Author Question: What is the greatest risk for J.F. during the process of rehydration, and what would you monitor to ... (Read 41 times)

lracut11 · **on:** Jun 25, 2018

What is the greatest risk for J.F. during the process of rehydration, and what would you monitor to detect its development?

What would be an ideal response?

Question 2

You were aware that as soon as J.F. became stable, she would be going home on TPN and IV antibiotics. As part of the discharge preparations, you contact the home care agency that will be providing her care.

List five important questions in assessing her home health care needs.

parshano · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Inability to oxygenate: Increased intravascular volume combined with aortic stenosis and
regurgitation can cause severe HF. Monitor for crackles, dyspnea, cough with frothy sputum,
increased pedal edema, jugular venous distention (JVD), confusion, anxiety, increased drowsiness
and lethargy, increased intensity of murmurs, and new S3/S4 heart sounds. Monitor hourly urine
output. Because of the patient's history of renal failure, the inability to excrete fluids normally will
greatly affect the patient's HF.

Answer to Question 2

Is her husband able to help care for her physical needs? Is he home during the day, or does he
work? Is he comfortable with tasks such as maintaining the PICC line, TPN administration, pain
management, and activities of daily living assistance?
Is her husband a good source of emotional support for her?
Does she have any other friends or relatives living nearby who would be available for help with
physical care or emotional support?
What additional assistance will she need from a home health care agency? Regular visits from a
registered nurse (RN) for antibiotic and TPN administration, IV maintenance, and pain control?
Home health aide? Housekeeper? Occupational therapist or physical therapist?
What is the physical setup of her home? Are there stairs she might be too weak to climb? Are there
any changes that would make things easier for her, such as converting a downstairs room into a
bedroom?
What is the family's financial situation? Should a social worker be brought in for consultation?
What are J.F.'s emotional and coping needs? Should you involve a psychotherapist in her care?
Significant others need to be taught how to measure and administer TPN before she leaves the
hospital.