Risk for Fluid Volume Deficit related to Low Birth Weight

Nursing Diagnosis Intervention

Nursing Care Plan for Low Birth Weight

Nursing Diagnosis : Risk for Fluid Volume Deficit age and extreme weight, excessive fluid loss (thin skin), less fat layer, immature kidney / failure to concentrate urine.

Goal: liquid fulfilled

Expected outcomes:

• Free of signs of dehydration.
• Shows the weight gain of 20-30 grams / day.

Interventions :

Independent:

• Compare the input and output of urine, every shift and balance each periodic cumulative 24 hours.
• Monitor the specific gravity of each finished urinating or every 2-4 hours to inspire urine from diapers when the baby can not stand the reservoir bag urine.
• Evaluation of skin turgor, mucous membranes, and the state of the anterior fontanelle.
• Monitor blood pressure, pulse, and mean arterial pressure (TAR).

Collaboration:

• Monitor laboratory examination in accordance with the indications; Ht.
• Give parenteral infusion.
• Give a blood transfusion.

Rationale :

• Output should be 1-3 ml / kg / h, while the need for fluid therapy is approximately 80-100 ml / kg / day on the first day, increased to 120-140 ml / kg / day on the third day postpartum. Blood sampling for tests lead to decreased levels of hemoglobin / hematocrit.
• Although renal immaturity and inconvenience to concentrate urine, usually resulting in a low specific gravity in preterm infants (range normal1,006-1,013). Low levels indicates excessive fluid volume and content of greater than 1.013 indicates the inability of fluid intake and dehydration.
• Loss or minimal fluid shifts can quickly lead to dehydration, visible by poor skin turgor, dry mucous membranes, and sunken fontanelle.
• Losing 25% of blood volume resulting in shock, with TAR 25 mmHg indicates hypotension.
• Dehydration increases hematocrit levels 45-53% above normal serum potassium.
• Hypoglycemia can occur due to loss through diarrhea or vomiting nasogastric tube.
• The replacement of body fluids increase the volume of blood, helps restore vasoconstriction due to hypoxia, acidosis, and right-to-left shunt through the PDA, and has helped in reducing complications necrotizing enterocolitis, and bronchopulmonary dysplasia.
• It may be necessary to maintain the levels of hematocrit / hemoglobin optimal and replace blood loss.