING TEST RESULTS



  • Phosphorus < 1.7 mEq/L in blood serum.

  • Spot urine sampling for diminished phosphate.

  • Parathyroid (PTH) levels elevated.

  • In anemia, low hemoglobin and hematocrit.

  • Elevated creatine kinase in rhabdomyolysis.


TREATMENT



  • Administer potassium phosphate to replace phosphate:

    • Oral for mild to moderate loss, or intravenous for severe loss.



  • Monitor for hypotension if intravenous replacement of phosphate.

  • Monitor serum phosphate, calcium, potassium, and magnesium levels every
    6 to 8 hours during initial replacement.

  • Diet high in phosphorus for chronic hypophosphatemia.


NURSING DIAGNOSES



  • Risk for injury

  • Imbalanced nutrition

Free download pdf