Pediatric Careplan

Topics: Dehydration, Hypovolemia, Term Pages: 3 (965 words) Published: June 18, 2013
Broward College
Department of Nursing


PATIENT INITIALS| | AGE| 14 months| SEX| | | OTHER MEDICAL DX| Gatroenteritis| ADMITTING DX| Fever, vomiting, diarrhea| DATE| 3/13| | | | | | | | | | | | |
NURSING DIAGNOSIS(in priority order)| PATIENT-CENTERED GOALS| NURSINGINTERVENTION| RATIONALE| EVALUATION| Fluid volume deficit r/t excessive gastrointestinal loss of fluids and electrolytes in stool and vomitus as evidenced by: Sub. Data: Pt’s mother verbalization of fluid loss, “My baby has had diarrhea and has vomited for the last two days.”Obj. Data: Pt has high urine specific gravity, increased hematocrit, increased body temperature and increased pulse rate.| Short Term GoalPt’s electrolyte values will remain within normal limits for age by end of day 3/26/13.Long Term GoalPt will exhibit normal elimination patterns for age by discharge.| - Assess Skin turgor, mucous membranes, and fontanels every shift.-Record intake and output every shift, including urine, stool, vomitus, and any other output to obtain fluid status.-Weigh pt every morning before first feeding. Child must be weighed without any clothing each time for most accurate weight.- Monitor IV fluid infusion every hour. - Monitor lab study results (electrolytes, pH and hematocrit).| - Because fluid imbalance is less stable in young children, an infusion rate that is too fast or too slow can lead to fluid imbalance more rapidly than in adults (Sparks 412)- To obtain fluid status. Increased output and decreased intake indicate fluid volume deficit. (Sparks 411)- To monitor weight loss. Loss of 5% per day indicates fluid deficit. (Sparks 411)- Fluid loss occurs first in extracellular spaces resulting in poor skin turgor, dry mucous membranes and sunken fontanels. (Sparks 411)- Electrolytes are excreted during fluid loss and may lead to electrolyte imbalance (Sparks 412)| STG pending. Sodium and potassium levels are within the normal range. Urine...
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