Caring for the Nguyens Elimination

CARING FOR THE NGUYENS 2

Nam Nguyen has been prescribed the following medicines: Lisinopril,

Hydrochlorothiazide and Metformin. The following are the electrolyte panel results from a blood

draw analysis he had done early in the day. Sodium 136 mEq/L, Potassium 3.0 mEq/L, chloride

96 mEQ/L, Bicarbonate 24 MEq/L , BUN 18mg/dL and Creatinine 0.8 mg/dL. Nam has a

medical history of hypertension, diabetes mellitus, obesity, osteoarthritis, and tobacco abuse.

Assessment questions based on the lab results to ask Nam would be has he had any recent

vomiting or diarrhea. Determine if he is experiencing any fatigue, numbness, muscle weakness

or an irregular heartbeat. Nam is taking Hydrochlorothiazide 25mg PO daily in the morning,

which is a diuretic and may be contributing to his loss of Potassium. Diuretics trigger potassium

loss and increase risk of hypokalemia (Learning, Jones, 2020 pg.716). Nam’s provider has

advised an 1,800-kcal diabetic diet with no added salt in a previous visit. I would like to review

Nam’s food diary to see what food changes he has made. Common food sources include

bananas, oranges, apricots, figs, dates, carrots, potatoes, tomatoes, spinach, dairy products and

meats. ( Treas, Wilkinson, Barnett, & Smith, 2017 pg. 1465). There is a possibility Nam does not

consume enough potassium in his diet causing his potassium levels to be slightly low. The

normal serum level for potassium is 3.5-5 mEq/L and Nam’s is 3.0 mEq/L. Potassium should

come from one’s diet rather than from supplements (Treas et al., 2017, pg 1466). Nam is also

taking Lisinopril, which can cause hyperkalemia (Learning et al., 2020, pg 718). If Nam

experiences fatigue, muscle weakness, nausea and vomiting he should return to the clinic for

further testing.

CARING FOR THE NGUYENS 3

References

Learning, J. &. (2020). NURSE’S DRUG HANDBOOK 2021 . S.1.: JONES & BARTLETT

Treas, L. S. (10/2017). Basic Nursing: Thinking, Doing and Caring. [Bookshelf Ambassadored].

Retrieved from https://ambassadored.vitalsource.com/#/books/9780803675858/