Nutrition, Fluids & Urinary elimination

Therapeutic diets

100

high fiber

whole grains, raw/dried fruits, oatmeal, steamed veggies

200

low sodium

no added salt (1-2 g)

300

low cholesterol

less than 300 mg/day

400

diabetic

balanced intake of protein, fats, carbs (1,800 calories)

500

dysphagia

pureed food & thickened liquids, mashed potatoes, scrambled eggs

Therapeutic diets

100

clear liquid 

clear juices, gelatin, broth, coffee, tea, popsicles, ice chips

200

full liquids

dairy products, pureed veggies, ice cream, pudding, yogurt

300

pureed

pureed meat, fruits, eggs

400

mechanical soft

diced, ground food, cottage cheese, pancakes, banana

500

soft/low residue

low in fiber, easy yo digest, pasta, tender meats

Fluid volume deficit/excess

100

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

200

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

300

risk factors/causes for FVE

–Altered kidney function

–Interstitial plasma shifts

–Excessive sodium intake

–Head injuries

–Syndrome of inappropriate antidiuretic hormone (SIADH)

400

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

500

BUN, creatine, & urine specific gravity

BUN:10-20

Creatine:0.6-1.2

USG: 1.010-1.030

Urinary elimination

100

anuria

less than 100 mL/24 hr

200

oliguria

less than 400 mL/24 hr

300

average adult urine produce

1,500-2,000 mL/day of urine

400

factors affecting urinary elimination

Age, pregnancy, diet, immobility, psychosocial factors, pain, surgical procedures, medications

500

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)