Nursing 211

N211: Health Differences Across the Lifespan I Hypovolemic Shock is related to external or internal blood or fluid loss. Reduced blood volume causes circulatory dysfunction and inadequate tissue perfusion. Without reversal, it can lead to cerebral and renal damage, cardiac arrest and death. Causes include blood loss, acute pancreatitis, dehydration from excessive perspiration, intestinal obstruction, severe diarrhea, protracted vomiting, inadequate fluid intake and diuresis. Signs and symptoms include cold, pale, clammy skin, decreased sensorium, hypotension with narrowing pulse pressure, reduce urine output, tachycardia, rapid and shallow respirations. Diagnostics Blood tests (elevated potassium, serum lactate, BUN), urine specific gravity (greater than 1.020), ABG reveals metabolic acidosis (decreased pH) decreased PO2 and increased PCO2. Nursing Interventions Include blood and fluid replacement, control of bleeding. Special consideration is the spiritual/religious beliefs of Jehovah’s Witness to refuse blood transfusions. Interventions include correcting fluid volume deficit, monitoring for adequate urine output, provide emotional support to the patient and his family to help them cope and to relieve anxiety. 1.26 Iron Deficiency Anemia Iron Deficiency Anemia is when hemoglobin levels are below normal range because of the body’s inadequate supply, intake or absorption of iron. Iron deficiency anemia is the leading hematologic disorder in children. The need for iron is greater in children than in adults because of accelerated growth. Anemia may be caused by the following: inadequate stores during fetal development, deficient dietary intake, chronic blood loss and poor utilization of iron from the body. Nurs ng Assessment Pallor, paleness of mucous membranes, weakness and fatigue. May be seen in infants 6 to 24 months old (times of growth); toddlers and female adolescents are most affected. Symptoms also include an overweight “milk baby “diet, dietary intake low in iron; milk intake greater than 32 oz./day; PICA habit. Diagnostics Decreased Hgb, HCT, serum iron and elevated total iron binding capacity (TIBC) Nursing Dia nosis • Altered nutrition, less than body requirements, related to insufficient iron intake, B12 and folic acid


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