Chapter 41:

● Patient presents to the ER with SOB related to COPD.

○ Write 3 nursing diagnosis for this patient.
● Ineffective Breathing Pattern related to COPD exacerbation.
● Activity Intolerance related to decreased lung function and dyspnea.
● Anxiety related to difficulty breathing and COPD exacerbation.

Chapter 42:

● Describe each of the following disturbances in electrolytes (include

values) and explain what complications a patient may display for
each of the disturbances.
● Hyponatremia:
○ Values: Serum sodium <135 mEq/L.
○ Complications: Neurological symptoms, confusion, seizures, and
potentially life-threatening cerebral edema.
● Hypernatremia:
○ Values: Serum sodium >145 mEq/L.
○ Complications: Dehydration, altered mental status, seizures, and risk of
neurologic damage.
● Hypokalemia:
○ Values: Serum potassium <3.5 mEq/L.
○ Complications: Muscle weakness, cardiac dysrhythmias, and impaired
renal function.
● Hyperkalemia:
○ Values: Serum potassium >5.0 mEq/L.
○ Complications: Cardiac arrhythmias, muscle weakness, and potential
cardiac arrest.
● Hypocalcemia:
○ Values: Serum calcium <8.5 mg/dL.
○ Complications: Neuromuscular irritability, muscle cramps, tetany, and
cardiac dysrhythmias.
● Hypercalcemia:
○ Values: Serum calcium >10.5 mg/dL.
○ Complications: Fatigue, weakness, confusion, constipation, and potential
cardiac arrest.
 ● Hypomagnesemia:
○ Values: Serum magnesium <1.5 mg/dL.
○ Complications: Muscle spasms, tremors, cardiac dysrhythmias, and
neuromuscular irritability.
● Hypermagnesemia:
○ Values: Serum magnesium >2.5 mg/dL.
○ Complications: Weakness, hypotension, respiratory depression, and
potentially cardiac arrest.
● Hypophosphatemia:
○ Values: Serum phosphate <2.5 mg/dL.
○ Complications: Muscle weakness, respiratory failure, and impaired cellular
function.
● Hyperphosphatemia:
○ Values: Serum phosphate >4.5 mg/dL.
○ Complications: Tetany, soft tissue calcifications, and potential organ
dysfunction.

Chapter 43:

● Write 5 nursing diagnoses for patients suffering from sleep

disorders or sleep disturbances. For each nursing diagnosis,
provide 2 nursing interventions.
● Disturbed Sleep Pattern related to sleep disorders:
○ Interventions:
■ Educate the patient on the importance of avoiding stimulants such
as caffeine or electronics close to bedtime.
■ Collaborate with the healthcare team to assess and address any
underlying medical or psychological causes.
● Fatigue related to inadequate sleep:
○ Interventions:
■ Encourage short, frequent naps during the day to alleviate sleep
debt.
■ Educate the patient on the benefits of physical activity for promoting
better sleep.
● Anxiety related to sleep disturbances:
○ Interventions:
■ Collaborate with the healthcare team to explore pharmacological
interventions for anxiety if non-pharmacological methods are
insufficient.
 ■ Establish a quiet and calming bedtime routine to reduce anxiety
and promote a restful sleep environment.
● Ineffective Sleep Quality related to environmental factors:
○ Interventions:
■ Provide comfort measures, such as a comfortable mattress and
pillows, to enhance sleep quality.
■ Encourage the use of relaxation techniques, such as progressive
muscle relaxation, to improve overall sleep experience.
● Impaired Cognitive Function related to sleep deprivation:
○ Interventions:
■ Monitor and document the patient's sleep patterns and collaborate
with the healthcare team to adjust interventions as needed.
■ Educate the patient on the long-term cognitive consequences of
sleep deprivation and the importance of prioritizing sleep