The underlying cause would be the acute gastroenteritis. Arant and Canavan (2009) suggest oral rehydration therapy (ORT) for mild to moderate dehydration. Plus ORT has more advantages than intravenous fluid. To begin it can be administered at home, requires less emergency department staff, and has shorter emergency department stays (Arant and Canavan, 2009). If the patient cannot tolerate ORT due to poor oral intake, the patient may instead due nasogastric rehydration therapy with ORT solution. The patient would receive one dose of ondansetron (Zofran) to help facilitate ORT due to it reducing incidents and frequency of vomiting (Arant and Canavan, 2009). Throughout the treatment, the nurse will monitor for rehydration, while monitoring vital signs every 15 to 30 minutes and record weight. Then the nurse will need to record accurate intake and output. (Hockenberry, Rodgers, and Wilson,
Dehydration should be corrected beginning with a 0.9% sodium chloride solution which will also help with deficits in body sodium. Maintenance needs calculated at 60mL/kg/day, as well as replacement fluids for ongoing losses and replenishment of fluids already lost should be figured up and started. As dehydration is corrected potassium levels will decrease rapidly so supplementation of potassium chloride, added to fluids is necessary, not to exceed 0.5mEq/kg/Hr, rechecking levels every 6-8 hours and adjusting supplement level accordingly. Phosphorous levels may also plummet after fluid therapy is started. Adding potassium phosphorous to fluids as a CRI of 0.01-0.03 mmol/kg/Hr. Recheck levels every 6-8 hours and adjust as needed. Hypomagnesium shouldn't become an issue if using 0.9% sodium chloride
The primary problem is the patient is having severe dehydration due to excessively having loose liquidly stools for the past two days caused by C. Diff.
Elevated urine microalbumin/creatinine ratio. His last labs in January did show a mild increase. I will recheck that along with a basic metabolic panel and inform him of those results. A copy of them will be sent to Dr. Dourdoufis, as
PHYSICAL EXAMINATION: Vital signs are WNL. Apparently he has had no chills, night sweats, or favors. Generalized malaise and a lack of energy have been the main concerns. HEART: Regular rate and rhythm with S1 and S2. No S3 or S4 is heard at this time. LUNGS: Bilateral rhonchi. No significant amphoric sounds are noted. ABDOMON: Soft nontender. No hepatosplenomegaly or masses are detected. RECTAL EXAM: Prostate smooth and firm. No stool is present for hemoccult test.
It is also important to keep accurate record of Liam’s fluid balance chart, and assess Liam’s capillary refill, skin turgor, fontanel condition and mucous membranes every shift, as they provide information about the infant’s hydration status (Axton & Fugate 2009). Urine analysis may be performed to provide information on hydration status and/or determine if Liam has urine tract infection (UTI) (Axton & Fugate 2009; Crisp, Taylor, Douglas, & Rebeiro, 2013). Management of dehydration would be one of nursing interventions if urine sample shows a high urine specific gravity, and antibiotics would be administered if a bacterium is detected in the urine sample (Axton & Fugate 2009). Feeding ability should be assessed in order to determine the route of fluid intake (i.e. oral, nasogastric or intravenous fluids) (PMH, 2013).
This compound do not require a prescribed or doctor's go to. It is made from the finest pharmaceutical grade components and is a supplement in the United States. Because this item is non-toxic, are patients not limited to eight-month regimens being used it.
Sammy noticed he was running intermittent low-grade fevers with intermittent diarrhea and nausea. He has been discarding his lunches and drinks at school. He
This 49-year-old African-American female was presented to Truman Medical Center - Emergency Department, on November 24, 2014 due to nausea, vomiting, and headaches for two days. She stated that she has no appetite and left lower quadrant pain. She was previously treated at Saint Luke Hospital - Emergency Department for her diarrhea, nausea and vomiting before transferred to TMC Hospital. At SLH - ED, she was given some Benadryl, Tylenol and IVF which showed no improvement and continue to have three to four times watery diarrhea with no blood or mucus associated with nausea and vomiting. Her medical history is significant of diabetes mellitus type 2, hypertension, intracardiac loop recorder and cerebro-vascular disease. Vital signs included a high oral temperature
Patient is presented to the ER with her mother after having been referred by her pediatrician. Mother complains nine month old patient is exhibiting symptoms she herself had been experiencing over the last year and a half or so. Mother and daughter share symptoms of intermittent fevers, swollen lymph nodes, weight loss/inability to gain weight, extreme fatigue with nocturnal wakefulness. The mother said she also experienced some muscle pain, confusion at times and possible personality changes. The mother told the ER doctor she attributed her symptoms to pregnancy but they continued after giving birth. They started off very mild but have been becoming more severe over the last year. During physical examination patient states having
The finished product need to contain active ingredients complying with the qualitative and quantitative composition of the marketing authorisation and are of the purity required.