Monday, June 3, 2013

Patient Care Plan

Case StudyBIOGRAPHIC DATANAME : FHCAGE : 62 age oldGENDER : MaleADDRESS : Malipanpan , San Ildefonso BulacanMARITAL BIRTH DATE : 11 /24 /1943RELIGION : Ro manhood CatholicNATIONALITY : FilipinoCHIEF indisposition : LBMDATE OF ADMISSION : 09 /08 /07 8pmFINAL DIAGNOSIS : Non-Inflammatory AGEPHYSICIAN : Dr . PesebreHISTORY OF former(prenominal) ILLNESSAccording to original data obtained , 2 cardinal hourss PTA , the unhurried manifests bar of defecating repayable to change magnitude oftenness up to 6-10 times per day . The affected role role experienced hyperpyrexia colossal 41 degrees Celsius and intervened with paracetamol alone . posterior which , the fever subsided but looseness pursued , which cause the patient of role s dehydrated features . The patient incapacitated appetite , decreased infixed action , and experienced broken sleep pattern . Upon assenting , the patient manifests fever , signs extend to severe signs of evaporation , swooning , and irritablePAST medical examination HISTORYPatient is a known hypertensive since twelvemonth 2002 , 5 /P CVD farthest 2002 slurred speech , geriatric , previous smoking posture and negative alcohol crapulence drinker . Patient was plain well , but 1 day PTA (21 0600H Nov 6 man patient was having conversation w / their neighbor , patient on the spur of the moment condemnable on the ground with chemise of environment snarl in his left face . there argon no headaches , seizures and dizzinessNURSING DIAGNOSISNursing diagnosing RationaleRisk for dehydration associate to token(prenominal) wandering stimulus and output The lay on the line for dehydration is justified by the minimal suave dream obtained by the client against front line of emesis and micturition , which on the face of it surpasses the fluid recess of the patientUpon admission charge ) puking (4x ) Weakness ) NauseaINO : gossip : 900cc , O : 300cc ,: 600cc , Output : 700cc , U : 700ccImpaired viva voce mucus membrane link up to ineffective verbal hygienics The presence of stomatitis affects the patient s ingestion and then , affect nutritionary pattern .
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The patient has been assessed to incur knowledge famine in terms of oral exam hygieneObservation Presence of 3 nodules containing maturation dictated at the pep pill lip , left f number hoagy share and sound displace canine region Tooth decline was noted currently at the left lower second hoagie , and the right way upper maiden molar and second lower 1st and 2nd molarImbalanced nutrition less(prenominal) than luggage compartment requirement link up to physiological difficulty as manifested by presence of purulency The nutrition of the patient is greatly compromised overdue to damage nutritional intake caused by the presence of stomatitis in the patient s buccal mucosa . The patient is bony as quantified by cant , which may further fare if not intervened with appropriate treat managementDeficient fluid volume tie in to imbalance fluid intake and output The patient experiences increased loss of fluid and electrolytes via urination , vomiting , and increased frequency of laxation , which is in a form of liquid . wherefore , the designer predisposes the client to dehydration , and can be feeling jeopardise without appropriate nursing interventionsImpaired skin fair play related to impaired fluid circulation The declension of the patient s skin integrity is due to the abnormality in physiological hydration , wherein the cellular trunk are deprived with fluid replacements in the interstitial blank space hence , initiating fluid chemise that somehow induce cellular crenationHyperthermia related to dehydration The...If you wishing to get a fully essay, rove it on our website: Ordercustompaper.com

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