Respond to your peers by extending, refuting/correcting, or adding additional nuance to their posts. Each post minimum 200 words with 1 academic source each less than 5 years old.
REPLY 1:
Based on Ms. Brown admission’s laboratory values, could you determine what type of water and electrolyte imbalance does she has?
Ms. Brown’s admission laboratory results show hyperglycemia (412 mg/dL) and hypernatremia (156 mEq/L), suggesting dehydration and hyperosmolarity. High serum potassium (5.6 mEq/L) suggests hyperkalemia. In untreated diabetes, high blood glucose causes osmotic diuresis, which can cause hypernatremia and hyperkalemia (Woyesa et al., 2019). Her serum chloride level is 115 mEq/L, indicating metabolic acidosis-related hyperchloremia. Metabolic acidosis is indicated by arterial blood gas readings of pH 7.30, PaCO2 32 mmHg, and HCO3- 20 mEq/L. Hyperglycemia-induced dehydration with hypernatremia, hyperkalemia, and hyperchloremia, aggravated by metabolic acidosis, characterizes hyperosmolar hyperglycemic condition with electrolyte abnormalities in Ms. Brown.
Describe the signs and symptoms to the different types of water imbalance and described clinical manifestation she might exhibit with the potassium level she has.
Ms. Brown’s test results suggest water and electrolyte imbalances, which can cause discomfort. Hyperglycemia-induced dehydration and hypernatremia can cause dry mouth, increased thirst, reduced urine production, weakness, disorientation, and lethargy (Workeneh et al., 2023). Hyperkalemia, with 5.6 mEq/L serum potassium, can cause muscular weakness, palpitations, nausea, and life-threatening cardiac arrhythmias. Hyperkalemia can alter cardiac conduction and cause ventricular fibrillation or asystole, which is problematic. Metabolic acidosis can cause fast breathing (Kussmaul respirations), bewilderment, and tiredness in Ms. Brown. Hyperkalemia can be caused by metabolic acidosis, which increases intracellular to extracellular potassium changes (Dépret et al., 2019). These imbalances and their clinical manifestations highlight Ms. Brown’s severe condition and the need for prompt fluid, electrolyte, and acid-base balance restoration to prevent cardiovascular collapse and organ dysfunction.
REPLY 2:
The patient has asthma, which can be classified as moderate persistent asthma. An individual is considered to have this severity of asthma if, without treatment, symptoms occur every day, and the patient needs to take inhaled asthma medication on a daily basis (Karagol & Bakirtas, 2021). In addition, moderate persistent asthma is diagnosed when a person’s symptoms interfere with their daily activities. They experience nighttime symptoms that occur more than one week, but these symptoms do not occur every day, and if their lung function tests are abnormal (Karagol & Bakirtas, 2021). The abnormal lung function tests mean that they are more than 60% but less than 80% of the expected value (Dlugasch & Story, 2023). D.R. exhibits symptoms that align with this type of asthma. The patient has symptoms, such as SOB, wheezing, and fatigue, among others, that occur daily. He takes an albuterol nebulizer every day and his symptoms that occur at night have happened for three nights in the past week. His peaks flow rates have ranged between 65-70%, and by the rate is usually lower by morning symptoms displayed by the patient indicate moderate persistent asthma.
There are many triggers for this health condition. They include pet fur, dust, pollen, a viral infection, emotions, sudden weather changes, smoke, and mold. The triggers considered and applicable for this patient are pollen and dust. Pollen and dust are common allergens that trigger asthma, and they are highly likely responsible for the patient’s symptoms.
REPLY 3:
Complementary clinical teams form noticeable units of specialists in the healthcare field who are the source of joint activity and are managed by well-enacted leadership; team members’ roles are well-defined, flexible enough to adapt to the changes, and they continue their professional education (Schmutz et al., 2019). These characteristics are, therefore, vital for proper communication, prompt decision-making, efficient use of resources, and implementation of by-products, which will, eventually, reduce the mortality and morbidity rates and improve the organization’s effectiveness.
Communication is an essential element of a clinical team, including effectively sharing critical information through specific and nonverbal ways, like handoff reports and body language (Teunissen et al., 2020). Support between interdepartmental team members, such as physicians and therapists, will allow patients to have excellent care as they benefit from different education and experience. Authentic leadership steers groups where superb leaders possess excellent competencies with a duality of command and influencing skills. Individual role awareness eliminates tensions and boosts effectiveness while articulating who is responsible for a particular task. Adaptability seems to be a distinctive factor enabling a team to adjust well to various conditions like staffing shuffling. A habit of constant learning, demonstrated by educational seminars and medical care issues, is the key to creating a culture of teamwork (Schmutz et al., 2019). The cooperation of the team makes it very successful and to achieve the sure and safe goals entrusted firstly by them.
REPLY 4:
Leadership, particularly authentic leadership, plays a vital role in shaping the patient safety culture among clinical nurses, as discussed by Lee et al. (2021). Genuine, transparent, and supportive leaders foster an environment where team members feel valued and motivated to contribute their best efforts toward patient care. In my experience, effective leaders in the ER not only provide direction and support but also empower team members to take initiative and make decisions when necessary.
Patient Safety is a primary concern in healthcare, and team effectiveness directly impacts this aspect. The study by Lai et al. (2024) demonstrates how the implementation of huddles can improve patient safety attitudes among clinical team members. These brief, focused meetings allow teams to address potential safety issues proactively, ensuring that patient care is not compromised. In the ER, where situations can change rapidly, having a team that is adapted to patient safety is indispensable.
Interprofessional Familiarity is another critical factor influencing team effectiveness. The randomized clinical trial by Iyasere et al. (2022) found that increased familiarity between medical residents and nurses led to improved team performance, communication, and psychological safety. In the ER, where collaboration across different professional roles is essential, fostering interprofessional familiarity can enhance teamwork and patient outcomes.
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