F&E Outline.docx

+-----------------------------------+-----------------------------------+ | Analyze factors that place | Older adults: | | clients at risk for fluid and | | | electrolyte imbalances across the | \- Decreased total body water | | li...

+-----------------------------------+-----------------------------------+ | Analyze factors that place | Older adults: | | clients at risk for fluid and | | | electrolyte imbalances across the | \- Decreased total body water | | lifespan. | | | | \- Inadequate nutrition | | | | | | \- Higher risk of acute and | | | chronic illnesses | | | | | | All ages: | | | | | | \- Changes in fluid intake and | | | output | | | | | | \- Chronic kidney or endocrine | | | disorders | | | | | | \- Taking medications that alter | | | fluid/electrolyte balance | | | | | | \- Any illness that impacts fluid | | | regulation | | | | | | Infants and children: | | | | | | \- Higher insensible water losses | | | through skin and respiratory | | | tract | | | | | | \- Faster depletion of body | | | water/electrolytes with vomiting, | | | diarrhea, etc. | | | | | | \- Inability to take in oral | | | fluids normally | +===================================+===================================+ | Plan prevention strategies | \- Encourage adequate fluid | | related to fluid and electrolyte | intake, typically 8 glasses or | | imbalances. | more of water per day unless | | | medically contraindicated. | | | | | | \- Educate patients, especially | | | older adults, on the importance | | | of staying hydrated to prevent | | | dehydration and complications | | | like urinary tract infections. | | | | | | \- Recommend a balanced diet rich | | | in electrolyte sources like dairy | | | products for calcium, | | | bananas/potatoes for potassium. | | | | | | \- For patients at risk like | | | older adults or those with | | | chronic illnesses, monitor fluid | | | intake/output and electrolyte | | | levels closely. | | | | | | \- Provide dietary counseling for | | | patients with conditions like | | | ESRD or diabetes that increase | | | fluid/electrolyte imbalance risk. | +-----------------------------------+-----------------------------------+ | Analyze assessment data through | \- Monitor vital signs like blood | | the use of information technology | pressure, pulse rate/quality for | | including diagnostic and | signs of fluid imbalance. | | laboratory tests to determine the | | | client's fluid and electrolyte | \- Assess weight changes, as this | | status. | is the best indicator of fluid | | | volume changes. | | | | | | \- Examine skin turgor, mucous | | | membrane moisture for signs of | | | dehydration. | | | | | | \- Order serum electrolyte tests | | | (sodium, potassium, chloride, | | | etc.) to check for imbalances. | | | | | | \- Check renal function tests | | | like BUN, creatinine to detect | | | impaired kidney function. | | | | | | \- Evaluate hemoglobin, | | | hematocrit levels which can | | | indicate hemodilution from fluid | | | overload. | | | | | | \- Use BNP (B-type natriuretic | | | peptide) test to diagnose heart | | | failure and guide treatment. | | | | | | \- Perform urinalysis to check | | | for proteinuria, high specific | | | gravity suggesting dehydration. | +-----------------------------------+-----------------------------------+ | Demonstrate nursing judgment, | \- Perform a thorough cultural | | while providing culturally | assessment to understand the | | competent care across the life | client\'s beliefs, values, and | | cycle for acutely ill clients | practices related to health, | | with fluid & electrolyte | illness, and treatment. | | alterations. | | | | \- Develop an individualized, | | | culturally-sensitive plan of care | | | that incorporates the client\'s | | | preferences, needs, and cultural | | | norms. | | | | | | \- Communicate effectively and | | | respectfully, using professional | | | interpreters if needed to ensure | | | understanding. | | | | | | \- Be aware of potential cultural | | | influences on diet, fluid intake, | | | and traditional remedies that may | | | impact fluid/electrolyte balance. | +-----------------------------------+-----------------------------------+ | Prioritize care for acutely ill | Assessment: | | clients with fluid and | | | electrolyte imbalances using the | \- Monitor vital signs, weight | | nursing process. | changes, skin turgor, mucous | | | membranes for signs of imbalance | | | | | | \- Assess intake/output, review | | | diagnostic tests (electrolytes, | | | renal function, etc.) | | | | | | Nursing Diagnosis: | | | | | | \- Risk for Deficient Fluid | | | Volume related to active fluid | | | loss | | | | | | \- Risk for Electrolyte Imbalance | | | related to disease process | | | | | | Planning: | | | | | | \- Collaborate with | | | interdisciplinary team on | | | fluid/electrolyte replacement | | | therapy | | | | | | \- Develop a plan to address | | | underlying causes and promote | | | fluid/electrolyte balance | | | | | | Implementation: | | | | | | \- Administer prescribed IV | | | fluids, medications as ordered | | | | | | \- Encourage oral fluid intake if | | | permitted | | | | | | \- Provide supportive care | | | (oxygen, positioning, etc.) | | | | | | \- Educate on dietary/fluid | | | restrictions as needed | | | | | | Evaluation: | | | | | | \- Monitor response to | | | interventions (vital signs, | | | weight, I/Os, lab values) | | | | | | \- Reassess for complications | | | like pulmonary edema | | | | | | \- Modify plan as condition | | | changes to maintain | | | fluid/electrolyte homeostasis | +-----------------------------------+-----------------------------------+ | Practice safe caring and | \- Implement interventions | | evidenced-based interventions for | cautiously, monitoring patient | | acutely ill clients with fluid | response closely | | and electrolyte imbalances. | | | | \- Follow evidence-based | | | protocols for IV | | | fluid/electrolyte replacement | | | rates | | | | | | \- Administer medications like | | | diuretics per guidelines to avoid | | | complications | | | | | | \- Provide thorough patient | | | education on dietary/fluid | | | restrictions | | | | | | \- Assess frequently for signs of | | | worsening imbalance or adverse | | | effects | | | | | | \- Collaborate with the | | | interdisciplinary team for | | | comprehensive management | | | | | | \- Stay updated on latest | | | research/guidelines for | | | fluid/electrolyte therapy | +-----------------------------------+-----------------------------------+ | Manage the principles of | \- Understand age-related changes | | pharmacology to the identified | in pharmacokinetics that impact | | concepts for clients with fluid & | drug absorption, distribution, | | electrolyte alterations across | metabolism, and excretion. | | the lifespan. | | | | \- Carefully review dosing | | | guidelines, adjusting as needed | | | for neonates, children, and older | | | adults who are at higher risk for | | | adverse effects. | | | | | | \- Monitor for potential drug | | | interactions and side effects | | | that can contribute to | | | fluid/electrolyte disturbances. | | | | | | \- Educate patients/caregivers on | | | proper medication administration | | | and adherence. | | | | | | \- Evaluate response to | | | medications like diuretics, | | | electrolyte supplements, | | | adjusting as needed based on lab | | | values and clinical status. | | | | | | \- Stay updated on latest | | | evidence for safe, effective | | | pharmacological management of | | | fluid/electrolyte disorders. | +-----------------------------------+-----------------------------------+ | Manage the appropriateness, | \- Verify medication orders | | accuracy, and client response to | against reputable drug references | | pharmacology principles for | for appropriate dosing, routes, | | clients with fluid & electrolyte | and indications. | | alterations | | | | \- Assess baseline | | | fluid/electrolyte status and | | | monitor lab values during | | | therapy. | | | | | | \- Administer medications exactly | | | as prescribed, observing for | | | adverse effects or lack of | | | expected response. | | | | | | \- Evaluate client\'s clinical | | | status, adjusting medications per | | | protocols if fluid/electrolyte | | | goals are not met. | | | | | | \- Provide thorough client/family | | | education on medications, | | | expected effects, and importance | | | of adherence. | | | | | | \- Collaborate with the | | | interprofessional team, making | | | recommendations for therapy | | | changes as needed. | +-----------------------------------+-----------------------------------+ | Collaborate with the | \- Communicate client assessment | | interdisciplinary team to plan | findings, lab values, and | | and implement interventions for | response to interventions clearly | | acutely ill clients with fluid | and promptly. | | and electrolyte imbalances. | | | | \- Participate in | | | interdisciplinary rounds to | | | discuss the plan of care and any | | | needed modifications. | | | | | | \- Consult with providers on | | | medication adjustments based on | | | the client\'s clinical | | | presentation. | | | | | | \- Coordinate with dietitians for | | | appropriate dietary restrictions | | | and supplementation. | | | | | | \- Work closely with pharmacists | | | to ensure safe medication | | | administration and monitoring. | | | | | | \- Involve physical/occupational | | | therapy for mobility and | | | positioning needs. | | | | | | \- Utilize social work and case | | | management for discharge planning | | | and resource coordination. | +-----------------------------------+-----------------------------------+ | Analyze the relationship between | \- Acid-base balance is closely | | fluid and electrolyte imbalances | tied, as electrolyte disorders | | and other concepts/systems. | can lead to metabolic acidosis or | | | alkalosis. | | | | | | \- Renal function is impacted, as | | | the kidneys regulate | | | fluid/electrolyte levels and are | | | affected by imbalances. | | | | | | \- Cardiovascular function | | | depends on proper | | | fluid/electrolyte status for | | | blood pressure, cardiac output, | | | etc. | | | | | | \- Neurological function is | | | affected, with imbalances causing | | | confusion, seizures, and other | | | neurological symptoms. | | | | | | \- Respiratory function is | | | impaired by fluid overload | | | leading to pulmonary edema. | | | | | | \- Nutrition plays a key role, as | | | dietary intake impacts | | | fluid/electrolyte levels. | | | | | | \- Elimination processes like | | | urination and perspiration affect | | | fluid/electrolyte balance. | +-----------------------------------+-----------------------------------+