Answer to Question 1
Assessment data to observe: general appearance and behavior, poor skin turgor, decreased urinary output, sunken fontanel (in infant), decreased weight, increased pulse and respiration, decreased blood pressure, prolonged capillary refill.
Nursing diagnosis: altered nutrition-less than body requirements related to diarrhea losses and inadequate intake; fluid volume deficit related to excessive GI losses in stool or emesis.
Goals: child will maintain adequate hydration as evidenced by absence of above symptoms; child will maintain appropriate nutrition for age as evidenced by eating and retaining foods; child will not spread the infection to others; the family will receive appropriate support and education, especially home care and prevention.
Nursing interventions:
administer rehydration liquids, beginning with small amounts and gradually increasing to a regular diet; administer IV fluids as ordered; strict intake and output; weigh daily; assess vital signs, skin turgor, mucous membranes, mental status; discourage intake of carbonated beverages, fruit juices, and gelatin (these are high in carbohydrates, low in electrolytes, and have a high osmosis level); instruct family in providing appropriate therapy, monitoring intake and output, and assessing for signs of dehydration.
Answer to Question 2
The client will verbalize a desire to lose weight; acknowledge factors that have contributed to being overweight; understand some of the foods that she has eaten in the past are high in fat and cholesterol; improve her nutrition habits and eat a well-balanced diet; participate in an exercise program at least three times per week; lose 1 to 2 pounds weekly.