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K.B. is a 32-year-old woman who was admitted to the medical floor for c/o fatigue and dehydration. While taking your nursing history you discover that she has diabetes and has been insulin-dependent since the age of 8. She has been in chronic renal failure and undergoing hemodialysis for the past 3 years. Her hemodialysis access is an AV Fistula in her left arm. Your initial assessment of K.B. reveals a pale, thin, lethargic woman in no acute distress. Her admitting chemistries are Na 145 mmol/L, K 6 mmol/L, Cl 93 mmol/L, HCO3 27 mmol/L, BUN 48 mg/dL, creatinine 5 mg/dL, glucose 238 mg/dL. Her skin is warm and dry to touch with poor skin turgor, and her mucous membranes are dry. Her VS are: 140/88, 116, 18, 99.90 F. She tells you she has been nauseated for 2 days so she has not been eating or drinking. She denies vomiting. Serum calcium, phosphate and magnesium have been drawn but are not yet available.
**As with the 1st care plan, identify K.B.’s priority issues and develop 2 care plans to address these issues.
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