Poor skin turgor, dry mucous membranes
Headache, drowsiness, decreased mental function
Changes in sensorium, e.g., stupor, confusion, lethargy, depression, delirium, comaDecreased deep-tendon reflexes, muscle weakness
Dyspnea on exertion
Hyperventilation, Kussmaul’s respirations (deep, rapid breathing)
Transfusion of blood/blood productsExposure to hepatitis virus
Fever, signs of sepsis
History of alcohol abuseUse of carbonic anhydrase inhibitors or anion-exchange resins, e.g., cholestyramine(Questran)
DRG projected mean length of inpatient stay depends on underlying cause
May require change in therapies for underlying disease process/condition
Refer to section at end of plan for postdischarge considerations
Decreased, less than 7.35.
Decreased, less than 22 mEq/L.
Less than 35 mm Hg.
Higher than 14 mEq/L (high anion gap) or range of 10–14 mEq/L (normal anion gap).
Increased (except in diarrhea, renal tubular acidosis).
May be decreased or increased depending on etiology.
Increased in DM, starvation, alcohol intoxication.
Plasma lactic acid:
Elevated in lactic acidosis.
Decreased, less than 4.5 (in absence of renal disease).
Cardiac dysrhythmias (bradycardia) and pattern changes associated with hyperkalemia, e.g., tall T wave.
1. Achieve homeostasis.2. Prevent/minimize complications.3. Provide information about condition/prognosis and treatment needs as appropriate.
1. Physiological balance restored.2. Free of complications.3. Condition, prognosis, and treatment needs understood.4. Plan in place to meet needs after discharge
Because no current nursing diagnosis speaks clearly to metabolic imbalances, the following interventions arepresented in a general format for inclusion in the primary plan of care.