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Patient Education
Dehydration and Geriatric Considerations of Care
AFIB CABG (< 1 year ago) Valve Replacement (< 1 year ago) Hypertension UTI Diabetes Loop diuretic, anti-hypertensive and cardiac glycoside use.
Diarrhea 3 days
Hypotension
Dizziness
*In this instance, medication use was not deemed to be a significant contributor to the patients clinical encounter.
Goals
Goal: To restore hydration through fluid infusion and minimize episodes of dehydration.
Why: Maintaining adequate fluid balance is an essential component of health across the life span; older adults are more vulnerable to shifts in water balance, both overhydration and dehydration, because of age-related changes and increased likelihood that they have several medical conditions. Dehydration is the more frequently occurring problem.
Foods that taste salty, such as French fries and salty snack foods, contain high amounts of sodium. But you might not be able to detect the high sodium levels in other foods, such as fast food meals, canned foods, deli meats, frozen dinners, processed baked goods and bottled condiments such as salad dressings.
Ironically, sports drinks with sugar can actually quench your thirst more slowly than plain water because the sugar draws water from your cells. Moreover, the sugar in beverages such as fruit juices, vitamin water and sports drinks is absorbed by your body more slowly than plain water. You should eat snacks from two food groups to avoid feeling dehydrated, such as a piece of fruit plus a piece of cheese or fruit plus whole grain crackers.
If you are lactose intolerant, those foods (foods that cause diarrhea) include most dairy products. Some lactose-intolerant people react to smaller amount of lactose in baked goods, cereals, soups, drinks, lunch meats, salad dressings and powdered drink supplements. Excess iron, either through iron supplements or too much red meat, also can cause diarrhea, according to the President's Council on Physical Fitness and Sports.
Dry or sticky mucous membranes in the mouth Skin that lacks its normal elasticity and sags back into position slowly when pinched up into a fold. Persistent fatigue, lethargy, muscle weakness or cramps, headaches, dizziness, nausea, forgetfulness, confusion, deep rapid breathing, or an increased heart rate. Decreased or absent urine output Decreased tears, sunken eyes
Emphasis on:
Need to notify healthcare provider if diarrhea occurs 3 or more times within a 24 hour period and/or for 3 consecutive days. Need for Self Monitoring: Medication use (diuretics) Voiding; malodorous or darkened urine. Decreased tears Bowel movements, constipation is an early sign Dizziness, dry mouth, rapid heart rate Fluid consumption Limit caffeine use Toileting Mobility
Immediate
Family:
Relatives live out of state but call and visit often. Intervention: Include them during educational opportunities; in person, over the phone and/or through printed recommendations.
Senior
Group:
Considers members of her senior group family, talks to them often. They compare notes on current illnesses and seek solutions for problems that develop. Intervention: Suggest attendance at a senior meeting or small gathering of friends to educate on the importance of hydration.
Church
Community:
Considers her church and fellow parishioners as her family and/or the people who sustain her. Intervention: Review church literature, in addition to a conversation with parish nursing ministry, and look for opportunities to introduce and stress the importance of hydration.
References
http://www.thecoca-colacompany.com/ourcompany/ hal_hydrationcalculator.html
http://www.bottledwater.org/hydration-calculator
http://www.seniors-site.com/nutritio/water.html