Sodium is low related to the kidneys not working properly due to the C. Diff infection the body is not retaining water and she appears to be dehydrated with dry lips and no shiny saliva present because she has had runny diahrrea for 2 days. This leads to dehydration and this can happen fast.
Mrs. Jameson was diagnosed with type 2 diabetes one year ago, and has been on treatment since then. She manages her own medication, and has a case manager who regularly checks up on her to ensure that her medications are up to date, as well as her physical exercise regime. However, the admission into the emergency room a week ago is an indication that she has not taken enough water and observing her diet, which has resulted in the observed symptoms. Her diagnosis is: Hypernatremia related to excessive loss of water and elevated sodium
You’ll first have to calculate for the dehydration, 8lb. is converted to 3.63kg. Take 3.63kg x 0.1(10%) = 0.363L/8hrs. Deficit of 0.045375L/hr x 1000L= 45mL/hr. Once patient is properly rehydrated and no sudden loses such as vomiting or diarrhea, drop down to a maintenance dose. You can calculate the maintenance dose by multiplying the weight in kg by itself twice. Press the square root button twice and multiple the result by 80 and divide the end result by 24. So, 3.63*3.63*3.63= 47.83, square root of 47.83= 6.91. Square root of 6.91 = 2.62. 2.62*80=210.38/24=8.76mL/hr. Place an IV catheter and monitor the catheter site for infection or swelling. “Intravenous fluid therapy involves placing an intravenous catheter in the leg or neck so that a continuous drip of fluids can be given directly into the bloodstream.”(Brooks) It’s important to monitor this patient closely, too much fluids on any animal can cause overload, “development of pulmonary edema from overload of the left side of the heart”, monitor respiratory rate and signs of distress. Continue to check the skin turgor of the patient and check the capillary refill time. Once the patient is of normal hydration, fluids can be discontinued at the
Follow the protocol for a possible hypoglycaemic episode. While taking his BGL I would confirm his "feelings" checking for other signs and ask if he had eaten all of his last meal. I would check his notes and confirm his last dose of medication and time given, consulting with the RN if unsure. (Learning Guide states 3.5mmol/L as a hypo).
Relating to the identified issues for Philip, as a nurse, it is very crucial and essential to take effectual nursing interventions to treat the current health concerns. So, before implementing any action, it is mandatory for a team and me to specify when and what intervention I want. In Philip’s case, it is necessary to target his low blood pressure at first place. If the blood pressure remains low, this could lead to other complications. Currently, it is important to administer bolus of fluid (e.g. 0.9% normal saline). I want to improve his haemodynamic state i.e. want his BP within normal limit and urine output back to normal over the next hour. In order to take action on established goals; as nursing professional, I will make sure that patient is comfortable and I will also repeat observations such BP, HR.
Hypovolemia can be due to many predisposing factors such as fracture and surgery. The patient experienced a type of open fracture which is categorize by a wound in combination with the fracture (Whiteing, N., 2008, p. 50). Open Reduction Internal Fixation (ORIF) is the most common surgical technique for patients with open fracture which also includes tibia and fibula (William, L & Hopper, P., 2011, p. 1071). Since it was a major surgery massive blood loss or hypovolemia can be experience by a patient who will undergo this procedure. Craft, J., Gordon C., & Tiziani, A. (2011, p. 895) states that hypovolemia is a decrease in extracellular fluid volume and decrease in blood volume. In addition, Buttaro, T., (2013, p. 982) implies that there is approximately two (2)
Due to cold conditions of spending nearly 30 hours at sea, Hypothermia was developed. The body was losing heat faster than it was gaining it and prolonged exposure to the cold conditions, led to the body temperature dropping below 35 degrees, lower than the healthy temperature of 37 degrees. In response, organs slow down, starting to fail. If temperature keeps decreasing organs will shut down leading to heart failure or death.
Hypothermia occurs when an infant's core body temperature drops below 97.5 degrees. When an infant experience cold stress conditions through being exposed to moist atmospheric conditions, then enters into an environment where they are unable to regain lost body heat, hypothermia sets in. Premature and low-birth weight babies are greater risk of hypothermia. However, in general all newborns are susceptible to hypothermia, as they do not have to ability to maintain proper body temperature. Here are some example of hypothermia in an infant:
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
Nearly 60% of the human body is water. The daily fluid intake required for an adult to consume should be about 2600ml. A healthy person’s average daily fluid output is anywhere between 2600 – 2900ml, balancing out the daily fluid intake. Our bodily fluids are consistently moving to help carry nutrients to the cells as well as it carries wastes away from the cells. Not everyone is able to balance the fluids in their body making them either retain more or lose more than the fluid required. When suspecting any fluid imbalance or seeing any changes, the client should seek for any medical help to their primary health care provider to evaluate the patient and begin any treatment initiation if needed. When trying to manage fluid balance in patients that are hypovolemic, Intravenous therapy (I.V) may be used to administer solutions and/or medications to help maintain fluid balance if needed.
Hypohydratation have an effect on body temperature during exercise because when we practice sports we use a lot of water to produce energy. If we don’t rehydrated regularly it can have an effect on our body. Water in our body plays an important role in thermoregulation and during an effort we produce energy so we produce heat. If we have less water in our body because of the production of energy and hypohydrataion we think that during effort thermoregulation will be less done. This study will demonstrate our hypothesis.
According to the presented case scenarios, the list of priorities is as follows: Claudia, Kate, Marcus, and Jennifer. Claudia’s admission history indicates unstable status related to severe dehydration due to a three-day history of vomiting and diarrhea, and inability to keep anything down for almost one day. The subjective symptoms are consistent with objective signs which include rapid pulse and cool and clammy skin. Tachycardia indicates the attempt of the body to compensate for the decreased cardiac output related to depleted stroke volume caused by dehydration. Abdominal cramps may indicate alterations in potassium level related to electrolyte imbalance second to fluid and
Reactive hypoglycemia, a rare form of hypoglycemia, increases insulin levels after the consumption of excess carbohydrates, leading to a drop in blood glucose levels. This differs from conventional hypoglycemia where blood glucose drops several hours after a meal, but can easily be returned to normal by the consumption of food. Reactive hypoglycemia can cause fatigue, dizziness, shakiness, and in extreme cases, a coma. Although no effective treatments exist, glucagon, a peptide hormone derived from pancreatic alpha cells, seems to reduce symptoms. In the proposed experiment, the effectiveness of glucagon relative to a regimen of dietary control, exercise, and Acarbose will be tested on Zucker-diabetic-fatty (ZDF) rats (Rattus rattus). Three
The hypotension is a condition in which the blood pressure is much lower than the values considered being normal. Blood pressure varies from person to person. In general it is considered hypotension a condition in which the maximum pressure (or systolic) is equal to or lower than 90 mmHg and the minimum (or diastolic) is equal to or less than 60 mmHg. The hypotension causes are multiple and different significance: therefore vary from a trivial dehydration to more serious disorders. Low pressure is a disorder that can affect any person regardless of age.