#29, #42

Hello ladies and some gents, this is my first post and I just wanted to say that everyone's collaboration has been very helpful to me, so in order to keep the mood going I have posted two of my answers. I didn't find them word for word in the text but I did try to use some of my "critical thinking skills' and this is what I came up with. Please feel free to add more or to correct anything you may find wrong.

29.)pp. 1068-1076

Nursing Interventions for immobile client:
Muscoloskeletal: ROM to prevent contractures, milk to prevent osteo
CV system: leg devices to increase venous return, food less in sodium to prevent edema, teaching not to use Valsalve maneuver, do not massage calves to prevent emboli.
Respiratory system: encourage deep breating and coughing exercises, change postions frequently to prevent pooling of secretions
Metabolic Systems: change positions frequently to avoid decresing metabolic rate and to avoid interrupting the balance between catabolism and anabolism; Encourage eating and drinking continuously to counteract the effects of anorexia as much as possible.
Urinary system: change position frequently to prevent urinary stasis and to prevent calculi from from finding an adequate location in which to form; encourage urination as much as possible (assuring that the client is comfortable) to prevent urinary retention and to prevent bacteria from growning(causing urinary infection)
GI system: Change position frequently; encourage ambulation to prevent constipation; encourage constant bowel elimination to prevent the weakening of the defecation reflex.
Psychoneurologic System: provide support and engage in active communication with client.

42.) pp 1369-1375; pp 1262-1265

Describe and discuss the assessment needed for client with:
Fluid and electrolyte imbalance:
i. Nursing hx: attention to chronic lung diseases or DM that can disrupt normal balances; find out food/fluid intak, fluid output and s/sx of altered fluid and electrolyte imbalance.
ii. Asses skin, oral cavity, mucous membrane, and eyes and CV, respiratory, neurologic, and muscular status.
iii. Check daily weights, vital signs, and I&O
iv. Lab test: electrolytes, CBC, osmolality, Urine Ph, specific gravity, ABG.
Urinary Elimination Dysfunction:
i. Nursing Hx: clients normal voiding pattern, frequenc, and appearance of urine, any recent changes, any past or current problems with urination, presence of ostomy, and any factors influencing the elimination pattern
ii. Asses skin for color, texture,and tissue turgor and presence of edema
iii. Percussion of kidneys, palpation and percussion of bladder
iv. Asses urine for organic and inorganic solutes to evaluat normal or abnormal urine function
v. Measure urine output (normal should be 60mL hr or 1500 mL/day)
vi. Measure residual urine: (should not be present, if is could indicate urinary stasis or UTI)
vii. Diagnostic test: BUN-for urea; creatinine clearance-to determine glomeluar filtration rate.