Why Is Mrs. Beck Likely Becoming Light-Household?

Clinical Application Questions
Shanti Sharma
RNSG 1413
May 25, 2018

Chapter 41: Fluid and ElectrolytesMrs. Hilda Beck is a 72-year-old seen by her health care provider this morning after falling at home because she became light-headed after vomiting and having diarrhea that has lasted over
24 hours. She was admitted for oral and intravenous (IV) fluid therapy.
1. Why is Mrs. Beck likely becoming light-headed? When should you expect this to resolve?
Answer: Mrs. Beck became light-headed because she has fluid volume deficit in her vascular compartment. Because of her the vomiting and diarrhea over 24 hours she has extracellular volume deficit.
The deficit should be resolved when Mrs. Hilda’s fluid volume is restored with IV
The recommendations for David to improve his sleeping patterns would be to help him develop a weight-loss program, as weight loss improves sleep. Teaching the patient to try elevating the head of his bed using extra pillows to prevent him from sleeping on his back, encouraging him to avoid or limit the consumption of alcohol, caffeine, and, nicotine before bedtime which can make the problem worse (Potter & Perry, 2013, p. 954). 3. Julie and David tell you that they are concerned about their 6-year-old daughter. She just started school and is having sleep problems. List at least four interventions for Julie and David to use to improve their daughter's sleep patterns.Answer: Some interventions for David and Julie to help improve their daughter's sleep patterns would be:
• Establishing a consistent bedtime routine (Potter & Perry, 2013, p. 954).• Environment controls: such as keeping the room well ventilated, adequate darkening of room, reduction of noise, and maintenance of comfortable room temperature (Potter & Perry, 2013, p. 954).• Encouraging her to avoid eating any heavy meals for 3 hours before bedtime (Potter & Perry, 2013, p. 954).
• Encourage her to do quiet activities such as listening to music, coloring, or reading a bedtime story (Potter & Perry, 2013, p. 954).• Encouraging her for activity and exercise during the morning or afternoon hours and avoid vigorous activities 2 hours before
It is very much important to measure the length, width, and depth of the wound once in every 24 hours. It is important to assess for presence of odor, signs of excessive wound drainage, and number of gauzes saturated (Potter & Perry, 2013, p. 1204)
2. A head-to-toe skin assessment is done per institutional policy on a daily basis. At the most recent assessment of Mrs. Stein's skin, redness was noted over the sacral area; on direct examination, a small area of denuded tissue was noted. The area was assessed and was found to have minimal depth and a red, moist base. How would you describe the impairment in skin integrity in your charting?
Answer: In the charting, the impairment of skin integrity will be classified as Stage II (Partial thickness skin loss) under depth of injury. The risk factors would be friction and impaired mobility. A pain assessment for any pain on a scale of 0 to 10, and color and type of tissue in wound (red, moist tissue, granulation tissue) (Potter & Perry, 2013, p. 1179).
3. What will you include in your plan of care for Mrs. Stein to address the impairment in skin integrity in the sacral