OK I realize this topic has been asked a million times, and I've actually been helped out a lot by searching the previous posts on here and going through links and study help already been given by AN members!!! However, I thought I'd throw out another request for help/tips about how to focus on the actual fluid/electrolytes & acid/base imbalance test. I'm in my 2nd semester of clinical (first med-surg course), and our instructor basically gave us powerpoint handouts and told us to read the book (5 chapters), and we'd "do fine".
My main fear is that we are going to be given scenarios where the patient is presenting with signs/symptoms and we are going to have to figure out what electrolyte imbalance they have. That's all fine, except that all the signs/ symptoms and causes and interventions seem to overlap!! I mean, I have literally been sitting here studying this entire week trying to work out some sort of method to distinguish between hyper/hyponatremia, fluid overload, dehydration, hypo/hyperkalemia, hypo/hypercalcemia, etc. and it seems like it's the luck of the draw when it comes to answering sample NCLEX questions online even!
For instance, there was a scenario where the patient is having diarrhea, is tachycardic, has postural hypotension, muscle twitching, dry mucous membranes, weakness, and the family reports neurological changes. The answer is hyponutremia, with other options being hypernatremia, hypokalemia or hyperkalemia. However, it seems like the answer could have been hypokalemia as well since it can be 1) caused by diarrhea, 2) signs are:variable pulse rate - rapid, thready; with orthostatic hypotension, Skeletal muscle weakness, Anxiety, lethargy, confusion (neurological changes...)
Ahhhhhhhhhhhhhhhh I am having the toughest time figuring out how to distinguish between these imbalances and it's not for lack of studying or trying! Does anyone have any tips or tricks of how to identify what they are asking for on the test? Is there a certain distinguishing factor between electrolytes that I'm missing? Maybe in the etiology or in the sign/symptom? This is driving me NUTS!