Nursing Fluid Balance Report

I am currently studying HNC Health Care and as part of my course I have to complete a graded unit, this will entail three stages; Planning, development and evaluation. This will be carried out while on placement within a hospital setting, within the planning stage I have to choose a patient and assist them with a nursing activity. I have chosen to follow Roper Logan and Tierney twelve activities of daily living the reason for this is that I find it to be the nursing model that is most effective as each activity has its own importance to the survival of life; also it follows the objectives of my graded unit. I have chosen the AL of eating and drinking as the patient I have chosen has severe Rheumatoid arthritis and has lost the use of her

The recording of Fluid Balance is an important role of the nurse, I assessed and recorded the fluid input and output, I ensured that all

A patient arrives at the hospital for their knee replacement surgery that has been scheduled for today. The patient is checked in at admitting and is called back to the pre-operative area by the nurse. The patient changes and the nursing staff begin to take the patient’s vital signs, review the patient’s history, draw blood for lab work and they let the patient know what to expect before, during and after surgery. The surgeon arrives and checks in with the patient, asks if they have any final questions before surgery and then leaves for the operating room to prepare. The patient is taken to the operating room, anesthesia is given, and the operation begins. The procedure goes smoothly and the patient is taken to the post-op area. When the patient comes out of the anesthesia, the surgeon

This piece of work will be based on the pre-assessment process that patients go through on arrival to an endoscopy unit in which I was placed in during my second year studying Adult diploma Nursing. I will explore one patient’s holistic needs, identifying the priorities of care that the patient requires; I will then highlight a particular priority and give a rational behind this. During an admission I completed under the supervision of my mentor I was pre-assessing a 37 year old lady who had arrived to the unit for an upper gastrointestinal endoscopy. During the pre-assessment it was important that a holistic assessment is performed as every patient is an individual with unique care needs as the patient outline in this piece of work has

Polit and Hungler (2001) . In (Shukla et al.,2008) study the Waterlow scale was used on 15 patients in two wards. Each patient was assessed daily by two different nurses over a period of seven days. A total of 28 clinical nurses were involved and a total of 210 assessments obtained. Statistical analysis demonstrated weak or a moderate degree of inter-rater reliability. Other authors suggested the water low scale too long and time consuming. Pang and Wong (1998).

What should the nurse suspect when hourly assessment of urine output on a postcraniotomy patient exhibits a urine output from a catheter of 1,500 mL for 2 consecutive hours?

The medical director ordered a postvoid catheterization, which yielded 100 mL of cloudy urine that had

During the pre-briefing, the group collectively discussed the patient’s history, presenting issues and other influences to the patient's care. As well, during this time, the group worked to identify role expectations, protocols, timelines and other presenting issues that would require consideration, including impaired circulation/post-op bleeding, mental status or hypoxemia. Decision-making in this aspect was based on the determined role and intended learning outcomes.

On my second day of clinical experience this week I focused a lot on time management and documentation for a full patient load, and also on the admission and discharge process. After taking report on all three of our patients, I began my initial morning assessments. It was clear that our 8-year-old post-operative appendectomy was ready to be discharged. My priorities were assessing her incision sites and ensuring the presence of bowel sounds, as well as making sure she did not have a fever and was tolerating a general diet. After completing my assessment and documenting in the computer, we

The aim of this essay is to demonstrate the assessment process of a patient using the Roper Logan and Tierney (RLT) model of nursing framework and to show how the nursing process works alongside this model. This will be shown by a holistic history of the patient being shown, followed by how the RLT model is applicable to this patient. This is then followed by one nursing intervention being discussed showing how the nursing process is applied to patient care. The patient will be referred to as Mr Frederick Valentine to protect the patient’s anonymity as stated in the Nursing and Midwifery Council Code of Conduct (2008) guidelines.

The purpose of this journal is to reflect on my experience and skills gained during my clinical placement at Ben Taub Hospital. On my first clinical day, I was excited and nervous at the same time. My first placement was in the PREOP/PACU area. I was assigned to help a patient who had been in the PACU area going on 2 days. Normally, once the patient comes from surgery they are only in the PACU area for a short period of time before they are discharged home or given a bed in another area of the hospital. This particular patient still had not received an assignment for a bed. The physicians would make their rounds to come check on him daily. The patient was a 28-year-old Hispanic male, non-English speaking, he had a hemicolectomy. He had a NG tube, urinary Foley catheter, and a wound vac. My preceptor had just clocked in and she needed to check on the patient’s vitals and notes from the previous nurse. Once she introduced me to the patient and explained while I was there, she then asked me to check his vitals. (Vital signs indicate the body’s ability to regulate body temperature, maintain blood flow, and oxygenate body tissues. Vital signs are important indicators of a client’s overall health status (Hogan, 2014). I froze for a quick second. I have practiced taking vitals numerous of times and I knew I could do it correctly. I started with the temperature first, when I was quickly corrected on a major mistake I had made by my preceptor. I HAD FORGOT TO WASH MY HANDS and PUT

Even if no one found out about this mistake, eventually it could happen again if you don’t take the necessary steps to correct your mistake, and this time it could be deadly for your patient.

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 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.

This past Friday at the Cardiac Catheterization Lab my mentor was not there but I still got to do everything that I enjoy doing, like watching procedures and talking to the doctors, nurses, and staff. When I arrived I knew my mentor would not be there so I had asked another one of the ladies in the office if there were any surgeries that were going on for me to watch. After I was given scrubs to change into I was able to go into where the surgeries are happening. I went into the control room that I was told to go and the nurses and other staff were preparing the patient and setting up the computers and everything they needed before the doctor arrived. The surgery overall was one I have seen before and not as exciting as some of the more unique and different ones that I have seen previously.