Monitoring C.W

1. Why will you want to monitor his fluid status very carefully? C.W has a past medical history of congestive heart failure (CHF). According to an article on Johns Hopkins Medical website, a congestive heart failure is when the heart does not pump well to meet the oxygen needs of the body. It is mostly caused by cardiomyopathy or other forms of heart diseases. The heart muscles becomes weak with patients with CHF. When this happens, blood returns to the heart and gets congested due to inability to pump blood out of the ventricles (Johns Hopkins Medical Center). Some of the symptoms include edema, shortness of breath, rapid weight gain and loss of appetite.

Therefore C.W’s fluid status should be monitored because of his past medical history of CHF. Fluid can accumulate in any part of the body especially the peripheral area. If care is not taken, it can lead to Heart failure which is when the heart cannot eject blood out of the heart. His input of fluid was 8.45 liters and output was 3.66. This means C.W could be retaining the rest of the fluid. Moreover the excess fluid could be the cause of his tachycardia, dizziness and disorientation. Thus, his fluid status should be monitored to prevent severe damage to the heart.

2. List 6 things you will monitor to assess C.W.’s fluid balance. Fluid balance is maintaining homeostasis in the body. It is the amount of fluid lost from the body (output) to the amount of fluid taken into the body (input). When assessing the fluid balance of a patient, his history, lab values, and physical examination should be taken into consideration. To assess C.W’s fluid balance, his level of consciousness, urine concentration, daily weight, skin turgor, input and output, temperature and vital signs.

3. Explain the purpose of the FFP for C.W.
Fresh frozen plasma (FFP) is the plasma of blood that has been thawed and frozen for future use. It tends to contain coagulation factors which helps prevent bleeding. The clotting factor is critical for normal hempstasis (LTCClaytonD.Simon,MC,USAMAJ(P)JeremyPerkins,MC,USA,LTCPaulBarras,AN,USA,COLBrianEastridge,MC,USA COLLorneH.Blackbourne,Therefore FFP was given to C.W due to his diagnosis (Dysentery). He had a red dark diarrhea which could have led him to lose blood. So administering FFP will help balance his hemostaisis

These clotting factors and fibrinogen arecritical fornormalhemostasis.

4. Are you worried by the elevated K? Why, or why not? Explain your answer.

Identify and discuss the patient’s PMH. State what the conditions are and how they contributed/correlate to his present condition.

Identify and discuss the medications he is on, their category, use and side effects and any drug-drug interactions that have contributed to his present condition.