Question

Mrs. Hilda Beck, age 72, fell at home because she became light-headed after vomiting and diarrhea that lasted over 24 hours. Even though she was nauseated, she drank some water because she knew she needed fluid. She was admitted for oral and intravenous (IV) fluid therapy. 1. What was problematic about Mrs. Beck's oral fluid replacement at home when she had vomiting and diarrhea? 2. Mrs. Beck's intravenous (IV) fluid order is 1000 mL 0.9% sodium chloride to run over 5 hours. Calculate the mL/hr that you should program into her infusion pump. 3. Mrs. Beck says, “When I get diarrhea, I should drink sodium-containing fluid when I'm thirsty.” She needs what additional teaching? Sleep Julie returns to the neighborhood health clinic for a follow-up visit. She tells you that, since she started her sleep-hygiene plan, she feels more rested. She tells you that she is concerned because her husband says that she has started snoring loudly when she's sleeping. 1. On the basis of Julie's husband's report of her snoring, which additional assessment data should you gather from her? 2. Julie tells you that her 76-year-old mother is having trouble sleep­ing after being in the hospital. Julie asks you about a prescription for a sleeping pill for her mother. What is your best response? 3. Julie and David tell you that they are concerned about their 14-year-old daughter. She just started high school and is having sleep problems. List at least three interventions for Julie and David to use to improve their teenage daughter's sleep patterns.

Answer 1

1)The main reason for Mrs.Hilda Beck difficulty in maintaining fluid replacement at home are due to

• Weakness due to loss of fluid from body
• High chances of regurgitating (vomitting)due to disturbed gastrointestinal function
• The acceptance of fluid is difficult due to intolerance

2)Given

Fluid:0.9%sodium chloride

Total volume :1000ml

Total time:5hours

Flow rate : Total volume×15÷Time to be transfused×60

=1000×15÷5×60

=50drops/minute

Here 1000ml =5 hours

So??=1hr

=200ml/hr (1000×1÷5)

3)Some of the additional health education which can be given

• To have plenty of juices,rice water,tea,soups
• Have fibre rich foods which are mild
• Avoid spicy oily ,deep fried food
• Avoid soft drinks,carbonated drinks
• Encourage to consume water

1)Snoring is caused when there is partial obstruction in the respiratory system and causing breathing difficulty making hoarse sound during sleeping. Some of the additional assessment needs are

• Assess for any respiratory issues that causes obstruction in air passage
• Monitor the weight of the patient ,if overweight can cause snoring
• Sleeping position some times can cause snoring
• The type of pillow used by the patient
• Check for hydration of the patient

2) Medications are prescribed only after examining a patient for the condition. Sleeping pills can not be prescribed without the physical presence of the patient. Encourage the patient to make her mother visit a physician to get the right treatment. The other education like sleeping earlier,avoiding excessive day time sleep,having dinner earlier,warm shower,having medication (if any) on time,listening to soft music,reading can enhance her mother's sleep pattern

3)The intervention needed for a teenage girl are

• talk to their child to know if they are mentally healthy and help to come out of it
• Avoid giving night time binge or coffee while studying this can prevent natural sleep
• Encourage the child to do exercises
• Create a sleep friendly bedroom
• Limit screens and bright lights