decline in physical development, changes in appetite, food intake, sleep & elimination patterns. B&W p.316H/O CA, Anemia, NIDDM, COPD ,A.Fib, Current necrotizing pneumonia, cathexia, empyemiaClient aware of health problems and the need for interventionsDiscouraged with his present state of health, but accepting of necessary rehab. Activities.Frustrated with self limitations.Self-ExpressionReflection, reminiscence, self-actualizing pursuits within physical capabilities. B&W p 898Neat, clean, well groomed; articulate; Affective response consistent with norms. Articulate; expresses self well.Concerned about his future at home. “Who will help me take care of my tubes at home?”Client expresses accep-tance of stage in life but not physical limitations.Skin & Tissue IntegritySkin more fragile - less elastic, less SC fat, blood vessels more fragile; Increases risk of skin tears. Vascular insufficiency increases risk of decubitus ulcer B&W p 974Warm, pale, good turgor. Reddened area on coccyxUnderstands import. of being turned in bed, moving extremities, & ingesting adequate fluids & food. Good personal hygiene.Client demonstrates a little anxiety about the possibility of developing a decubitis ulcer.Client verbalizes anxiety about possibility of skin & tissue breakdownNutritionBody maintenance and repair, type and quality of food, calories must be rich in nutrients. Lowered calorie requirements due to lower BMR B&W p 1082Cachexia secondary to malnutrition, poor intake. TPN q 12 hrs, supplementsClient understands his need to increase the food intake for adequate nutrition & healing.Client does not like hospital food but tries to eat as much as possible. He also dislikes his supplements.Client wants to gain weight stating, ”I try to eat more than I want.”Fluid BalanceDecreased renal concentra-tion fx. Increased loss amounts of water & salt, muting of thirst response, decreased intake. B&W p1558Good skin turgor, no ede...
