Reference no: EM132908292

As a new nurse you are assigned to work with a preceptor in the Emergency Department. It is a very busy day and it seems as if every patient, regardless of chief complaint, has an issue with fluid, electrolyte, and/or acid-base balance. The first patient you see is a 37-year-old landscaper who is brought to the ED after collapsing on a job at the local country club. He is slightly confused but is able to tell you he feels dizzy and weak. His skin is flushed, dry, and with poor turgor. He has dry, sticky mucous membranes. The nurse identifies a nursing diagnosis of deficient fluid volume.

Question 1: Describe how each of the following would change and the rationale for the change in the presence of deficient fluid volume:

Heart rate

Blood pressure

Serum hematocrit

Urinary output

Urine specific gravity

Weight

Question 1: What is usually the first indicator that an individual needs more fluids?

Question 2: The ED physician orders IV fluids for this patient. What types of fluids are indicated for a fluid volume deficit due to dehydration?

Question 3: The fluid order is to start 1000 mL of fluid as ordered at 150 mL/hr. The infusion tubing has a drop factor of 15 gtt/mL. This infusion will run by gravity rather than an infusion pump. How many drops per minute should you time the infusion at to ensure the correct hourly rate?

Question 4: The patient has a "full sleeve" tattoo on both arms. Discuss the implications of this finding and how you will initiate the intravenous site.

Question 5: You have difficulty finding a vein in the presence of the deficient fluid volume. List 3 strategies that you can use to help make a vein more visible/palpable?

Question 6: Considering the diagnosis, patient presentation, and fluid orders, what size catheter is indicated in this situation? Give a rationale for your choice.