Isotonic Fluid Case Study

Impaired gas exchange should still be kept in the plan of care for the resident as they have not meet the expected outcome of oxygen saturation of 95 % in 24 hours. One intervention I would add to this diagnosis would be for the nurse to assist and instruct the patient to deep breathe and perform

* Monitor fluid and electrolyte status. Disturbances can have an adverse effect on ICP. Closely monitor IV fluids with the use of an accurate intravenous infusion

The patient will require surgery to repair the hole in the intestines, and subsequently will have a drainage tube, NG tube, and feeding tube. All drains will need to monitored for placement/movement, and drainage. Input and output will be closely monitored and recorded. The patient will remain on NPO, or nothing by mouth, to rest the bowels along with frequent assessments to monitor for infection and bleeding. The nurse will need to monitor for bowel sounds, vital sign changes, temperature changes, pain, abdomen girth, and wound/incision inspections. The following labs will require monitoring: CBC, H&H, albumin, BUN & creatinine, glucose, and ABG’s and lactic acid if sepsis is suspected. Careful and frequent monitoring of labs will alert the nurse if the patient develops sepsis, or hypovolemia due to excessive bleeding (Belinhof, et al., 2012). In addition to vital signs and labs, the nurse will also include patient assessment into consideration before drawing conclusions by means of critical thinking. After the full assessment has been made, the nurse will report any findings to the health care provider that require further investigation or

It has the correct fluid amount for the patient and providing an appropriate balance of electrolytes.

right-sided CHF = fluid may back up into your abdomen, legs and feet, causing swelling.

The main priority for all the pediatric patient was to make sure they are getting enough air. They needed an open airway. Without an open airway nothing else matters. To help with the patients airways we monitored their O2 sats and if they were low we made sure to apply oxygen, and continue to monitor their sats. Once oxygen was applied we worked on

Focusing was a challenge to push aside emotions and concentrate on other feelings was uncomfortable at first. Realizing your body actually responds to emotions in an unpleasant way is awkward. Coming to terms with this being unhealthy, and how to let requires a conscious effort.

Nursing Intervention • Monitor vital signs • Administer antipyretic per order • Note causative factors that contribute to fluid volume deficit • Administer IV fluids per order • Assess skin for changes in color, temperature

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.

Respiratory rate may increase with the presence of interstitial pulmonary process or chest wall restriction, but tidal volume typically remains unchanged. The presence of slow, gasping ventilatory maneuvers is an ominous sign suggesting cerebral hypoxemia.

Vital signs monitoring and Oxygen administration as needed. The patient require close monitoring to detect any deterioration. Oxygen may be required if the patient is unable to maintain a saturation of above 92%.

Cell function changes depending on the types of fluid loss. There are three types of fluid loss: Isotonic fluid, hypotonic fluid, and hypertonic fluid.

The fluid loss that results from the adenylate cyclase stimulation of cells depends on the balance between the amount of bacterial growth, toxin production, fluid secretion, and fluid absorption in the entire gastrointestinal tract. The outpouring of fluid and electrolytes is greatest in the small intestine, where the secretory capacity is high and absorptive capacity low. The diarrhoeal fluid can amount to many liters per day, with approximately the same sodium content as plasma but two to five times the potassium and bicarbonate concentrations. The result is dehydration (isotonic fluid loss), hypokalemia (potassium loss), and metabolic acidosis (bicarbonate loss). The intestinal mucosa remains unaltered except for some hyperaemia, because

It is important to ensure that if the individual is feeling down, depressed, tired or anxious that their emotions are dealt with as soon as possible. As our emotions can affect our pain, this could possible send the individual in a downwards spiral. In this situation the individual can seek further help on how to deal with their emotions in relation to their pain. The individual could seek

The defining characteristics of the nursing diagnosis were dyspnea, along with an abnormal breathing pattern (Ackley & Ladwig, 2014). In order to alleviate symptoms of heart failure, Osborne et al., (2014) suggests use of loop diuretics to facilitate the removal of excess fluids which often accumulates in the lungs (Osborne et al., 2014). Therefore, patient C.Z. was educated on the importance of taking her medications as prescribed; she was also encouraged to ingest less than 2 grams of sodium on a daily basis coupled with a fluid restriction of 1500 milliliters (mLs) per day. An additional goal for patient C.Z. during her hospital stay was to maintain O2 saturations greater than 92% on room air, complete ten repetitions of incentive spirometry every hour while she was awake, reaching a level of at least 1500 mLs; and finally, ambulation as tolerated no less than three times per day prior to her