Question

32-year-old white female presented to the ER room, Sunday night at 1830. She reports, N/V/D since Saturday night at midnight. Reports being unable to keep any fluids down, despite attempts with sips of H20. reports 6-7 episodes of vomiting and dry heaving. Reports multiple episodes of diarrhea. The client reports incontinence with stool. Reports currently unable to produce urine. rates pain 3/10, diffuse to the abdomen. reports neck pain and rib pain from dry heaving. write with your findings, what does the lab work suggest? physician recommendations, 2 nursing diagnoses with 3 interventions.

Answer 1

Clinical condition of the white female presented to the Emergency Department :

Nausea, Vomiting, Diarrhoea	Unable to produce urine
Stool Incontinence	Neck and Rib pains, 3/10 pain

Laboratory Investigations :

• Complete blood cultures for proteins and also bacteria
• Urinary creatine levels can be assessed for end organ damage
• CT Scan of abdominal and Pelvic organs for any urethral infections
• Severe Sepsis or Septic shock findings as Systemic Inflammatory Response Syndrome and End organ damage through Lactic acid, Bilirubin and platelet counts
• Stool cultures for Clostridium difficult organism

Nursing Diagnosis and Interventions.

1. Altered fluid and electrolyte imbalance related to Diarrhoea as evidenced by Dehydration.	Interventions: 1.Assess the patient condition through laboratory electrolyte levels. 2. Electrolyte replacement should be performed through fluid administration E.g.. 0.9% Sodium Chloride. 3. Educate the patient about fluid rich and mineral rich diets Juices , fruits etc.
2. Decreased urinary out put related to Dehydration as evidenced by inability to produce urine.	Interventions: 1. Encourage the patient to take more amount of fluids 1500 to 2000ml. 2. Ask the patient to be seated near to tap water which aids in urination. 3. Provide sita bath to the patient which helps in voiding.

Below are the some of the findings

Nausea/ Vomiting/Diarrhoea DEHYDRATION (Due to excess loss of fluid because of vomitings and diarrhoea) • Acute or chronic renal failure. • Drugs such as chemotherapeutic, ACE Inhibitors Produces less amonunt or unable to produce urine as kidneys store The body liquid • Obstruction in the urinary tract Severe Sepsis/Septic Shock infections associated with renal failure
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