Therapeutic diets
high fiber
whole grains, raw/dried fruits, oatmeal, steamed veggies
clear liquid
clear juices, gelatin, broth, coffee, tea, popsicles, ice chips
risk factors/causes for FVD
vomiting, ngt suctioning, diarrhea
diabetes insipidus, kidney disease, adrenal insufficiency
hemorrhage
hyperventilation, prolonged fever
enteral feedings w/o sufficient water intake
anuria
less than 100 mL/24 hr
low sodium
no added salt (1-2 g)
full liquids
dairy products, pureed veggies, ice cream, pudding, yogurt
clinical manifestations for FVD
■Hypothermia or hyperthermia
■Tachycardia
■Thready pulse
■Hypotension
■Hypoxia
■Tachypnea
■Dizziness
■Syncope
■Thirst
■Dry mucous membranes
■Vomiting
■Oliguria
■Acute weight loss
■Diminished capillary refill
■Clammy skin
■Sunken eyeballs
■Flattened neck veins
■Decreased skin turgor
oliguria
less than 400 mL/24 hr
low cholesterol
less than 300 mg/day
pureed
pureed meat, fruits, eggs
risk factors/causes for FVE
–Altered kidney function
–Interstitial plasma shifts
–Excessive sodium intake
–Head injuries
–Syndrome of inappropriate antidiuretic hormone (SIADH)
average adult urine produce
1,500-2,000 mL/day of urine
diabetic
balanced intake of protein, fats, carbs (1,800 calories)
mechanical soft
diced, ground food, cottage cheese, pancakes, banana
clinical manifestations for FVE
■Tachycardia
■Bounding pulse
■Jugular vein distension
■Hypertension
■Tachypnea
■Confusion
■Muscle weakness
■Weight gain
■Ascites
■Dyspnea
■Orthopnea
■Crackles
■Edema
■Increased central venous pressure
factors affecting urinary elimination
Age, pregnancy, diet, immobility, psychosocial factors, pain, surgical procedures, medications
dysphagia
pureed food & thickened liquids, mashed potatoes, scrambled eggs
soft/low residue
low in fiber, easy yo digest, pasta, tender meats
BUN, creatine, & urine specific gravity
BUN:10-20
Creatine:0.6-1.2
USG: 1.010-1.030
Labs & Diagnostic Tests
■X-ray
■Bladder Scanner
■Renal Scan/ Ultrasound
■Cystoscopy
■Urinalysis
■24hr Urine Collection
■Nursing Interventions: Bladder training Q2-3hrs, privacy, Kegel’s, relaxation, decreased caffeine, measure I&O (less than 30ml/hrconcerning)