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FREE archived webcasts from the Webinar series based upon Planetree's “Putting Patients First” series published in AJN. Which drug would be least effective in lowering a client’s serum potassium level? Mercy College of Ohio, a Catholic institution with a focus on healthcare, educates and inspires students to lead and to serve in the global community. Topics covered includes: Nurse and Nursing as a profession, Anatomy and Physiology, Introduction to Psychology, Principles and practice of nursing, Health Assessment and Physical Examination, Medical and surgical Asepsis, First Aid and Hospital Housekeeping.

Pages: 418

Publisher: Macmillan; 5th edition (1984)

ISBN: 0024025003

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Write these five on the nursing care plan in the activity column. • • Weigh daily and monitor trends Monitor hydration status (e.g., moist mucous membranes, adequacy of pulses, and orthostatic blood pressure), as appropriate Assess location and extent of edema, if present Monitor patient’s weight change before and after dialysis, if appropriate Administer IV therapy, as prescribed Administer prescribed diuretics, as appropriate Instruct patient on nothing by mouth (NPO) status, as appropriate Encourage significant other to assist patient with feedings, as appropriate Monitor patient’s response to prescribed electrolyte therapy • • Count or weigh diapers as appropriate Monitor for indications of fluid overload/retention (e.g., crackles, elevate CVP or pulmonary capillary wedge pressure, edema, neck vein distention, and ascites), as appropriate Monitor vital signs, as appropriate Monitor hemodynamic status, including CVP, MAP, PAP, and PCWP, if available Monitor nutrition status Administer IV fluids at room temperature Administer prescribed nasogastric replacement based on output, as appropriate Offer snacks (e.g., frequent drinks and fresh fruits/fruit juice), as appropriate Consult physician, if signs and symptoms of fluid volume excess persist or worsen Administer blood products (e.g., platelets and fresh frozen plasma), as appropriate Maintain accurate intake and output record Monitor laboratory results relevant to fluid retention (e.g., increased specific gravity, increased BUN, decreased hematocrit, and increased urine osmolality levels Insert urinary catheter, if appropriate Monitor food/fluid ingested and calculate daily caloric intake, as appropriate Give fluids, as appropriate Distribute the fluid intake over 24 hr., as appropriate Promote oral intake (e.g., provide a drinking straw, offer fluids between meals, and change ice water routinely), as appropriate Restrict free water intake in the presence of dilutional hyponatremia with serum Na level below 130 mEq per liter Arrange availability of blood products for transfusion, if necessary Prepare for administration of blood products (e.g., check blood with patient identification and prepare infusion setup), as appropriate Request that tube placement be checked by xray examination when placement is questionable Consult with other health care team members in selecting the type and strength of enteral feeding Hold and talk to infant during feeding to simulate usual feeding activities Irrigate the tube every 4 to 6 hr. during continuous feedings and after every intermittent feeding Slow tube feeding rate and/or decrease strength to control diarrhea Hold tube feedings if residual is greater than 150 cc or more than 110% to 120% of the hourly rate in adults Change feeding and infusion tubing regularly, according to agency protocol Discard enternal feeding containers and administration sets every 24 hours Monitor for presence of bowel sounds every 4 to 8 hr., as appropriate Elevate head of the bed during feedings Monitor for proper placement of the tube by inspecting oral cavity, checking for gastric residual, or listening while air is injected and withdrawn, according to agency protocol Monitor fluid and electrolyte status Offer pacifier to infant during feeding, as appropriate Discontinue feedings 30 to 60 min. before putting in a head-down position Use clean technique in administering tube feedings Monitor for sensation of fullness, nausea, and vomiting Keep cuff of endotracheal or tracheostomy tube inflated during feeding, as appropriate Wash skin around skin level device daily with mild soap and dry thoroughly Refill feeding bag every 4 hr., as appropriate Check residual every 4 to 6 hr. during continuous feedings and before each intermittent feeding Keep open containers of enternal feeding refrigerated Check water level in skin level device balloon, according to equipment protocol Prepare patient for home tube feedings, as appropriate Refer for diagnostic workup to determine cause of being underweight, as appropriate Monitor for nausea and vomiting Monitor daily calories consumed Instruct on how to increase calorie intake Weigh patient at specified intervals, as appropriate Determine cause of nausea and/or vomiting, and treat appropriately Monitor serum albumin, lymphocyte, and electrolyte levels Provide a variety of highcalorie nutritious foods from which to select Provide rest periods, as needed Provide foods appropriate for patient: general diet, mechanical soft, blenderized or commercial formula via nasogastric or gastrostomy tube, or total parental nutrition, as ordered by physician Discuss with patient and family socioeconomic factors contributing to inadequate nutrition Teach patient and family meal planning, as appropriate Administer medications to reduce nausea and pain before eating, as appropriate Encourage increased calorie intake Provide oral care before meals, as needed Assist with eating or feed patient, as appropriate Consider patient’s food preferences, as governed by personal choices and cultural and religious preferences Ensure that patient is in a sitting position before eating or feeding Create a pleasant, relaxing environment at mealtime Serve food in a pleasant, attractive manner Discuss with patient and family perceptions or factors interfering with ability or desire to eat Teach patient and family how to buy low-cot, nutritious foods, as appropriate Encourage attendance at support groups, as appropriate Refer to community agencies that can assist in acquiring food, as appropriate Reward patient for weight gain Weigh patient at specified intervals Monitor patient’s emotional response when placed in situations that involve food and eating Schedule treatments and procedures at times other than feeding times Monitor for dry, thin hair that is easy to pluck Monitor skinfold measurements;triceps skinfold, midarm muscle circumference, and midarm circumference Monitor food preferences and choices Monitor for pale, reddened, and dry conjunctival tissue Monitor for redness, swelling, and cracking of mouth/lips Note significant changes in nutritional status and initiate treatments, as appropriate Provide optimal environmental conditions at mealtime Monitor trends in weight loss and gain Monitor parent/child interactions during feeding, as appropriate Monitor for dry, flaky skin with depigmentation Monitor gums for swelling, sponginess, receding, and increased bleeding Monitor albumin, total protein, hemaglobin, and hematocrit levels Provide nutritional food and fluid, as appropriate You have successfully completed your first nursing care plan using the standard nursing language vocabularies of NANDA, NOC, and NIC. 1 , e.g. Bundle: Personal Nutrition, read for free http://108.61.177.7/ebooks/bundle-personal-nutrition-9-th-mind-tap-nutrition-1-term-6-months-printed-access-card.

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