Eclampsia 4-real-presentation

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<h1 class="h-slideshow-title">Eclampsia 4 Real</h1>

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<span class=".h-username fn ">tramadol rx</span></a>
<span class="quiet when-comment-value">3 months ago</span>
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<a href="#" class="ilink action-spam loggedin-only" rel="nofollow">spam</a>
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<blockquote class="comment-item-value">Fioricet is often prescribed for tension
headaches caused by contractions of the muscles in the neck and shoulder area. Buy
now from <a href='http://www.fioricetsupply.com'>http://www.fioricetsupply.com</a>
and make a deal for you.</blockquote>
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<span class=".h-username fn ">lalamei</span></a>
<span class="quiet when-comment-value">4 months ago</span>

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<blockquote class="comment-item-value">thanks a lot for this....</blockquote>
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<a href="/pacemy" class="userimage-link h-author-photo url" title="pacemy | I like
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<span class=".h-username fn ">Pier Luigi Delvigo</span></a>
<span class="quiet when-comment-value">2 years ago</span>

</span>
<blockquote class="comment-item-value">For Blood Safety, look at please : <a
href='http://picasaweb.google.com/delvigo/BloodSafety'>http://picasaweb.google.com/
delvigo/BloodSafety</a>#</blockquote>
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<span class="quiet h-summary"><span class='when-fav-value'>4 months
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<h2 class="h-slideshow-title">Eclampsia 4 Real - Presentation Transcript</h2>
<ol class="transcripts h-transcripts"><li>CASE STUDY BSN III-F GROUP 18
</li><li>Pregnancy Induced Hypertension </li><li>Introduction <ul><li>Eclampsia, a
dramatic and often unpredictable complication of pregnancy-induced hypertensive
disorders, is characterized by sudden hypertension, proteinuria, edema, and
seizures. </li></ul><ul><li>A relatively rare syndrome, eclampsia complicates
approximately 3 in 100 pregnancies, with higher incidence rates in preeclamptic or
twin pregnancies, women of low socioeconomic status or in developing countries, and
nulliparous patients younger than 20 years or multiparous patients older than 35
years of age. </li></ul><ul><li>However many medical disorders can occur during
pregnancy, childbirth, and in the post delivery time. One of those disorders in
pregnancy is eclampsia. </li></ul><ul><li>Eclampsia is a major cause of perinatal
morbidity and mortality and can present during the antepartum, intrapartum, or
postpartum periods. Late postpartum eclampsia presents as convulsions, with onset
occurring at more than 48 hours postpartum. </li></ul></li><li>Demographic Data </
li><li>Eclampsia was found to be more common among young and adolescent women . Age

Distribution Age group [ years ] 22 [46.80%] 19 [40.42%] 3 [6.38% ] 3 [ 6.38%] 19
or less 20-24 25-29 30 or more </li><li>Significance of the Study <ul><li>Pregnancy
Induced Hypertension is a rare complication that occur within 42 days after
delivery. We have chosen this case for the reason, that we became curious and
interested regarding the deeper medical diagnosis for the occurrence of the certain
disease. </li></ul><ul><li>It is very necessary for pregnant women to have
knowledge concerning the subject matter for them to be aware and educated about the
possible complications that may arise on their pregnancy.
</li></ul><ul><li>Educating them to seek early and regular prenatal care is the
best way to prevent complications that may lead to maternal various diseases.
</li></ul></li><li>Study of the Subject Matter </li><li>What is Pregnancy-induced
Hypertension? <ul><li>Pregnancy-induced hypertension is defined as the development
of new arterial hypertension in a pregnant woman after 20 weeks gestation .
</li></ul><ul><li>It occurs most often in young women with a first pregnancy. It is
more common in twin pregnancies, in women with chronic hypertension, preexisting
diabetes, and in women who had PIH in a previous pregnancy
</li></ul></li><li><ul><li>Symptoms seen in patient: </li></ul><ul><ul><li>Blood
pressure elevation (140/100) </li></ul></ul><ul><ul><li>Episodes of Two-Clonic
Seizure </li></ul></ul><ul><ul><li>Blurred Vision
</li></ul></ul></li><li><ul><li>Diagnostic done with the patient:
</li></ul><ul><li>Diagnosis is often based on the increase in blood pressure
levels, but other symptoms may help establish eclampsia as the diagnosis. Tests for
eclampsia may include the following: </li></ul><ul><ul><li>Blood pressure
measurement </li></ul></ul><ul><ul><li>Urinalysis
</li></ul></ul><ul><ul><li>Frequent weight measurements
</li></ul></ul><ul><ul><li>Blood Chemistry </li></ul></ul><ul><ul><li>Hematology </
li></ul></ul></li><li><ul><li>Treatment done with the patient:
</li></ul><ul><ul><li>Bed rest (either at home or in the hospital may be
recommended) </li></ul></ul><ul><ul><li>Hospitalization (as specialized personnel
and equipment may be necessary) </li></ul></ul><ul><ul><li>Magnesium sulfate given
IV by infusion pump to prevent or limit seizures </li></ul></ul><ul><ul><li>Anti-
Convulsion </li></ul></ul><ul><ul><li>Anti-Hypertensive
</li></ul></ul><ul><ul><li>Foley catheter </li></ul></ul><ul><ul><li>Normal
Delivery </li></ul></ul><ul><ul><li>Calcium Channel Blocker
</li></ul></ul></li><li>Anatomy and Physiology </li><li>Reproductive System
</li><li><ul><li>Functions: </li></ul><ul><li>Production of female sex cells
</li></ul><ul><li>Reception of sperm cells from the male
</li></ul><ul><li>Nurturing the development of and providing nourishment for the
new individual </li></ul><ul><li>Production of female sex hormones.
</li></ul></li><li>Baby and Placenta </li><li><ul><li>The placenta is also a kind
of padding, and maintains a unique environment in which your baby can develop and
grow. The placenta forms from the same cells as the embryo and attaches itself to
the inner wall of the uterus, growing as your baby grows and the volume of your
amniotic fluid increases. When it's finished growing, it is circular and
weighs about a pound; when the body expels it after the birth, many women are
surprised at its size and weight. </li></ul></li><li>Blood Vessel
</li><li><ul><li>Functions: </li></ul><ul><li>Carry blood
</li></ul><ul><li>Exchange nutrients, waste products and gases
</li></ul><ul><li>Transport </li></ul><ul><li>Regulate blood pressure
</li></ul><ul><li>Direct blood flow </li></ul></li><li>Structure and Functions of
Blood Vessels Structure Functions Arteries - The walls (outer structure) of
arteries contain smooth muscle fiber that contract and relax under the instructions
of the sympathetic nervous system. Transport blood away from the heart; Transport
oxygenated blood only (except in the case of the pulmonary artery). Arterioles -
Arterioles are tiny branches of arteries that lead to capillaries. These are also
under the control of the sympathetic nervous system, and constrict and dilate, to
regulate blood flow. Transport blood from arteries to capillaries; Arterioles are
the main regulators of blood flow and pressure. Venules - Venules are minute
vessels that drain blood from capillaries and into veins. Many venules unite to

form a vein. Drains blood from capillaries into veins, for return to the heart
</li><li>Structure Functions Capillaries - Capillaries are tiny (extremely narrow)
blood vessels, of approximately 5-20 micro-metres (one micro-metre =
0.000001metre) diameter. There are networks of capillaries in most of the organs
and tissues of the body. These capillaries are supplied with blood by arterioles
and drained by venules. Capillary walls are only one cell thick (see diagram),
which permits exchanges of material between the contents of the capillary and the
surrounding tissue. Function is to supply tissues with components of, and carried
by, the blood, and also to remove waste from the surrounding cells ... as opposed
to simply moving the blood around the body (in the case of other blood vessels);
Exchange of oxygen, carbon dioxide, water, salts, etc., between the blood and the
surrounding body tissues. Veins - The walls (outer structure) of veins consist of
three layers of tissues that are thinner and less elastic than the corresponding
layers of arteries. Veins include valves that aid the return of blood to the heart
by preventing blood from flowing in the reverse direction. Transport blood towards
the heart; Transport deoxygenated blood only (except in the case of the pulmonary
vein). </li><li>Comparison between Arteries and Veins Arteries Veins Transport
blood away from the heart; Transport blood towards the heart; Carry Oxygenated
Blood (except in the case of the Pulmonary Artery); Carry De-oxygenated Blood
(except in the case of the Pulmonary Vein); Have relatively narrow lumens Have
relatively wide lumens (see diagram above); Have relatively more
muscle/elastic tissue; Have relatively less muscle/elastic tissue; Transports
blood under higher pressure (than veins); Transports blood under lower pressure
(than arteries); Do not have valves (except for the semi-lunar valves of the
pulmonary artery and the aorta). Have valves throughout the main veins of the
body. These are to prevent blood flowing in the wrong direction, as this could (in
theory) return waste materials to the tissues. </li><li> </li><li>Narrowing of
the blood vessels resulting from contraction of the muscular wall of the vessels,
particularly the large arteries, arterioles and veins. The process is the opposite
of vasodilation, the widening of blood vessels. When blood vessels constrict, the
flow of blood is restricted or slowed, thus, retaining body heat and increasing
vascular resistance. Cutaneously, this makes the skin turn paler because less blood
reaches the surface. This helps to prevent the radiation of heat. Blood Vessel are
tubes which carry blood. Veins are blood vessels which carry blood from the body
back to the heart. Arteries are blood vessels which carry blood from the heart to
the body. There are a few main blood vessels which connect to different chambers of
the heart. The aorta is the largest artery in our body. The left ventricle pumps
blood into the aorta which then carries it to the rest of the body through smaller
arteries. The pulmonary trunk is the large artery which the right ventricle pumps
into. It splits into pulmonary arteries which take the blood to the lungs. The
pulmonary veins take blood from the lungs to the left atrium. All the other veins
in our body drain into the inferior vena cava (IVC) or the superior vena cava
(SVC). These two large veins then take the blood from the rest of the body into the
right atrium. Abnormal Normal </li><li>Heart </li><li><ul><li>Functions:
</li></ul><ul><li>Generating blood pressure </li></ul><ul><li>Routing blood </li></
ul><ul><li>Ensuring one-way blood flow </li></ul><ul><li>Regulating blood supply </
li></ul></li><li>Blood flow through the Heart </li><li>Brain Controls the central
nervous system (CNS), by way of the cranial nerves and spinal cord, the peripheral
nervous system (PNS) and regulates virtually all human activity. Involuntary, or
&quot;lower,&quot; actions, such as heart rate, respiration, and digestion,
are unconsciously governed by the brain, specifically through the autonomic nervous
system. Complex, or &quot;higher,&quot; mental activity, such as thought,
reason, and abstraction,
is consciously controlled. </li><li>Neurons </li><li>Generalized seizures are
caused by abnormal electrical activity at multiple locations in the brain and/or
over a large area of the brain. This results in loss of consciousness and body
stiffening, which is followed by shaking of the arms and legs. Abnormal electrical
activity may start in one part of the brain and cause isolated symptoms. Sometimes
this abnormal electrical activity spreads through the brain, resulting in a

generalized seizure. Seizures can be caused by a specific area of the brain that is
injured or inflamed, or they can be due to stress on the brain from a more
widespread systemic process, such as severely low blood sugar. </li><li>Name: Ms.
M.T Age: 19 Sex: Female Address: 69 Pooc Maligaya, San Vicente, San Pedro Laguna
Civil Status: Single Occupation: None Name of Spouse: Mr. Benigno Carpellar Date
of Admission: August 07, 2008 PATIENTâ ™S PROFILE </li><li>Chief Complaint:
Seizures History of present Illness: Patient delivered at San Pedro Municipal
Hospital. After hours she had 2 episodes of tonic clonic seizures hence referral to
our institution and then subsequently admitted. Physical Examination: Li open,
uterus oblique, no abnormal masses Admitting Diagnosis: NSD Day 0 Post Partum
Eclampsia G1P1(1001) BRIEF HISTORY </li><li>LABORATORY RESULTS </li><li>HEMATOLOGY:
Diagnostic Exam Result Normal Range Findings Hemoglobin 136 M:140-170 / F:120-140
gml/dl Increased Hematocrit .41 M:0.44-0.54 âH“ F:0.37-.47 Normal WBC 9.0 5.0-10.0
Normal Platelet 280 150-400cc/mL Normal ABO Typing â3 œ Aâ7 </li><li>DIFFERENTIAL
COUNT : Diagnostic Exam Result Normal Range Findings Segmenter 69 40-60 Increased
Lymphocytes 31 20-40 Normal </li><li>URINALYSIS: Diagnostic Exam Result Normal
Range Findings Color Yellow Yellow/Amber Normal Transparency Clear Clear Normal
Reaction 5.0 4.8-7.8 Normal SP Gravity 1.030 1.015-1.025 Increased Sugar Negative
Negative Normal Protein Negative Negative Normal Pus Cells 2-3 HPF 0-4 HPF
Increased RBC 1.5-2.0 HPF 0-3 HPF Normal Epithelial Cells Few Few Present Normal </
li><li>BLOOD CHEMISTRY: Diagnostic Exam Result Normal Range Findings BUN 12.3 mg/dl
10-50 mg/dl Normal Creatinine 1.1 mg/dl F:0.5-1.0 mg/dl M:0.6-1.2 mg Increased SGOT
26.8 1u/L 10-40 IU/L Normal SGPT 13.9 1u/L 5-35 IU/L Normal
</li><li>PATHOPHYSIOLOGY </li><li>MEDICAL MANAGEMENT DOCTORâ1 ™S ORDER RATIONALE
<ul><li>AUGUST 08, 2008: </li></ul><ul><li>Please admit to OBW
</li></ul><ul><li>Secure consent </li></ul><ul><li>3. NPO temporarily, DAT when
fully awake </li></ul><ul><li>4. IVF D5LRS 1L * 20 gtt/min + 10 u oxytocin. </li></
ul><ul><li>Medication: </li></ul><ul><li>5. Cefuroxime 1.5 g/IV LD ANGT Cefalexin
500 mg/cap q8 * 7 days </li></ul><ul><li>6. Magnesium Sulfate 4g SIVP then 5 g/ IM
on each buttocks followed by 5 g/ IM or alternating buttock q6 * 4 doses
</li></ul><ul><li>To provide maximum care to the patient </li></ul><ul><li>It
includes explanation of the procedure to gain patients cooperation, and for
patientâ ™s documentation which can be used for legal purposes.
</li></ul><ul><li>To prevent aspiration that maintains nutritional needs.
</li></ul><ul><li>Fluid replacement and route for intravenous medication. Oxytocin
helps induced uterine contraction and prevents post partum hemorrhage
</li></ul><ul><li>Anti-infectives; Prevents occurrence of infections
</li></ul><ul><li>Anti-convulsants and Laxative; for prevention of seizure. Watch
out for signs of < tendon reflex, < urine output, > respiratory rate.
</li></ul></li><li>DOCTORâo™S ORDER RATIONALE <ul><li>Nifedipine 10 mg/ tab BID
(one fully awake) </li></ul><ul><li>8. Insert foley catheter </li></ul><ul><li>9.
Monitor VS q1 including Input and Output and second please </li></ul><ul><li>Refer
accordingly. </li></ul><ul><li>ADDENDUM: </li></ul><ul><li>Request for the ff:
</li></ul><ul><li>CBC with blood typing </li></ul><ul><li>Platelet
</li></ul><ul><li>SGOT,SGPT,BUN,CREA,LDH </li></ul><ul><li>Urinalysis
</li></ul><ul><li>refer to Medicine for co-management </li></ul><ul><li>AUGUST 09,
2008 </li></ul><ul><li>May consume IVF once magnesium sulfate is completely given.
</li></ul><ul><li>Follow up all Lab Results </li></ul><ul><li>May remove foley
catheter after last dose of magnesium is given </li></ul><ul><li>Continue VS
monitoring </li></ul><ul><li>Refer </li></ul><ul><li>7. Calcium channel blocker;
for anti-hypertensiveness. </li></ul><ul><li>8. For accurate monitoring of I and
O; prevention of injury, < bladder retention </li></ul><ul><li>9. Deviations
from baseline monitoring </li></ul><ul><li>CBC to facilitate possible blood
transfusion, platelet count to determine bleeding tendencies; SGOT, SGPT, BUN,
CREA, LDH; is to rule out PIH either pre-eclampsia, chronic pregnancy. Urinalysis
is for direct quantification of protein. </li></ul><ul><li>Refer for hypertensive
management. </li></ul><ul><li>Follow up laboratory results to facilitate fast
recovery. </li></ul><ul><li>Remove Foley Catheter to provide comfort and adequate
rest and sleep. </li></ul></li><li>Drug Study </li><li><ul><li>Double check the

doctor`s order, the meds to be given, the dosage, the route, and the time and
frequency. </li></ul><ul><li>Monitor vital signs </li></ul><ul><li>Use cautiously
in patients hypersensitive to penicillin because of possibility of cross-
sensitivity with other beta-lactam antibiotics. </li></ul><ul><li>Ask patient about
past reaction to cephalosporin or penicillin therapy before giving first dose.
</li></ul><ul><li>Identify the patient. </li></ul><ul><li>If large doses are given
or if therapy is longed, monitor patient for superinfection, specially in high-
risk. </li></ul><ul><li>Diarrhea </li></ul><ul><li>Loose Stools
</li></ul><ul><li>Abdominal pain </li></ul><ul><li>Nausea and
</li></ul><ul><li>Vomiting </li></ul>Contraindicated in patients hypersensitive to
drug or other cephalosporins. Infections of the urinary and lower respiratory
tracts. Cefuroxime is a second-generation Cephalosporin that inhibits cell-wall
synthesis, promoting osmotic instability; usually bactericidal. Generic Name
Cefuroxime Classification: Cephalosporin, second generation Dosage: 1.5 g IV LD
Nursing Responsibilities Side or Adverse Effects Contraindication Indication
Mechanism of Action Drug Name </li><li><ul><li>identify the patient.
</li></ul><ul><li>double check the doctor`s order, the meds to be given, the
dosage, the route, and the time and frequency. </li></ul><ul><li>monitor vital
signs </li></ul><ul><li>Use cautiously in patients with heart failure or
hypotension and in elderly patients. </li></ul><ul><li>Donât ™t give immediate-
release form with-in one week of acute MI or in acute coronary syndrome.
</li></ul><ul><li>Monitor blood pressure regularly, especially in patients who take
beta-blockers or anti-hypertensive. </li></ul><ul><li>Watch for symptoms of heart
failure. </li></ul><ul><li>Headache </li></ul><ul><li>Fatigue or Lethargy
</li></ul><ul><li>Edema </li></ul><ul><li>Weakness or Muscle cramps
</li></ul><ul><li>Dizziness </li></ul><ul><li>Disturbed equilibrium
</li></ul><ul><li>Flushing </li></ul><ul><li>Contraindicated in patients
hypersensitive to drugs. </li></ul>Vasospastic angina, classic chronic stable
angina pectoris. Unknown. Thought to inhibit calcium ion influx across cardiac and
smooth-muscle cells, decreasing contractility and oxygen demand. Also may dilate
coronary arteries and arterioles . Generic Name: Nifedipine Classification:
Calcium channel blocker Dosage: 10 mg 1 tab. BID Nursing Responsibilities Side
and Adverse Effects Contraindication Indication Mechanism of Action Drug Name
</li><li><ul><li>Identify the patient. </li></ul><ul><li>Double check the doctor`s
order, the meds to be given, the dosage, the route, and the time and frequency.
</li></ul><ul><li>Monitor vital signs </li></ul><ul><li>Use cautiously in patients
with suspected cardiac disease, CVA, or severe renal impairment and in those taking
other anti-hypertensives. </li></ul><ul><li>- </li></ul><ul><li>Tachycardia
</li></ul><ul><li>Edema </li></ul><ul><li>Angina </li></ul><ul><li>pectoris </li></
ul><ul><li>Palpitations </li></ul><ul><li>Nausea and </li></ul><ul><li>Vomiting </
li></ul><ul><li>Diarrhea </li></ul><ul><li>Anorexia </li></ul><ul><li>Constipation
</li></ul>Contraindicated in patient hypertensive to drug and in those with
coronary artery disease or mitral valvular rheumatic heart disease. Essential
hypertension (orally, alone, or with other anti-hypertensives), severe essential
hypertension (parenterally, to lower blood pressure quickly) Unknown. A direct-
acting vasodilator that mainly relaxes anteriolar smooth muscle. Generic Name
Hydralazine Classification: Antihypertension Nursing Responsibilities Adverse
Effects Contraindication Indication Mechanism of Action Drug Name
</li><li><ul><li>Identify the patient. </li></ul><ul><li>Double check the doctors
order, the meds to be given, the dosage, the route, and the time and frequency.
</li></ul><ul><li>Monitor vital signs </li></ul><ul><li>Use cautiously in patients
with impaired renal function. Also use cautiously in woman who are in labor.
</li></ul><ul><li>If used to treat seizures take appropriate seizure precautions.
</li></ul><ul><li>-Monitor fluid intake and output. </li></ul><ul><li>Drowsiness
</li></ul><ul><li>Depressed </li></ul><ul><li>reflexes </li></ul><ul><li>flaccid
paralysis </li></ul><ul><li>Hypothermia </li></ul><ul><li>Hypotension
</li></ul><ul><li>Parenteral Administration contraindicated in patients with heart
block or myocardial damage. Also contraindicated in patients with toxemia of
pregnancy during 2 hours preceeding delivery. </li></ul>To prevent or control

seizures in preeclampsia or eclampsia. May decrease acetylcholine released by nerve
impulses, but its anticonvulsant mechanism is unknown.
Generic Name : Magnesium sulfate Classification: Anticonvulsant Dosage: 4gm
SIVP and; 5g IM on each buttocks Nursing Responsibilities Adverse Effects
Contraindication Indication Mechanism of Action Drug Name </li><li>Nursing care
Plan </li><li>Patientâa™s Name: M.T Age: 19 Medical Diagnosis: Pregnancy Induced
Hypertension Nursing Diagnosis: Decreased Cardiac Output related to decreased
venous return . Short Term Goal: At the end of my shift, patient will have a
decreased blood pressure and will be able to have an adequate rest and sleep.
Long Term Goal: At the end of hospitalization, patient will be able to maintain
vital signs within acceptable range. CUES PROBLEM SCIENTIFIC RATIONALE
INTERVENTIONS RATIONALE EVALUATION <ul><li>SUBJECTIVE: </li></ul><ul><li>âi œ Hindi
pa ko makabangon nahihilo akoâTas verbalized by the patient
</li></ul><ul><li>OBJECTIVES: </li></ul><ul><li>Increased Blood Pressure (140/100)
</li></ul><ul><li>restlessness </li></ul><ul><li>Weak in appearance
</li></ul><ul><li>Dizziness </li></ul>Hypertension -Inadequate blood pumped by the
heart to meet the metabolic demands of the body. [note: In a Hyper Metabolic state
although cardiac output and tissue perfusion are interrelated, altough there are
differences. When cardiac output is decreased tissue perfusion problems will
develop however, tissue perfusion problems can exixt without decreased cardiac
output. <ul><li>Monitor Blood Pressure; every 15mins. During critical phase; ever
1-4hrs. As conditions improves. </li></ul><ul><li>Provide adequate rest by
positioning client. </li></ul><ul><li>Give information about positive signs of
improvements, such as decreased edema, improved vital signs and circulation </li></
ul><ul><li>. </li></ul><ul><li>Encourage fluid intake. </li></ul><ul><li>Provide
quite environment. </li></ul>-Provides baseline for comparison to follow trends
and evaluate response to interventions. -Decreases oxygen consumption and risk for
de-compensation and for maximum comfort. -To provide Encouragement. -To minimize
dehydration. -To promote adequate rest. Goal Met. The patient will be able to have
an adequate rest and sleep, and the patientâ ™s blood pressure will decreased. The
patient will be able to respond well to interventions and performed actions.
</li><li>Patientâb™s Name: M.T Age: 19 Medical Diagnosis: Pregnancy Induced
Hypertension Nursing Diagnosis: Impaired physical mobility related to decrease
muscle strength Short Term Goal: After rendering my nursing intervention, patient
will be able to verbalize understanding of situation and individual treatment
regimen and safety measures. Long Term Goal: Upon discharge, the patient will be
able to maintain or increase strength and function of the affected and
compensatory body part. CUES PROBLEM SCIENTIFIC RATIONALE INTERVENTIONS RATIONALE
EVALUATION <ul><li>OBJECTIVES: </li></ul><ul><li>Limited ROM (Range of Motion)
</li></ul><ul><li>Slowed movement </li></ul>Impaired Physical Mobility Limitation
in independent, purposeful physical movement of the body or of one or more
extremities <ul><li>Note situations such as surgery, fractures, amputations and
tubings (catheter). </li></ul><ul><li>Observe movements when client is unaware of
observations. </li></ul><ul><li>Support affected body parts/joints using pillows.
</li></ul><ul><li>Encourage adequate intake of fluids. </li></ul><ul><li>Encourage
clientâu™s involvement in decision as much as possible. </li></ul>- It may restrict
movement -to note any incongruencies with reports of abilities -to maintain
position of function and reduce risk of pressure ulcers -promotes well being and
maximizes energy production. -enhances commitment to plan optimizing outcomes Goal
Met: The patient will be able to verbalize understanding of situation and
individual treatment regimen and safety measures. The patient will be able to
maintain proper function of the part being affected.
</li><li> </li><li> </li></ol>
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