NOC Suggested Outcome Fall Prevention Minimize risk factors that precipitate

Noc suggested outcome fall prevention minimize risk

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NOC Suggested Outcome: Fall Prevention : Minimize risk factors that precipitate falls. The child does not fall or suffer other injury. NOC Suggested Outcome: Energy Conservation : Manage energy to sustain activity. The child engages in normal developmental activities and receives adequate rest. NIC Priority Intervention: Fluid Management: Promote fluid balance. Monitor weight daily. Assess intake and output every shift. Assess heart rate, postural blood pressure, skin turgor, small-vein filling time, capillary refill time, fontanel (infant), and urine specific gravity every 4 hours or more frequently as indicated. Administer intravenous fluids as ordered. Monitor for crackles in dependent portions of the lungs. NIC Priority Intervention: Fall Prevention : Institute special precautions. Raise the side rails of the bed. Ensure that a small child does not become tangled in bed covers. Monitor level of consciousness every 2–4 hours or more often as indicated. Monitor serum sodium concentration daily or more often. Have the child sit before rising from bed and assist to stand slowly. NIC Priority Intervention: Activity Therapy : Plan activities to meet child’s developmental needs. Plan activities appropriate for the age of the child that can be done in bed. Group nursing interventions to provide time for the child to rest. Provide assistance during meals and other activities as needed. NURSING CARE PLAN The Child with Severe Dehydration GOAL INTERVENTION RATIONALE EXPECTED OUTCOME 1. Fluid volume deficit related to excess losses and inadequate intake The child will return to normal hydration status and will not develop hypovolemic shock. 2. Risk for injury related to decreased level of consciousness The child will not experience injury. 3. Activity intolerance related to bedrest/immobility The child will engage in normal activity for age.
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  • Winter '17
  • Abdelrahim Attieh
  • Hypovolemia, decreased level of consciousness

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