Although fluid choice and rate is the decision of the
VS, the VN will be able to provide better care of the patient
with an understanding of the processes that occur
as a result of fluid therapy. The VN should possess
the ability to recognise signs that indicate improvement,
or conversely, recognise the patient’s condition
deteriorating. An initial assessment was made of the
patient’s heart rate, pulse quality, mucous membrane
colour, capillary refill time and respiratory rate as recommended
by Gurney (2008) who emphasises the
importance of monitoring these parameters to gauge
a response to the fluid therapy treatment. These parameters,
as well as chest auscultation, were assessed
on admission and then every 30 to 60 minutes. A sign
of improvement would be normalisation of the above
parameters (Higgins, 2009). A concern of fluid therapy,
especially when given at high rates, as in this case,
is over infusion. A crystalloid solution swiftly equilibrates
with the interstitial space meaning interstitial
oedema will be a result of over infusion; signs of limb
oedema or pulmonary oedema highlighted by the patient
coughing or ‘crackles’ heard on chest auscultation
should be observed for (Steward, 2007).
Although fluid choice and rate is the decision of theVS, the VN will be able to provide better care of the patientwith an understanding of the processes that occuras a result of fluid therapy. The VN should possessthe ability to recognise signs that indicate improvement,or conversely, recognise the patient’s conditiondeteriorating. An initial assessment was made of thepatient’s heart rate, pulse quality, mucous membranecolour, capillary refill time and respiratory rate as recommendedby Gurney (2008) who emphasises theimportance of monitoring these parameters to gaugea response to the fluid therapy treatment. These parameters,as well as chest auscultation, were assessedon admission and then every 30 to 60 minutes. A signof improvement would be normalisation of the aboveparameters (Higgins, 2009). A concern of fluid therapy,especially when given at high rates, as in this case,is over infusion. A crystalloid solution swiftly equilibrateswith the interstitial space meaning interstitialoedema will be a result of over infusion; signs of limboedema or pulmonary oedema highlighted by the patientcoughing or ‘crackles’ heard on chest auscultationshould be observed for (Steward, 2007).
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