Goals for Intravenous Fluids

The goals for administering Intavenous Fluids

• To provide water, electrolytes, and nutrients to meet daily
requirements
• To replace water and correct electrolyte deficits
• To administer medications and blood products

Brunner and Suddarth 2010

Fluids administered for all Types of Shock

Fluid administed for all types of shock

may include crystalloids
(electrolyte solutions that move freely between intravascular
and interstitial spaces), colloids (large-molecule intravenous
solutions), or blood components.

Brunner and Suddarth 2010

Hospital Acquired Pneumonia

Hospital-acquired pneumonia (HAP) is pneumonia that develops 48 hours or longer after admission to a hospital. HAP is the second most common nosocomial infection.

-Medscape

Ventilator Associated Pneumonia

Ventilator-associated pneumonia (VAP) is pneumonia that develops 48 hours or longer after mechanical ventilation is given by means of an endotracheal tube or tracheostomy.

-Medscape

Normal ABG values

  • pH (7.35-7.45)
  • PaO2 (75-100 mmHg)
  • PaCO2 (35-45 mmHg)
  • HCO3 (22-26 meq/L)
  • Base excess/deficit (-4 to +2)
  • SaO2 (95-100%)

Acute Respiratory Distress Syndrome- Definition & Pathophysiology

Acute Respiratory Distress Syndrome [ARDS] is an acute condition characterized by bilateral pulmonary infiltrates and severe hypoxemia in the absence of evidence for cardiogenic pulmonary edema.

In this condition, the small blood vessels leak leading to fluid bluid up in the alveoli. This is described as diffuse alveolar damage (DAD) and lung capillary endothelial injury. This fluid prevents effective oxygen to carbon dioxide transfer into and out of the body respectively. Therefore carbon dioxide is not cleared and oxygen uptake is impaired.

The early phase is described as being exudative, whereas the later phase is fibroproliferative in character.

ARDS was recognized as the most severe form of acute lung injury (ALI), a form of diffuse alveolar injury. As this condition is life-threatening; many patients with ARDS require life support with a ventilator in an intensive care unit to assist with breathing.

Pathophysiology of ARDs

Medscape & Stevens et. al 2018

Glycosuria

A condition where there is sugar in urine often related to diabetes and/or kidney illness.

Epistaxis

Epistaxis, a hemorrhage from the nose, is caused by the rupture
of tiny, distended vessels in the mucous membrane of any area of the nose.

Brunner & Suddarth, 2010

Epixtasis case study & Nursing Care Plan

Nursing Process Case Studies: Epixtasis

A 14 year old male comes into the emergency with complaints of dizziness, headache & bloody vomitus for 1 day. He has been nose bleeding passively for three days & actively for 24hours. The accompanying guardian has had him lean back in an effort to stop the bleeding.

On assessment he has cold clammy skin and is weak looking while being pale with some confusion. Vital signs: BP 94/55, HR: 120b/m, Spo2 94% on room air with a temperature 34.9 degrees celsius having cold clammy skin.

Write a care plan for this patient on Epixtasis. Let us know in the comments section how that goes. Here is a seven column Nursing Process and some tips and ideas on writing Nursing Care Plans.

Nursing Process Practice Cases: Pneumonia

An 84 year old female Patient in the unit is being treated for Chronic bacterial pneumonia. In handover assessment, she appears weak while presenting with complaints of hotness of body, headache, chest pain of 7/10 and difficulty breathing. Vital signs; BP 92/50mmHg, pulse of 110 b/m SPO2 84% on room air with respirations of 22b/m temp 38 °C. She is diaphoretic with skin pinch return greater than 3 seconds.

Write a care plan for this patient. Let us know in the comments section how that goes. Here is a seven column NCP and some tips and ideas to get you off on the right foot.