Risk for Fluid Volume Deficit related to Low Birth Weight

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.

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Risk for Fluid Volume Deficit related to Vomiting

Vomiting is defined as the discharge of the contents of the stomach up into the mouth by force. Vomiting can be an attempt removing toxins from the gastrointestinal tract such as diarrhea, lower gastrointestinal tract.

Vomiting can be caused by many things such as the following:

• Congenital abnormalities
• Infection of the digestive tract
• Feeding the wrong way
• Poisoned

Complications of vomiting are as follows :

• Dehydration or alkalosis, due to loss of body fluid / electrolyte
• Ketosis from not eating and drinking
• Acidosis caused a sustained ketosis can be a shock even to seizures
• Abdominal muscle tension, conjunctival hemorrhage, esophageal rupture, aspirations, caused by severe vomiting.

Persistent vomiting can lead to complications of dehydration, electrolyte disturbances, rips Mallory Wiess, aspiration of gastric fluid.


Nursing Diagnosis for Vomiting

Risk for Fluid Volume Deficit related to the feeling of nausea and vomiting

Goal: Maintain the balance of fluid volume.

Outcomes: The client does not nausea and vomiting.

Intervention:
1. Monitor vital signs.
Rationale: An early indicator of hypovolemia.

2. Monitor intake and output and urine concentration.
Rationale: Decreased urine output and concentration will improve the sensitivity / sediment as one impression of dehydration and require increased fluids.

3. Give fluid little by little but often.
Rationale: To minimize the loss of fluids.

4. The risk of infection associated with an inadequate immune, characterized by: body temperature above normal. Increased respiratory rate.

Source : http://nurseskomar.blogspot.com/2013/10/nursing-diagnosis-for-vomiting-risk-for.html

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