| Course | NR 283 Pathophysiology |
|---|---|
| Week | 5 |
| Paper type | Laboratory value interpretation |
| Length | About 1,150 words, 3 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 283 Week 5
Laboratory Value Interpretation: Three Days of Vomiting in a 45-Year-Old Woman, Every Result Read for Direction, Cause and What She Would Look Like
Student Name
College of Nursing, Chamberlain University
NR 283: Pathophysiology
Instructor Name
Month Day, Year
Laboratory Value Interpretation: Three Days of Vomiting in a 45-Year-Old Woman, Every Result Read for Direction, Cause and What She Would Look Like
The Patient and the Results
Ms. G. is 45, a school bus driver, admitted from the emergency department after three days of vomiting that began with a stomach virus in her household. She has kept down only sips of water. She has no diarrhea, takes no diuretics and has no kidney disease. On admission she is dizzy when she stands, her mouth is dry, her heart rate is 108 and her blood pressure 102/64 lying down. Details are composite.
Table 1
Admission Laboratory Results
| Test | Result | Reference range | Direction |
|---|---|---|---|
| Potassium | 2.9 mmol/L | 3.5 to 5.0 | Low |
| Chloride | 88 mmol/L | 98 to 106 | Low |
| Bicarbonate | 34 mmol/L | 22 to 29 | High |
| Sodium | 134 mmol/L | 135 to 145 | Slightly low |
| Blood urea nitrogen | 38 mg/dL | 7 to 20 | High |
| Creatinine | 1.4 mg/dL (baseline 0.9) | 0.6 to 1.1 | High |
| Hemoglobin | 15.8 g/dL | 12.0 to 15.5 | Slightly high |
| Glucose | 104 mg/dL | 70 to 99 fasting | Near normal |
| Arterial pH and PaCO2 | 7.50 and 46 mmHg | 7.35 to 7.45; 35 to 45 | pH high; carbon dioxide slightly high |
Note. Reference ranges are those printed on the laboratory report.
Her results are taken one at a time below, each stated first by direction, then by what would move it that way in her, then by what she would look like as a result. The set is then read together and ordered by what cannot wait.
Direction Before Meaning
Bicarbonate high, pH high. She has a metabolic alkalosis. Stomach fluid is rich in hydrochloric acid; three days of vomiting removed acid from her body, leaving more bicarbonate behind. Emmett (2020) describes metabolic alkalosis as having two parts: the process that generates it, here the loss of stomach acid, and the processes that maintain it, which in vomiting include loss of body fluid and chloride that prevent the kidneys from excreting the extra bicarbonate. She would look much as she does: weak, possibly with muscle cramps or tingling, and at risk of heart rhythm problems in combination with her low potassium.
Carbon dioxide slightly high. Her breathing has slowed a little to hold on to carbon dioxide, which is acidic, partly offsetting the alkalosis. This is compensation, not a separate lung problem; her breathing rate of 14 fits it.
Chloride low. Chloride was lost with the hydrochloric acid in her vomit. Low chloride is also one of the reasons her kidneys cannot correct the alkalosis on their own, which is why replacing chloride, as salt solution, is part of the treatment.
Potassium low. Some potassium was lost in the vomit, but more is lost in the urine: the kidneys, responding to low body fluid, hold on to sodium and let potassium go, and the alkalosis also shifts potassium into cells. At 2.9 mmol/L, she could have weakness, constipation, and changes on the heart monitor such as flattened T waves or extra beats. This is the most dangerous number on the sheet.
Volume, in Three Results
Urea nitrogen and creatinine high. Both rose because less blood is reaching her kidneys, not because her kidneys are diseased. Her ratio of urea nitrogen to creatinine is about 27, higher than usual, which fits reduced blood flow to the kidneys from dehydration. Her creatinine of 1.4 is more than 50% above her baseline of 0.9, which means she has an acute kidney injury that should reverse with fluids.
Hemoglobin slightly high. She has lost water, not blood, so her red cells are more concentrated. When she is rehydrated, her hemoglobin is expected to fall to her usual level. Knowing that prevents a later normal hemoglobin from being misread as bleeding.
Sodium slightly low. She has lost salt and water, and has been drinking sips of plain water, which replaces water without salt. The drop is mild and needs no specific treatment beyond saline.
Normal Results Earn Their Space
Her glucose of 104 mg/dL matters because it is normal. Vomiting and dehydration in an adult can be caused by diabetic ketoacidosis, which would also produce weakness and a high heart rate. A normal glucose closes off that explanation, and it tells the team that her acid-base problem is an alkalosis from vomiting, not an acidosis from ketones. Without the normal result on the page, a reader could not be sure.
What the Results Cannot Show
The results describe her blood at one moment; they do not show how much fluid she has lost in total, how fast her potassium is still falling, or whether something other than a virus is causing the vomiting. Three days of vomiting after a household stomach virus is the likely story, and the results fit it. But if the vomiting continued after the rest of her household recovered, or if she had abdominal pain, a swollen abdomen, or vomit that looked like coffee grounds or bile, the results would fit other causes too, such as a bowel obstruction, and the team would need to look for them. The nurse's part is to keep asking about the vomiting itself: how often, how much, what it looks like, and whether anything else has changed.
The results also cannot show her symptoms. A potassium of 2.9 in one person causes nothing noticeable; in another, it causes weakness and palpitations. The heart monitor, her report of how her muscles feel, and her ability to stand without dizziness are the findings that tell the team how she is tolerating the numbers, and they are checked alongside every repeat result.
The Set Read Together, Ordered by What Waits
Read together, the results describe one story: three days of losing stomach fluid have left her short of water, salt, chloride and potassium, alkalotic, with her kidneys under-perfused. The order of care follows the danger. First, potassium: she is placed on a heart monitor, and potassium replacement is started as ordered, because a potassium of 2.9 with an alkalosis can cause dangerous rhythms. Second, volume and chloride: normal saline restores her circulating volume, which lets her kidneys excrete the extra bicarbonate and recover their filtration. Third, the vomiting itself: an antiemetic as ordered, so she can start taking fluids by mouth. Fourth, monitoring: repeat potassium and creatinine in six hours, urine output measured each hour, and orthostatic vital signs before she walks.
The results that can wait are the ones expected to correct themselves once she is rehydrated: the sodium, the hemoglobin and the mild compensatory rise in carbon dioxide. They are recorded now so that their return to normal can be recognized later as recovery rather than as a new change.
References
Emmett, M. (2020). Metabolic alkalosis: A brief pathophysiologic review. Clinical Journal of the American Society of Nephrology, 15(12), 1848-1856. https://doi.org/10.2215/CJN.16041219
The Chamberlain NR 283 Week 5 instructions
The Week 5 assignment gives you a patient and a set of laboratory results and asks you to interpret them. Expect the instructions to ask what each abnormal value means, what caused it in this patient, how values relate to one another and what the nurse would watch for, in an APA paper with sources. Interpretation goes beyond saying high or low: give the direction, the cause in this patient and the effect you would expect to see. Normal results matter when they rule something out. Read the set together as one story. Note what the numbers cannot tell you, and consider a specimen problem when a value and the patient disagree.
How this NR 283 Week 5 example is built
The paper opens with Ms. G.'s story and a table of results with reference ranges and direction. It then takes each result in turn. Bicarbonate and pH are high from lost stomach acid, framed by Emmett (2020). A slight rise in carbon dioxide is compensation. Low chloride explains why the kidneys cannot correct the alkalosis. Potassium at 2.9 falls through urine as well as vomit. A volume section reads urea nitrogen, creatinine and hemoglobin as dehydration. Glucose at 104 earns space by ruling out ketoacidosis. A section says what results cannot show, such as total fluid lost. The close reads the set as one story and orders care, starting with a heart monitor for potassium.
NR 283 Week 5 rubric: what full points look like
Lab interpretation rubrics typically grade accurate identification of abnormal values, explanation of cause in this patient, links among results, clinical significance and nursing priorities, and APA. Explanation of cause carries the most points, which is why each result names what moved it in Ms. G. rather than in a general patient. Linking results earns credit when chloride and potassium are tied to the alkalosis instead of treated separately. Clinical significance is shown by naming what she would look like. Normal results discussed for what they exclude meet a criterion many students miss. Ordering care by danger demonstrates the prioritization these rubrics reward. A source on alkalosis supports the mechanism.
NR 283 Week 5 help: mistakes that cost points
The heaviest loss is a value restated in words, high or low, with nothing added. Meaning given for a general patient instead of this one, when the history decides the explanation, also costs marks. Ignoring normal results suggests the set was not read in full. Treating a number as an emergency with nothing in the patient to support it, or passing over a result while the patient deteriorates, both lose points. Not considering a repeat draw when value and patient disagree is a gap. Reference ranges are on the report; you need not memorize them. Send your results table and case, and a full NR 283 interpretation can be written from them.
Get a NR 283 Week 5 example written to your instructions
Send the Week 5 results exactly as your section published them, the rubric or table template that came with them, and the patient details you were given. We write a custom interpretation against those figures, each one taken through to the patient, and send it back inside 24 to 48 hours. The first is free.
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NR 283 Week 5 questions, answered
Do the reference ranges have to be memorized?
No, and the example does not assume it. Ranges differ between laboratories and most classrooms supply the ones they want used, so the figure to work from is whichever is printed beside the result. What is being marked is the sentence after the range, where a value turns into something about the patient, and that sentence is the same work under any set of ranges a section publishes.
Should the interpretation name a condition?
Only where the prompt asks, and then as somewhere the results led rather than something announced at the top. Naming a condition is not the graded move at this stage and it is not what a nurse contributes standing at a bedside. What counts is that the reading arrives at an observation, and that the paper says what would be watched or passed on because of it.
What if two results seem to contradict each other?
Name the conflict rather than smoothing it over. A set that pulls in two directions is often built that way on purpose, and the answer that reads best states the disagreement in plain terms, offers the explanation covering most of the picture, then says which further test would decide the remainder. Confidence the figures cannot support costs more than an honest limit.
Where can I find a free NR 283 Week 5 sample paper?
The full Week 5 laboratory interpretation for Ms. G., with the results table, each value read for direction and cause and the care order, is reproduced here.
Why is Ms. G.'s potassium low in the NR 283 Week 5 example?
Some potassium was lost in vomit, but more was lost in urine as her kidneys held sodium in response to low volume, and the alkalosis shifted potassium into cells, leaving 2.9 mmol/L.