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Care of The Patient with Health Issues Outline

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NR 324 Course Content Guideline Outline
The purpose of this outline is to provide a tool to organize and direct your learning to ensure you
understand and can apply the information presented in lecture.
Outline Content
• The bolded title is the lecture topic.
• Each line item encompasses the topic content areas requiring focused attention.
• The italics item references a table or section in the course text book.
• The italic section is to be reviewed to enhance your understanding of the content.
Care of the Patient with Fluid and Electrolyte Imbalances
This section is to be completed prior to lecture on May 4/5
th
and May 7/8th
FVE (this is not a completed review of FVE)
Population at Risk / Causes (Table: Extracellular Fluid Imbalances)
o Excessive isotonic or hypotonic IV fluids
o Heart failure
o Long-term use of corticosteroids
o Renal failure
o Primary polydipsia (Drinking excessive fluids)
o SIADH (Excessive ADH, endocrine disorder)
o Cushing syndrome (Excess Cortisol)
Clinical Manifestations / (Table: Extracellular Fluid Imbalances)
Headache, confusion, lethargy, seizures, coma (Neurological)
o Jugular venous distention
o Peripheral edema
o Bounding pulse, increased BP, increased CVP
o Polyuria (with normal renal function)
o Dyspnea, crackles, pulmonary edema (Primary Concern HYPOXIA)
o Weight gain
o Muscle spasms
o S3 heart sound
Lab Values
- Sodium (135-145): Decreased below 135
- Serum osmolality 275- 285: Decreased below 275
- Hematocrit BUN, (Volume indicators): Decreased
- Urine specific gravity 1.005 – 1.030: Decreased below 1.005
Nursing Management (TEXT Section) / Nursing Implementation (TEXT Section)
o Daily Weight same time
o Patient Safety
o Lab Findings
o I & O
o Cardiovascular Care, Vital Signs, JVD, Edema
o Respiratory Care; Crackles, congestion, hypoxia
o Skin Care

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Collaborative Care (TEXT Section)
o Treating the underlying cause and remove fluid without producing abnormal changes in
the electrolyte composition or osmolality.
o Give diuretics
o Fluid and sodium restriction
FVD
Population at Risk / Causes (Table: Extracellular Fluid Imbalances)
o Hemorrhage
o Diabetes insipidus
o Osmotic diuresis
o ↑ insensible water loss/perspiration; high fever
o Inadequate fluid intake
o GI losses; diarrhea, vomiting, NG suctioning
o Third-space burns/pancreatitis
o Overuse; diuretics
Clinical Manifestations (Table: Extracellular Fluid Imbalances)
o Drowsiness; lethargy
o Restlessness
o Cold clammy skin
o Dry mucous membranes
o ↓ urine output; concentrated
o ↓ capillary refil
o ↓ skin turgor
o ↑ respiratory rate
o ↑ pulse
o Seizures/ coma
o Postural hypotension
o ↓ CVP
o Weakness, dizziness
o Weight loss
o Seizures, coma
Lab Values
- Sodium (135-145) increased above 145
- Serum Osmolality (275-285) increased above 285
- Urine Specific Gravity 1.005-1.030 increased above 1.025
- Hematocrit and BUN (Volume indicators) increased
Nursing Management (TEXT Section) Nursing Implementation (TEXT Section)
o Monitor I/O; accurately recorded provides information of fluid losses
o Monitor VS; thorough cardiovascular assessment
o Daily weight; done at the same time each day. Wearing the same clothing
o Cardiovascular Care: Monitor vital signs, ↑ heart rate, peripheral vasoconstriction, weak
and thread pulses, orthostatic hypotension
o Respiratory Care: monitor pulse oximetry, ↑ respiratory rate, hypoxia
o Skin Care: examine skin turgor, folds; skin may appear warm, dry, and wrinkled.
o Severe: skin can be cool and moist. Oral mucous membranes will be dry, tongue
may be furrowed, patient will complain of thirst.

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NR 324 Course Content Guideline Outline The purpose of this outline is to provide a tool to organize and direct your learning to ensure you understand and can apply the information presented in lecture. Outline Content • The bolded title is the lecture topic. • Each line item encompasses the topic content areas requiring focused attention. • The italics item references a table or section in the course text book. • The italic section is to be reviewed to enhance your understanding of the content. Care of the Patient with Fluid and Electrolyte Imbalances This section is to be completed prior to lecture on May 4/5th and May 7/8th FVE (this is not a completed review of FVE) Population at Risk / Causes (Table: Extracellular Fluid Imbalances) o Excessive isotonic or hypotonic IV fluids o Heart failure o Long-term use of corticosteroids o Renal failure o Primary polydipsia (Drinking excessive fluids) o SIADH (Excessive ADH, endocrine disorder) o Cushing syndrome (Excess Cortisol) Clinical Manifestations / (Table: Extracellular Fluid Imbalances) Headache, confusion, lethargy, seizures, coma (Neurological) o Jugular venous distention o Peripheral edema o Bounding pulse, increased BP, increased CVP o Polyuria (with normal renal function) o Dyspnea, crackles, pulmonary edema (Primary Concern HYPOXIA) o Weight gain o Muscle spasms o S3 heart sound Lab Values - Sodium (135-145): Decreased below 135 - Serum osmolality 275- 285: Decreased below 275 - Hematocrit BUN, (Volume indicato ...
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