decreased TK output and decreased Hb Assessment date: 25-11-2012 Diagnostic statement (PES): Excess fluid volume related to compromised regulatory mechanism secondary to end-stage renal failure as evidence by peripheral edema and patient’s weight gained from 69.8kg to 73.6kg within 4 days. Assessment Nursing Diagnosis Goals & Expected Outcomes Nursing Interventions Rationales Methods of Evaluation Subjective data: 1. The client claimed her weight started to gain
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and it gets backed-up in the lungs. A buildup of fluid in the lungs‚ called pulmonary edema‚ can cause shortness of breath and often leading to right sided heart failure. Right sided heart failure is when the right ventricle cannot pump out enough blood‚ causing fluid to back up in the vein and capillaries. The backup of fluid leaks out and builds up in the tissue‚ a condition called systemic edema. The edema is commonly noticed in the lower half of the
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inhibitors PREGNANCY (D) 2nd‚3rd trimester. Dosage: Adult: PO: 2.5mg/day then 2.5-20 mg/day divided bid or daily. Pharmokinetics: half life: 1-2 hrs‚ onset 1-2‚ peak 3-6. Nursing implications: check for allergies. check for hypotension. check for edema Atorvastatin: Drug Cards Ramipril: Functional class: Antihypertensive Chemical class: ACE inhibitors Action: ACE inhibitors reduce ACE. ACE converts angiostenin I to angiostenin II‚ which narrows heart vessels‚ which causes high BP. ACE
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NAME:furosemideBRAND NAME:LasixDRUG CLASSIFICATION:Loop DiureticDOSAGE:Adults-Edema: initially‚ 20-80mg/day PO as single dose. If needed‚ a second dose may be given in 6-8 hour.-acute pulmonary edema 40mg IV over 1-2 minute maybe increased to 80mg IV given over 1-2 min if response is unsatisfactory after 1 hour. -hypertension: 40mg BID PO‚ if needed‚ additional hypertensive may be added.PEDIATRICS-Edema: 2mg/kg/day PO-pulmonary edema:1mg/kg/IV or IM. May increase by 1mg/kg in 2hour.ROUTE: Oral‚ IV‚ IM |
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Nursing Diagnosis # 1 Ineffective breathing pattern related to decreased oxygen saturation‚ poor tissue perfusion‚ obesity‚ decreased air entry to bases of both lungs‚ gout and arthritic pain‚ decreased cardiac output‚ disease process of COPD‚ and stress as evidenced by shortness of breath‚ BMI > 30 abnormal breathing patterns (rapid‚ shallow breathing)‚ abnormal skin colour (slightly purplish)‚ excessive diaphoresis‚ nasal flaring and use of accessory muscles‚ statement of joint pain‚ oxygen
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Recognition of abnormal Head CT findings 2013 Sue Crowley 2013 Sue Crowley Until the CT tech took images to show what the problem was 2013 Sue Crowley Content • • • • • • • • • Head Trauma Facial Trauma Intracranial hemorrhage Intercranial pressure Stroke Ruptured aneurysms Hydrocephalus Brain tumours Multiple sclerosis 2013 Sue Crowley The Canadian CT Head Rule head rule • will permit physicians to standardize care of patients with head injuries and to be much more selective in the use
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Cold & Compression • Devices can utilizes cold and compression therapy together to treat an injury • Can use intermittent circumferential or sequential Circumferential can be used to prevent the formation of edema • Can use continuous cold therapy units Useful in preventing edema Injury Response Process - Effects • Movement of fluids is caused by various pressure gradients • Two pressure gradients are being utilized External compression causes the gradient between the tissue hydrostatic
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adequate blood supply edema may develop. (Cadwallader p. 1141). Where edema occurs depends on what side of the heart is failing. Left-sided heart failure results from the inability of the left ventricle to function properly. Blood fails to get out to other parts of the body as quickly as it returns from the lungs. When blood doesn’t get back to the heart‚ it backs up in the lungs blood vessels. Blood is then forced into the intracellular space in the lungs causing pulmonary edema. (Cadwallader pp.
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Accessory muscles of respiration = intercostals and neck muscles may be used to increase ventilation in pt’s with labored breathing midline) Afebrile = no fever Ambulate = to walk Analgesic = relieving pain Anasarca = severe generalized edema Anuria = absence of urine formation Antihypertensive = an agent that prevents high blood pressure Antipyretic = an agent that reduces fever Ascites = accumulation of fluid in the peritoneal cavity (abdomen) Auscultation = listen for sounds
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Heart failure happens when a disease affects the heart’s ability to deliver enough blood to the body’s tissues. Often‚ a person with heart failure may have a buildup of fluid in the tissues‚ called edema. Heart failure with this kind of fluid buildup is called congestive heart failure. Where edema occurs in the body depends on the part of the heart that is affected by heart failure. Heart failure caused by abnormality of the lower left chamber of the heart (left ventricle) means that the left ventricle
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