Assessing Urine Output: A Critical Step in Fluid Therapy Management for Gastroenteritis and Electrolyte Imbalances

The nurse is caring for a newly admitted patient who has severe gastroenteritis. The patient’s electrolytes reveal a serum sodium level of 140 mEq/L and a serum potassium level of 3.5 mEq/L. The nurse receives an order for intravenous 5% dextrose and normal saline with 20 mEq/L potassium chloride to infuse at 125 mL per hour. Which action is necessary prior to administering this fluid?a. Evaluate the patient’s urine output.b. Contact the provider to order arterial blood gases.c. Request an order for an initial potassium bolus.d. Suggest a diet low in sodium and potassium.

The correct action prior to administering the prescribed fluid is to evaluate the patient’s urine output (option a)

The correct action prior to administering the prescribed fluid is to evaluate the patient’s urine output (option a).

Gastroenteritis, which is inflammation of the gastrointestinal tract, can result in excessive fluid loss through diarrhea and vomiting. This can lead to dehydration and electrolyte imbalances, such as hyponatremia (low sodium level) and hypokalemia (low potassium level).

The nurse needs to evaluate the patient’s urine output to assess their renal function and determine if there is any compromise in kidney function. Urine output is an important indicator of renal perfusion and function. If there is decreased urine output, it may suggest renal dysfunction or impaired fluid balance, which can impact the prescribed fluid therapy.

The other options, contacting the provider to order arterial blood gases (option b), requesting an order for an initial potassium bolus (option c), or suggesting a diet low in sodium and potassium (option d), are not the necessary actions prior to administering the fluid in this scenario.

Arterial blood gases may be useful in evaluating acid-base disturbances, but there is no indication in the scenario to suggest the need for this assessment. Additionally, a potassium bolus may not be necessary unless there are severe or life-threatening hypokalemia symptoms, which are not mentioned in the scenario. Lastly, suggesting a low-sodium and low-potassium diet may be appropriate in some cases, but it is not the necessary action prior to administering the prescribed fluid.

Thus, the nurse should prioritize evaluating the patient’s urine output to ensure the appropriate fluid therapy for the management of the patient’s gastroenteritis and electrolyte imbalances.

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