Question

Case: Patient has diarrhea 8 hours prior to admission. According to him, he passed out watery stool 4 times. To replace fluid and electrolyte lost, he drank Pocari Sweat and water every time he defaces. Physical examination done. Tongue slightly dry, skin turgor (+), VS within normal, no complaint of body weakness.

what are the for this care plan

1. scientific rationale

2. objectives short and long

3. evaluation

Answer 1

Nursing care plan for dehydration :-

# ASSESSMENT

- Subjective :-

Loss of Appetite

- Objective :-

Dry mouth

Fatigue or weakness

# DIAGNOSIS

Acute Dehydration due to due to bloody diarrhoea

# PLANNING

After 8 hrs of nursing intervention the patient will display improvement on the Objective cues

# INTERVENTION :-

Monitor and document vital signs

Assess skin turgor and mucous membranes for signs of dehydration.

Assess color and amount of urine

Monitor temperature

Promote increase in fluid and electrolyte intake

Administer parenteral fluids as ordered

# RATIONALE

To evaluate patient's current health status

Skin in elderly patients loses its elasticity; therefore skin turgor should be assessed over the sternum or on the inner thighs

Concentrated urine indicates fluid deficit

To replace loss body fluid

Anticipate the need for an IV fluid with immediate infusion of fluids for patients with abnormal vital signs.

# EVALUATION

Goal was met.After 8 hrs of nursing intervention the patient displayed improvement on the Objective.