Excess fluid volume with Maslow's

CT Pixie, BSN, RN · May 5, 2012

A normal fluid volume is a basic human body need (too much or too little isn't good). Your title says EXCESS fluid volume, so..WHY is too much fluid an issue? What will an excess fluid volume do or not do? Explain that and there's your WHY.

Esme12, ASN, BSN, RN · May 5, 2012

i believe that it would fall under psychological but my teacher is asking me to add why in my case study. i just figured fluid is a basic need but don't know how to state why. thanks for the help. i hate case studies!

welcome to an! the largest nursing online community. we are happy to help you with homework but we will not do it for you. we will lead you to the right place so you can answer it yourself therefore developing those critical thinking skills so vital to being a good nurse.

if water is basic need for "survival" it would be physiologic not psychological.

so in your case study....why does the patient have excess fluid. are the in heart failure? renal failure? yes fluid/water is vital to human survival but what would make it detrimental to human survival. how would it threaten human survival. how does this apply to you patients assessment? what does you assessment tell you. we need more information the patient before you can make a decision how this affects you patient. does the fluid over load cause a decreas in o2? more information is needed.

look at maslow's to tell you which priority precedes the next.

the greatest priority is at the bottom (the largest platform)and work your way up

let the patient drive your diagnosis not try to fit the patient to the diagnosis you found first. you need to know the pathophysiology of your disease process. you need to assess your patient, collect data then find a diagnosis. let the patient data drive the diagnosis. what is your assessment? is the patient having pain? are they having difficulty with adls? what teaching do they need? what do you want to push fluid or restrict fluids? will you give diuretics? what does the patient say? what are the labs? what does the patient need? what is the most important to them now?

the medical diagnosis is the disease itself. it is what the patient has not necessarily what the patient needs. the nursing diagnosis is what are you going to do about it, what are you going to look for, and what do you need to do/look for first.

care plans when you are in school are teaching you what you need to do to actually look for, what you need to do to intervene and improve for the patient to be well and return to their previous level of life or to make them the best you you can be. it is trying to teach you how to think like a nurse. think of them as a recipe to caring for your patient. your plan of how you are going to care for them.

from a very wise an contributor daytonite.......make sure you follow these steps first and in order and let the patient drive your diagnosis not try to fit the patient to the diagnosis you found first.

daytonite...........every single nursing diagnosis has its own set of symptoms, or defining characteristics. they are listed in the nanda taxonomy and in many of the current nursing care plan books that are currently on the market that include nursing diagnosis information. you need to have access to these books when you are working on care plans. there are currently 188 nursing diagnoses that nanda has defined and given related factors and defining characteristics for. what you need to do is get this information to help you in writing care plans so you diagnose your patients correctly.

don't focus your efforts on the nursing diagnoses when you should be focusing on the assessment and the patients abnormal data that you collected. these will become their symptoms, or what nanda calls defining characteristics.

here are the steps of the nursing process and what you should be doing in each step when you are doing a written care plan:

assessment (collect data from medical record, do a physical assessment of the patient, assess adls, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
determination of the patient's problem(s)/nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use)
planning (write measurable goals/outcomes and nursing interventions)
implementation (initiate the care plan)
evaluation (determine if goals/outcomes have been met)

a dear an contributor daytonite always had the best advice.......check out this link.

https://allnurses.com/nursing-student...is-290260.html

you need a good care plan book. i prefer gulanick: nursing care plans, 7th edition. they have an online care plan constructor. it used to be free but they caught on so now you need to buy the book to use the constructor.

care plans must be chosen from the "approved" script....nanda. i think the biggest mistake students make is that the need to let what the patient says, does and feels (the assessment) dictate what you do next. not the medical diagnosis and try to fit the patient into diagnosis.

what is this patient telling/showing you?

cfballardx2 · May 6, 2012

excess fluid volume related to ascites and peripheral edema from portal hypertension, manifested by distended abdomen and edema in ble. the goal is that patient will have no increase in edema and return to normal fluid balance. on maslow’s hierarchy of needs this would falls under physiologic (why?) . intervention: measure client’s abdominal girth every day, at same time, with same tape measure and mark the measurement. rationale: to conclude if the patient’s ascites is growing, declining, or staying the same. evaluation: patient’s abdominal girth has declined. intervention: administer lasixs as ordered while tracking i and o. rationale: the lasixs well help remove excess fluid and decrease edema. while monitoring i and o you can track fluid removal. evaluation: lasixs administered and output is greater than input. interventions: daily weight. rationale: monitoring daily weight shows if the lasixs is working to reduce edema. evaluation: clients edema on ble is diminished. intervention: maintain client in semi fowler’s position if dyspnea or ascites is present. rationale: gravity improves lung expansion by lowering diaphragm and shifting fluid to lower abdominal cavity. evaluation: a patient state breathing is easier.

my patient has cirrhosis. the why in read is my instructor asking why. thanks for yu help

cfballardx2 · May 6, 2012

We made this patient up so everything is driven by mwah!

CT Pixie, BSN, RN · May 6, 2012

Regardless of whether or not the info on the patient is made up, your teacher is asking WHY fluid volume is necessiary for homostasis and why it falls under the physiological needs. So,ok then, WHY does your body need the correct balance of fluids. I'm assuming you've taken A&P. Think back, why does the body need the correct amount of fluids. What happens to the cells if there is too much or too little, what happens if the fluid is hypotonic or hypertonic, what happens to your heart rate and blood pressure as well as the pH of the blood with excess fluids in the body.

Esme12, ASN, BSN, RN · May 6, 2012

excess fluid volume related to ascites and peripheral edema from portal hypertension, manifested by distended abdomen and edema in ble. the goal is that patient will have no increase in edema and return to normal fluid balance. on maslow’s hierarchy of needs this would falls under physiologic (why?) .
intervention: measure client’s abdominal girth every day, at same time, with same tape measure and mark the measurement.
rationale: to conclude if the patient’s ascites is growing, declining, or staying the same. evaluation: patient’s abdominal girth has declined.
intervention: administer lasix as ordered while tracking i and o.
rationale: the lasik well help remove excess fluid and decrease edema. while monitoring i and o you can track fluid removal.
evaluation: lasix administered and output is greater than input. if you decrease the patients fluid load will they feel/breathe better?
interventions: daily weight.
rationale: monitoring daily weight shows if the lasixs is working to reduce edema. evaluation: clients edema on ble is diminished.
intervention: maintain client in semi fowler’s position if dyspnea or ascites is present. rationale: gravity improves lung expansion by lowering diaphragm and shifting fluid to lower abdominal cavity.
evaluation: a patient state breathing is easier.
my patient has cirrhosis. the why in read is my instructor asking why. thanks for your help

schools and instructor do students a disservice. care maps/case studies/care plans the first most important information gathering tool is assessment. what you see, hear and touch. what the patient says ans complains of your patient has ascites from cirrhosis. if they are going to be fictitious the least they could do in provide you with the proper data. this angers me....and they wonder why students are struggling. :banghead:

why would so much excess fluid be detrimental for your patient? would it be detrimental to their breathing?

first you need to know what cirrhosis is. then what is ascites is. what detrimental effects does excessive ascites cause to the patient the patient's nutritional status....is there a loss of albumin. will crowding of the abdomen cause crowding leading to difficulty breathing? what type of cirrhosis is this as it would change your treatment. is this patient an alcoholic? is this from right heart failure and portal hypertension for the right sided failure? cor pulmonale?

cardiac cirrhosis (congestive hepatopathy)

medscape: medscape access

cirrhosis

medscape: medscape access

ascites

medscape: medscape access

medscape requires registration but it is free and a great source/resource

according to maslow's what comes first. i like to say what will kill/hurt them first. think abc's.

"on maslow’s hierarchy of needs this would falls under physiologic (why?) ."

in your interventions and rationales you have answered your own question.

Awesomejessica89 · May 6, 2012

in the lowest part of hire achy is physiological needs like food drink oxygen and sex, this would fall under there as it is needed to sustain life

born_this_way · Jan 7, 2016

Thank you CT Pixie and Esme12. Great explanations both of you. Is this how you should think while answering for NCLEX questions? I am prepping for nclex and have poor content. I have Hurst Review and also Mosby's Comprehensive Review book which breaks down Maslow concepts (ie Oxygenation and everything that relates to oxygen)

How should I integrate the body systems? Study the Liver first, portal hypertension, F&E, cardio, renal, and resp? then localized vs systemic? So no matter what s/s besides the associated/related ones, I can integrate , think and understand the body system as a whole, I can predict and answer any nclex question? thanks :)