Jonas is admitted with 1,000 ml of diarrhea per day for the last 3 days. An IV of 0.45% NaCl mixed with 5% dextrose is infusing. Which of the following nursing interventions is the most appropriate?
A. Get an infusion controller from the central supply.
B. Mix all antibiotics in 0.45% NaCl with 5% dextrose.
C. Check the patient’s potassium level and contact the doctor for IV additive orders.
D. Assess the patient for signs of hyperkalemia.
Correct Answer: C. Check the patient’s potassium level and contact the doctor for IV additive orders.
Potassium is lost via the GI and renal systems. Prolonged or excessive diarrhea can lead to hypokalemia. In the event of hypokalemia, a potassium additive would likely be prescribed. When a client experiences diarrhea, the stomach contents which is high in potassium get flushed out of the gastrointestinal tract into the stool and out of the body, resulting in hypokalemia.
Option A: Encourage increased fluid intake of 1.5 to 2.5 liters/24 hour plus 200 ml for each loose stool in adults unless contraindicated. Increased fluid intake replaces fluid lost in liquid stools.
Option B: Administer antidiarrheal medications as prescribed. Bismuth salts, kaolin, and pectin which are adsorbent antidiarrheals are commonly used for treating the diarrhea of gastroenteritis. These drugs coat the intestinal wall and absorb bacterial toxins.
Option D: Assess for abdominal pain, abdominal cramping, hyperactive bowel sounds, frequency, urgency, and loose stools. These assessment findings are commonly connected with diarrhea.
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