excess loss of GI flds (diarrhea, vomiting, drainage), loss of plamsa or whole blood (burns, hemorrhage), excessive perspiration, fever, decreased oral intake, confusion, depression, diuretics wt loss, poor skin turgor, orthostatic hypotension, tachycardia, dry mucous membranes, thirst, confusion, flat neck veins, lethargy, oliguria, weak and rapid pulse acute wt gain, edema, htn, polyuria, JVD, full and bounding pulses, decreased HCT, hgb, rbc, increased RR, dyspnea, orthopnea, crackles, rales, increased HR, possible cerebral edema decreased body temp, decreased BP, increased HR, weak pulse, increased RR, weakness, wt loss, N/V, increased HCT, Hgb, RBCs (low sodium levels) vomiting, diarrhea, NG suction, kidney Dz, diuretics, burns, SIADH, water gain (HF, Kidney failure, SIAHD, impaired water excretion, excessive hypotonic IVF) (low sodium)- dry skin, mucous membranes, increased HR
early signs- muscle and abd cramps, weakness, fatigue, anorexia, N/V
late signs-cerebral edema, H/A, personality changes, irritable, lethargy, muscle twitching, tremors, hyperreflexia, sever neuro changes (confusion, hallucinations, seizures *if 115 or below)
cellular dehydration, thirst, lethargy, dry swollen tongue, weakness, dry mucous membranes, flushed skin, fever, n/v, anorexia, increased pulse, hallucinations, delusions, disoriented, HTN, can progress to seizures, coma, and death. cardiac dysrhythmias, muscle weakness, cramps, fatigue, anorexia, N/V, increased sensitivity to dig toxicity, upset stomach, intestinal distention, decreased bowel sounds; weak irregular pulses; slow, shallow & fast respirations, depressed reflexes tetany (muscle spasms, numbness, tingling of fingers, lips and feet), hyperactive reflexes, Trouseau's and Chwostek's sign, muscle cramps, pathological fractures (chronic low), bronchial muscle spams, acute abd pain, decreased BP and HR, can progress to airway obstruction, dysrhythmias, convulsions, cardiac arrests hypo-active reflexes, weakness, in-coordination, n/v, thirst, fatigue, constipation, abd pain, lethargy, anorexia, personality changes, flank pain if kidney stones, cardiac arrest. low magnesium (alcoholism, GI loss, kidney disease, rapid blood administration, prolonged TPN, thiazide diuretics, aminoglycosides, inflammatory bowel disease, polyuria; decreased potassium, malnutrition, aldosterone excess) hypotension, flushed face, sweating, diarrhea, decreased HR, N/V, feeling of warmth; as increases, s/sx of CNS depression (weakness, lethargy, weak DTRs, drowsiness); marked high-respiratory depression, coma, bradycardia, heart block, cardiac arrest red=in severe anemia
skin-paleness, coldness, yellowing
intestinal-changed stool color
central-fatigue, dizziness, fainting
blood vessels-low BP
palpitations, rapid HR, chest pain, angina, heart attack, dysrhythmias, enlarged spleen, smooth and shiny tongue, spoon shaped fingernails
beef liver, red meat, fish, poultry, tofu, dried peas, beans and fruit, whole grains, citrus fruits help the iron absorb, veggies dark green leafy vegetables (spinach and broccoli), breakfast cereals (fortified with iron) infertility, hypothyroidism, depression, cognitive decline (neurological and psychiatric disfunction), low energy, numbness, needs to be caught early and treatment started early nerve damage can not be corrected, trouble with balance, walking, constipation, diarrhea, abd bloating, loss of appetite, weight loss, smooth red/thick tongue "beefy" educate pt on dietary sources of folic acid (fruits, green leafy veg., beans, legumes, citrus fruits, whole grains, poultry, pork, shellfish, and liver)
oral dose of folic acid (0.1-5mg/daily)
if severe deficiency, may require parenteral dosage first, then oral maintenance dosages
if pt has had a partial or total gastrectomy, a lifelong, monthly dose may be required.
failure to thrive
unpredictable, erratic behavior, seizures
older children display bizarre or schizoid behavior (fright reactions, screaming episodes, head banging, arm biting, catatonia-like positions)
delayed development, psychiatric disorders, mental disability, poor bone strenght, skin rashes, must odor to breath, skin and urine when PKU builds up in their system
fair skin, light colored hair, light colored eyes (PKU plays a role in melanin production)
decreased physical mobility-dietary, failure to heed defecation reflex, advanced age, habitual use of laxatives, pregnancy, hemorrhoids, drugs, other lifestyle factors
chronic illness (Parkinson's, MS, RA, eating disorders)
stress, medication-i.e. opiates
GI tract-vague abdominal pain, cramping, diarrhea, & vomiting.
lungs-fever chills, dyspnea, wheezing, cough, blood tinged sputum, pneumonia.
pancreatic & biliary ducts-agonizing pain.
heavy infection-all the way up to anorexic, swollen belly.
cramping pain in LLQ, low grade fever, change in bowel habits, occult blood.
assess-tenderness, palpable mass, fever, leukocytosis
*peritonitis-abd rigidity, abd pain, loss of bowel sounds-shock
other complications perforation, fistula formation, bowel obstruction, GI bleed, sepsis.
chills, fever, flank pain, nausea, vomiting, costoveterbral angle tenderness, enlarged kidneys upon palpation.
CBC-increased WBCs, UA-bacteria, WBCs, RBCs, urine culture-causative organisms
dysuria and frequency