Page 17 - INTRODUCTION OF NURSING 1.4 The Nursing Process (PART 2)
P. 17

Nursing Assessment








                                       Assessment                                                                        Rationales


                                                                                       Decreased output may


                                                                                       indicate dehydration or poor renal perfusion.
               Monitor fluid intake
                                                                                       Avoid fluid overload to prevent pulmonary
               and urine output (and/or central
                                                                                       edema, pneumonia, and taxing an already
               venous pressure).
                                                                                       compromised cardiac and renal status.





               Check for electrolytes,
                                                                                       Acidosis may emerge from hypoventilation
               arterial blood gases, and oxygen                                        and hypoxia.


               saturation by pulse oximetry.
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