Elimination concept notebook PDF

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Summary

concept notebook pertaining to a patient the concept of elimination includes drugs and interventions...

Description

Name: Brittany Jensen Course: BSN 205-06 Faculty Facilitator: LaShelle Draper MSN Ed, RN

Concept: Elimination Activity: Elimination VCBC Date & Time of ELA in MST: 7/21/21 9-1130

Concept Notebook Please fill in all of the information above. All Concept Notebooks must be completed in your own words. Please do not use any direct quotes. Any time you use a source to help write your narratives or collect information, use an in-text citation per APA guidelines. All references must also be listed below. ANY plagiarism issues noted will result in a 0 grade. The assignment will need to be redone for the ability to pass the course, but your score will remain a 0. If you have previously done a Concept Notebook on this concept from another course, you do not need to include that information here. All content should be new with a thorough explanation of how this concept relates to your client chosen from this Experiential Learning Activity. You will have 48 hours from the time your Experiential Learning Activity ends to complete this assignment. Please note that any late submissions will result in a 0 grade per the Experiential Learning Late Policy. This will also serve as a study aide for you as you continue through the program, study for the HESI and NCLEX exams. Client (virtual or living) background: Please tell us a little about the client you cared for today, either virtual or living. For living clients, no personal identifying information needed. Richard Royer is a 92-year-old male that was admitted to the hospital after a fall at home. He is a SimChart patient. Related concepts (explain): 

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Mobility- Mr. Royer has a wound on his foot which gives him impaired mobility, this affects his Elimination because he is not able to get to the bathroom as easily as he needs to. His impaired mobility could lead to constipation. (Giddens, 2017) Cognition- Mr. Royer suffers from dementia so this may impair his ability to ensure adequate nutrition and fluid intake which then impairs his elimination by giving him a low urinary output and inadequate nutrition to be able to have a bowel movement that could lead to

Related exemplars:   

Urinary Tract Infection Benign Prostatic Hyperplasia Renal Failure (Giddens, 2017)

constipation. (Giddens, 2017) Related Assessments (explain): 

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Abdominal Assessment this would include interview questions regarding health history of abdominal organs, as well as asking about whether the patient has had a colonoscopy as part of colon cancer screening. Then inspection of the abdomen would be done to look for any abnormalities such as scars, protrusions, or discoloration. This would be followed by auscultation to listen to bowel sounds as well as the aorta. Last palpation and percussion would be done to check for masses and to determine if the liver, spleen, and kidneys are normal. (Yoost, 2020) Respiratory Assessment Because Mr. Royer has heart failure it is important to assess his lung sounds to ensure that he is properly eliminating fluid and not taking it on in his heart and lungs. Clear lung sounds would let us know that he is not experiencing fluid overload. (Yoost, 2020) Cardiovascular assessment- Mr. Royer has heart failure so it is

Related Lab & Diagnostic Test (explain):  Urinalysis- There may be urinalysis done using a sample from Mr. Royer’s foley catheter. Urinalysis is done to look for many conditions. In this case it would be done to determine if there is blood or bacteria present in the urine which would be indicative of infection. (Giddens, 2017)  Renal function testsSince Mr. Royer has several medical conditions it is important to ensure that his kidneys are functioning properly. The renal function tests would include BUN, creatinine, and blood urea nitrogen clearance. These are excreted from the kidneys, so they provide insight as to how well the kidneys are functioning. (Giddens, 2017)  Culture- Urine cultures are done to determine if there is presence of bacteria in the urine. Additionally, sensitivity may be done to determine what the bacteria is so that the appropriate antibiotics can be prescribed. (Giddens, 2017)

Related Nursing Interventions (explain):  Insert foley catheter as ordered by provider, this will be to prevent urinary retention, but also to monitor output of urine. (Yoost, 2020)  Educate patient and family on importance of adhering to fluid restrictions to prevent fluid overload. (Yoost, 2020)  Administer furosemide as ordered to prevent fluid overload by diuresis. (Yoost, 2020)

important to assess his heart sounds but also his pulses, venous return, and assess for edema. Mr. Royer may have edema in his lower extremities since he does not eliminate fluid properly due to the heart failure. If Mr. Royer has significant edema this is important to report so that he can be put on diuretics to help remove some of the fluid from his body. (Yoost, 2020) Related Medications (explain): 

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Carvedilol (Coreg) 6.25mg by mouth twice daily with meals. This is given for his heart failure to help improve the contractility of the heart muscle so that his body can more effectively pump blood throughout his body. With regards to elimination this medication will ensure that the blood pumps adequately and therefore fluid can be adequately removed. (Lilley, 2017) Furosemide (Lasix) 80mg IV daily. This is a loop diuretic that works by increasing elimination of fluid to treat edema and heart failure. (Lilley, 2017) Ceftriaxone 1g IV every 24 hours. This is an

Potential Complications (explain):  Constipation. If Mr. Royer’s fluid intake and nutrition is not properly managed, especially because of his dementia he may suffer from constipation from dehydration or lack of fiber. (Giddens, 2017)  Renal Failure- Mr. Royer has diabetes so if his blood glucose is not properly managed, he may end up with kidney damage that leads to kidney failure. (Giddens, 2017)

Collaborative Care (explain): 

Important collaborative care for Mr. Royer would be to facilitate an appropriate diet with the nutrition. The nurse would need to collaborate with the dietary department to ensure that Mr. Royer gets a low sodium, high fiber, and low carbohydrate diet since he has diabetes and heart failure. Ensuring proper nutrition will ensure that Mr. Royer does not get dehydrated or constipated and that he is able to heal properly so that he can go home.

antibiotic that works by killing bacteria that are causing infection in the body. Ceftriaxone is used to treat urinary tract infections. (Lilley, 2017) References:

Giddens, J. F. (2017). Concepts for Nursing Practice, (2nd ed.). Elsevier. Lilley, L. L., Rainforth Collins, S., & Snyder, J. S. (2017). Pharmacology and the nursing process. (8th ed.). Elsevier. Yoost, L.C. B.(2020). Fundamentals of Nursing. (2nd ed.). Elsevier...