Case Study - Caring for Clients With Fluid, Electrolyte, and Acid-Base Imbalances

Ms. Sallie James, a 56-year-old female client, is admitted to the hospital on Thursday with chronic renal failure (CRF). She reports a 3-lb weight gain from yesterday. She is on a fluid restriction of 1,000 mL/day. She states it is her normal to not produce any urine each day. A client in CRF may not produce any urine once being dialyzed because the kidneys are functioning very minimal and the hemodialysis process removes the excess fluids and accumulated nitrogenous wastes and excess electrolytes. She is on a renal diet, which restricts protein, potassium, sodium, and phosphorous. She receives hemodialysis three times a week on Mondays, Wednesdays, and Fridays. The LPN/LVN caring for the client reviewed the chart noting the following abnormal electrolytes and must determine the needed nursing management.

Sodium, 130 mEq/L

Potassium, 6.5 mEq/L

a. What nursing management related to the electrolyte imbalances is necessary for the client?

b. What treatments should the nurse anticipate will be needed for the client and why?