Fluid Management Journal Article

NMC (2015) particularly points out hygiene care with fluid assistance is essential in the fundamentals of care. The study by Doyle, Lennox and Bell (2013) shows patient experience associates with the measures of quality of care. Without ongoing identify and meet patient changing needs, I would have not achieved the patient satisfaction as shown in appendix 1. NMC (2015) states all resources should be identified effectively to maintain or enhance the quality of care. For personal development both in practice and in theory, I feel I should carry on more research on diagnosing hydration for early effective interventions to prevent patient deteriorating directly or indirectly caused by dehydration (appendix 5). Wilson (2014) reports good hydration practice must become a part of regulated and inspected care

The patient in “The Red Hat Hikers” scenario is suffering from hyponatremia. Hyponatremia is defined as a serum sodium level of less than 136mEq/L. Sodium is an electrolyte that is found predominately in the extracellular fluid, and it is the chief regulator of water in the body. Sodium is also important for muscle contraction, nerve impulses, acid-base balance and chemical reactions that occur inside the cell (McCance & Huether, 2014). Normal sodium levels in the body are maintained by the kidneys and the hormone aldosterone. Aldosterone is secreted by the adrenal cortex at the completion of the renin-angiotensin-aldosterone system, and it helps stimulate the proximal tubules of the kidneys to reabsorb sodium and water. The anti-diuretic hormone (ADH) also indirectly affects sodium levels because it regulates water balance in the body (McCance & Huether, 2014).

Prediction of fluid responsiveness has been investigated to prevent fluid overload because excessive peri-operative fluid administration can be a contributory factor to postoperative complications, prolonged length of hospital stay, organ failure and mortality1-4.

D2: Analyse the impact on the human body of dysfunctions in relation to water balance

541). Interventions should be rendered continuously, promptly and appropriately as it can cause life-threatening complications (Holt 2009, p. 26). Apparently, the patient is stable, but continuous assessment and management should be done to avoid recurrences of untoward signs andsymptoms and prevent potential complications. Firstly, continuous assessment and vital signs should be done and these include blood pressure, cardiac rate, respiration, venous distention and skin turgor to assess possible occurrence of fluid overload as a result of rapid administration of large fluid that is often needed to treat the patient with DKA (Smeltzer & Bare 2004 p. 1185). Aside from this, documentation of fluid intake and output should be monitored and documented to assess for circulatory overload and renal function (Holt 2009, p. 61). Significantly, it is integral in the provision of continuous care that nurses reassess the factors that may have contribute or led to DKA, and educate the patient and his family about strategies to prevent its recurrences (Smeltzer & Bare 2004 p. 1186; Lemone, Burke & Bauldoff 2011, p. 551).

D2- Analyse the impact on the human body of the dysfunction in relation to water balance.

Section four reviews the points to remember. The importance of weighing yourself daily and seeking medical attention for gaining more than three pounds or more in a day or five pounds in a week is a stressed key point. Watch your salt and fluid intake and take your medication as directed if having trouble understanding or needing assistance due to cost or no transportation to be able to pick up medication please notify the clinic.

For many years, hospital personnel have struggled with maintaining the accuracy of fluid intake/output measurements of patients. Your decision to focus a change project aimed at addressing this issue and making changes to correct the problem is important to maintain the safety of patients during hospitalization.

(2015) found that the use of comprehensive hydration assessment tools implement and monitor a real change in culture and attitude towards hydration in hospitalised older adults. This change improves the recognition of hydration status and the compliance with treatment. It compared two cohorts, those who were assessed as dehydrated patient compared to the group of euhydarted (separated into two groups by using serum osmolality).

Mr George Jensen is experiencing post-operative hypovolaemia from a right tibia and fibula surgery, as a result of falling off the roof cleaning the gutters. It is therefore important to get an understanding of what hypovolaemia is and the pathophysiology behind this condition before treating the condition. According to Kettley and Marsh (2016), hypovolaemia is defined as inadequate filling of blood or fluids within the body’s circulatory system. Approximately one-third of the total body fluid is distributed in the extracellular compartment, of which one-quarter resides within the vasculature. Hypovolaemia can be divided into two separate categories, of which include absolute hypovolaemia, and relative hypovolaemia. Absolute hypovolaemia is usually caused by excessive fluid loss, such as blood loss from trauma or surgery, plasma loss from burns, or ECF loss from diarrhoea and vomiting. Relative hypovolaemia occurs in sepsis and anaphylaxis, where total body fluid content is high but the intravascular compartment is deplete (Kettley & Marsh, 2016). In relation to this, Mr George Jensen would be suffering from absolute hypovolaemia, due to an open reduction and external fixation of his fractures post surgery.

Nursing interventions the Enrolled Nurse could do for a patient with fluid overload may include reporting to the doctor, decreasing the IV rate or ceasing the IV depending on the Doctors orders, regular monitoring of the patient’s vital signs including listening to the patients lungs (Farrell & Dempsey, 2014, p 153). Obtaining a daily weight of the patient, a weight measurement is a good indicator of how much fluid is in the body when comparing the readings from day to day that may be recorded in the progress notes as well as the observation chart. As well as placing the patient on a fluid balance chart that monitors the amounts of fluids going in and out of the body over a period of time. As the patient may have difficulty breathing position

Consider a fluid restriction to prevent possible fluid overloading due to his decreased renal function (Vera, 2011).

Per our conversation on Tuesday, November 15, 2016,at 1:07 p.m. Ms. Sandy Brinson has been informed by the SCVRD Ombudsman that someone for the PA (OVR) will be contacting her in regards to scheduling an appointment to apply for VR services within the state of PA. I will follow up with Ms. Brinson before the close of business on Monday, November 21, 2016 in order to close the loop. Afterwards, the PA (OVR) will contact SCVRD in regards to applying for VR services in the state of SC.

Test characteristics for pre-hydration IVC/Ao ratio and physician clinical diagnosis are shown in supplementary table 4. The IVC/Ao ratio had an area under the curve (AUC) of 0.87 (95% CI: 0.79, 0.95) with sensitivity of 82% and specificity of 91% for prediction of significant dehydration at a cutoff point of 0.75. While, physician clinical diagnosis had an AUC of 0.73, with a Sensitivity of 77%, Specificity of 63% for prediction of significant dehydration. ROC curve for prehydration IVC/Ao ratio for detection of significant dehydration in infants was shown in Figure 2. Intra-rater reliability in this study was assessed, and we found that IVC/Ao ratio measurement in our study had an intra-class correlation coefficient of 0.81 (95% CI 0.6 to 0.88).

This is especially important on those patients admitted with low mortality risk DRGs. This is accomplished by identifying and preventing, potentially avoidable complications and adverse events. For example, patients admitted for syncope and collapse secondary to dehydration will more than likely be placed on IV Fluids. One goal would be to hydrate the patient and reevaluate them throughout their hospitalization for improvement. However, if the patient’s intake and output is not monitored closely, the patient can become volume overloaded and develop symptoms similar to those seen with Right Sided Heart Failure. Once that happens, the patient will require additional medications and additional hospital days because of provider error of not placing an order for the Nurses to monitor his/her volume status.