Situation: Mrs. T, age 56 years, is in the hospital for treatment of dehydration. Her only previous medical history includes Alzheimer's disease. The emergency room physician documented that the dehydration and electrolyte imbalances are the result of a lack of nutrition and fluids.
Background: Mrs. lives alone, but an adult daughter lives nearby. Her daughter visited her this morning and realized the food she left for her Mother three days ago was left untouched. Her daughter believes her increased confusion is due to her aggressive Alzheimer's disease. Mrs. T's mental status will be evaluated after the acute delirium from multielectrolyte imbalances has been corrected.
You are assigned to Mrs. T on her 2nd hospital day. You continue your client assessment, encourage the client to drink clear liquids, maintain strict I&O; and continue to review the daily serum chemistry reports. The RN provides IV fluids, administers prescribed medications, and begins discharge plans with Mrs. T's daughter. You are working closely with the RN to prevent self harm due to forgetfulness, infections, and skin breakdown.
Assessment: Mrs. T's admission assessment findings include disorientation to person, place, time, and situation; generalized muscle weakness; dry sticky mucous membranes and lips; tachycardia; poor skin turgor; and a urine output of less than 30 mL for the first hours after a retention catheter was inserted. The physician has begun intravenous fluid replacement therapy with multielectrolytes. Mrs. T has a sitter with her around-the-clock to help the nursing staff provide for her safety.
Diagnostic laboratory tests results include a sodium 154 mmol/L; potassium 2.7 mmol/L; serum osmolality 440 mOsm/kg, and a urine specific gravity of 1.100.
What types of fluids would you recommend that Mrs. T's daughter stock in her Mother's home for rapid electrolyte replacement in the future?
Two Highest Priority Nursing Diagnoses?
Identify two areas of functional health patterns that you would like to obtain on Mrs. T. Explain how you will obtain this information and from what source(s).
i take my hat off to you if it only takes you 17 months to master care plan writing. it took me at least 3 years on the job! and that's being conservative. i never really understood the nursing process fully until i had been working for at least a year as an rn. it's not an easy concept to grasp, but once you start to "get it" and the light bulb turns on upstairs your nursing life will make an 180 degree turn around and you will look at and solve problems much differently, more rationally. you don't learn everything in nursing school. nursing school just opens the door. i am still learning things.
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i confess i feel much better knowing that it takes proper experience on top of school for these. we learned about assessments but received no guidance on doing these (i guess like the op)...it makes me feel like witless wonder.
Our teacher is big on "Explorative Learning".... I am almost done with my first semester of nursing school... and I need the break. Although, I don't know what I'll do with out the constant worry of having assingnments due.
DolceVita, ADN, BSN, RN
1,565 Posts
i confess i feel much better knowing that it takes proper experience on top of school for these. we learned about assessments but received no guidance on doing these (i guess like the op)...it makes me feel like witless wonder.