CRITICAL THINKING INCIDENTProblemIn order to treat the dehydration the patient arrived with, doctors gave him normal saline to increase fluid levels. The patient was left with fluid overload. The patient arrived with dehydration and during his hospital stay he developed fluid overload. How did this happen? General information An 85-year-old woman was admitted to hospital due to a fall. The patient was diagnosed with rhabdomylosis syncope, which is the breakdown of muscle fibers leading to kidney damage (Rhabdomyolysis - PubMed Health). The patient has a medical history of Wegener's granulomatosis, which is a disorder in which blood vessels become inflamed, making blood flow difficult (Wegener's granulomatosis - PubMed Health). The patient also has a medical history of atrial fibrillation, glaucoma, hypothyroidism, thoracic spine pain, and confusion. The patient has already undergone cataract surgery. After assessment, the patient had a total flow rate of 320 ml. The patient had generalized edema and appeared to have gained weight. The patient showed signs of agitation and a change in his mental status. Significant laboratory values ​​for this health care problem: • High WBC 11.0 (normal: 3.8-10.5 K/uL) • Low hemoglobin 10.3 (normal: 13-17 g/dL) • Low hematocrit 31 .8 (normal: 39-50%) • Low RBC 3.63 (normal: 4.2-5.8 M/uL) • High BUN 26.0 (normal; 7-23 mg/dL) • High Creatine Kinase702 (normal: 60-400 IU/L) • High sodium 160 (normal: 135-145 mEq/L) Medications: • Latanoprost (Xalatan): treats ocular hypertension and open-angle glaucoma • Levothyroxine (Synthroid) : treats hypothyroidism and prevents goiter.• Iosartan (Cozaar): it is an angiotensin II and is a powerful vasoconstrictor• Spironolacton...... middle of paper ......n by evaluating the patient's lungs, I did not see or hear any form of breathing problems. The patient did not present any shortness of breath (dyspnea). The patient did not have a persistent cough or any form of wheezing. Usually, in patients with heart problems, the need to urinate at night is increased, although the patient did not need it. The patient showed no signs of chest pain, which is another sign of CHF and HF. Since the patient did not have the main signs of heart problems, I was able to rule out fluid overload due to heart problems. Overall, patients can experience fluid overload for many reasons. The three main reasons one may develop fluid overload are a large volume of intravenous fluids, heart problems, or kidney failure. In my patient's case, the main reason she developed fluid overload was kidney failure..