Case Study on Fluid Volume Deficit, Acute Pain, and Nursing Actions

This case study focuses on a patient, Mr. Ron Fraser, experiencing fluid volume deficit (hypovolemia) and acute pain following an operation, potentially related to colon cancer treatment. The analysis identifies abnormal cues such as increased respiratory rate, low blood pressure, decreased urine output, nausea, and a high pain score. Contributing factors to fluid deficit include inadequate fluid intake, while acute pain is linked to hypotension, abdominal distension, and reduced oxygen saturation. The study discusses the physiological responses associated with these problems, including the impact of colon cancer and its treatment on hydration, as well as the relationship between emotional stress and physical symptoms. Nursing diagnoses are formulated, with goals of care and specific nursing actions outlined to address both fluid deficit and acute pain, including fluid management, lifestyle modifications, emotional support, and pain management strategies. The importance of monitoring vital signs, providing necessary interventions, and establishing effective communication with the patient is emphasized to improve patient outcomes.

Name of patient: Mr Ron Fraser
Scenario 2B - Fluid volume deficit (Hypovolaemia) and Acute Pain
List the clusters of abnormal cues related to the above priority problems in the identified scenario situation. Provide the normal value or range for
an in-text reference

Abnormal cues relevant to fluid
status
Abnormal cues relevant to pain Normal value Reference (in-text only)
Respiratory rate 22 which is higher
than the normal value
Due to increase in pain it increases
individual pain.
12 to 16 breath per minutes (de Carvalho and et. al., 202
Low blood pressure (hypotension)
92/60
Pain and dehydration, emotional stress 120/80 (Warren and et. al., 2019)
High pain score 8/10 High pain score 0 means no pain, 1-3 mild pain, 4-7
moderate pain, 8 and more is severe
pain.
(Zeidman and et. al., 2021)
Less urine output 30ml/hr Obstruction or blockage leads to body
pain which is a symptoms and lead to
decreases in urine output.
Normal range 1.5 to 2 ml/kg/hour (Turkington and et. al., 2019
Feeling nauseated and not able to drink
sips of water.
Abdominal pain and cramps due to less
drinking of water can occur.
590 to 740 ml per hour (Puri and et. al., 2020)
Haemo-serous drainage in belovac 300 to 500 ml thick. (Devnani and et. al., 2020)
Oxygen saturation 93% 95% (Vesoulis and et. al., 2022)

Process information – Discuss the Contributing factors for:
Fluid deficit
Fluid deficit refers to a state or condition which can occur when individual body fluid output get exceeds the fluid intake. This can be there when there is less
water in individual body. There is various contributing factor for the fluid deficit within individual body which are going to be discussed further.
Vomiting, diarrhoea, sweating, nausea, decreased intake of water, GI suctioning, inability to gain access to fluids, osmotic diuresis, coma, haemorrha
dysfunction. According to case scenario, patient is facing the issue of inadequate fluid intake and decrease in the fluid intake which are causing different he
issues and includes the fluid deficit.
Patient is not able to intake several sips of water which is causing difficulty to get normal water fluid and cause the fluid deficiency within individual. Thi
several impact on individual health where increase in breathing can also occurs.
Acute Pain
There is various risk factor which are leading to cause the acute pain within patient. This may include the low blood pressure or hypotension which is one o
cause which are causing acute pain. Due to not taking proper intake of fluid create the issue of low blood pressure which also leads to cause pain within
patient.
Due to lower uptake of water and electrolyte leads to create the risk of getting lower blood pressure which also leads to carry on the hypotension and ca
individual.

Slightly distended abdomen is also cause pain which occurs due to bloating of gas, which can be either due to accumulated fluid, digestive content of tissues.
lead to chronic or acute.
Due to less oxygen saturation also leads to create an impact on individual which cause stress and difficulty in intake of oxygen and needed supplementary su
to deficiency in intake of oxygen can also cause some pain which can play and important factor of acute pain.
Process information – Discuss physiological responses associated with the problems and link these to the presenting symptom (cues).
Fluid deficit: As per the case scenario of Mr. Fraser, the cancer in the colon generally begin when the healthy cells within the lining of the rectum and colo
as well as grow out of control, and can forming a collective mass is known as tumor. In this, a tumor may be cancerous or benign. the cancerous tumor i
malignant, meaning it can increase as well as spread towards the other organs or parts of the human body. in addition to this, there are the environmental fa
genetic factors which can cause the colorectal cancer do so by simply promoting the acquisition of the mark behaviours of the cancer in the epithelial cells o
context with Mr. Fraser’s case, he was a heavy smoker and drink alcohol in moderations. such that people who smoke can effectively develop the wide as w
colon polyps. it is identified that the risk of improving cancer of colon from smoking is as elevated as the people with colon cancer. the patients can develop
colon if they are having absence of daily physical activities, reduced healthy diets, obesity and overweight, consumption of alcohol, consuming high
components, or tobacco use. all these such factors can effectively contribute to the colon cancer among people. In addition to this, one of the major probl
causes cancer of colon patients face as a side effect of both their disease as well as the treatment is dehydration. it can be caused by various multiple f
diarrhoea, sickness, fever, bleeding or not able to ingest enough fluid during the course of a day (Colon Cancer and Hydration: Keeping Well, Staying Health
As per his case, his post operative condition was quite deteriorating as his urine output through the IDC is in-between 30 to 65ml per hour. It is important
must be taken on the oral fluids and nutrition supplements as it is needed for his condition to be back to normal. as per the view of case scenario, his condi

the afternoon were below the normal for example, his urine output is reduced to 10ml per hour and he is not able to take deep breath on the command of phy
Acute pain: As per the case scenario of Mr. Fraser, the person who can involve reduced blood pressure levels and having diabetes type 2 are generally havin
pain. from the study, it is identified as the men who are hyposensitive generally at higher risk of improving the prostate cancer, whereas, the wome
hyposensitive are at greater risk of developing the endometrial as well as the breast cancer. having reduced blood pressure levels are generally the common
of the cancer treatment. these all can be caused by having inadequate amount of physical activity, not consuming enough amount of food components
lifestyle, overeating, consumption of alcohol, excessive smoking and many more. Furthermore, healthy eating can play a significant role in preventing
illnesses among people (Whelan and Johnson, 2018).
It is identified by the healthcare professional that prior post operation, his condition become more deteriorating such that patient is not able to take a deep b
commanded. His abdomen is slightly distended, having occasional bowel sound. He also involves the area around the incision becomes slightly pinkish an
minimal haemo-serous drainage in the Belovac.
Actual nursing diagnosis with
related to and evidenced by
statements
Goal of care
including
SMART
outcome criteria
Priority Nursing actions including specific
detail
Rationales for each action explained with
in text reference
Fluid volume deficit
(Hypovolaemia)
Related to:
Clinical review
of patient
deteriorating post
operative care to
The nursing interventions in order to reduce the
hypotension such as alteration in lifestyle. the care
nurses can suggest the changes in the lifestyle,
containing drinking enough amount of water,
avoiding alcohol, and many more. the patients
It is acknowledged by providing effective
care actions to Mr. Fraser that he can able to
overcome his conditions such as
hypotension. by prescribing him effective
medications and advices of consuming more

The patients who are having fluid
volume deficit can involve compliant
with weakness as well as thirst which
can or cannot be accompanied by
tachycardia or weak pulse rates.
patients can involve weight loss
depending over the severity of the
fluid volume deficit, concentrated
urine output or the reduced urine
output. as per the case scenario, Mr.
Fraser is having reduced urine output.
In addition to this, the patient is also
suffering from low blood pressure
levels, the hypovolemia can
effectively cause the reduced cardiac
output as well as hypotension by
efficiently reducing the preload. the
hypovolemia can outcome from the
loss of circulating the blood volume
after the haemorrhage or from
inappropriate enhancement in the
capacitance of the blood vessels as in
provide care
management and
clinical support
to over through
the possible
internal bleeding.
who are having low blood levels can use more salt
amount in their food, wear the compression
stocking such that elastic stockings are more
commonly used to relieve the swelling and pain of
the veins can effectively aid to decrease the
pooling of blood within legs. the care nurses can
also provide medications that can be effectively
used to treat the hypotension such as
Flurocortisone can effectively encourage the blood
to raise its volume. the physicians can often use
the medication midodrine in order to increase the
blood pressure levels within people having
hypotension. In this, the nursing intervention can
involve in his case is to safely administration of
fluids, monitor the weight of patient, visualize his
vital signs and symptoms, and provide oxygen if
necessary. The care nurse must frequently re-
access his blood pressure levels, the volume
status, his respiratory rate, urine output, his body
temperature and the oxygen saturation level.
salt can help him to reduce his illness
effectively ( Abdelhafiz, 2022).

the vasodilatory shock.
Evidenced by:
Low blood pressure (hypotension),
2020
Actual nursing diagnosis with Goal of care Priority Nursing actions including specific Rationales for each action explained with

related to and evidenced by
statements
including
SMART
outcome criteria
detail in text reference
Acute Pain
Related to:
Emotional stress can cause both the
mental, behavioural as well as
physical stress to the patient. the
physical symptoms can involve
heavy chest pain, elevated heart beat
rate or the chest pain, pain in neck or
shoulders, whole body ache and
many more.
The pain is generally influenced by
emotions, and the cycle of pain as
well as emotions are quite inter-
associated. in this, the emotions can
directly make influence over the
physical change as well. such that, a
person is feeling nervous or anxious,
the muscles become tighten as well
as that physical alterations can
To reduce acute
pain due to
possible internal
bleeding to attain
good health post
operative care.
To overcome the emotional stress of the patient,
the care nurses must make an effective
conversation with the patient so that patient can
feel good or satisfied. having effective
communication can help the care workers or
nurses to develop some trustful relationships with
patients, it is because it can foster the patients to
share their feelings and emotions more effectively
with care nurses. the care nurses must listen to the
patients and can try to understand the values and
assist them by providing effective emotional
support. In addition to this, the nursing
intervention that are needed to be taken to save the
patient from his deteriorating conditions due to
acute pain such as its management can be done
with help of effective medications such as
paracetamol, opioid drugs and many more. It can
be managed by some relaxation therapies such as
yoga, meditation or hypnotherapy.
By providing effective care services and
establishing effective communication with
patient, he can positively able to share his
feelings and emotions with care nurses. it is
identified that establishing effective
communication with patients can help the
care nurses to provide the care treatment as
per their needs (Traumer, Jacobsen and
Laursen, 2019).

effectively contribute towards the
enhanced pain.
Evidenced by:
Emotional Stress: Warning Signs,
Management, 2020

Reference List
Books and Journals:
Abdelhafiz, A.H., 2022. Ischaemic heart disease. Pathy's Principles and Practice of Geriatric Medicine, 1, pp.388-399.
de Carvalho, I.R., Nunes, T., de Sousa, L. and Almeida, V., 2020. The combined use of salivary cortisol concentrations, heart rate, and
respiratory rate for the welfare assessment of dogs involved in AAI programs. Journal of Veterinary Behavior, 36, pp.26-33.
Devnani, A.S., Yeak, R.D.K. and Fahrudin, C.H., 2020. Osteomyelitis of the Knee Following Intra-Articular Injections: A Case Series. JNMA:
Journal of the Nepal Medical Association, 58(223), p.195.
Puri, I., Sharma, D., Gunturu, K.S. and Ahmed, A.A., 2020. Diagnosis and management of tumor lysis syndrome. Journal of Community
Hospital Internal Medicine Perspectives, 10(3), pp.269-272.
Traumer, L., Jacobsen, M.H. and Laursen, B.S., 2019. Patients’ experiences of sexuality as a taboo subject in the Danish healthcare system: a
qualitative interview study. Scandinavian journal of caring sciences, 33(1), pp.57-66.
Turkington, L., Ward, E.C. and Farrell, A.M., 2019. An investigation of taste intensity, palatability, effervescence, and sip volumes of
carbonated liquid stimuli for use in videofluoroscopic studies. American Journal of Speech-Language Pathology, 28(3), pp.1248-1256.
Vesoulis, Z., Tims, A., Lodhi, H., Lalos, N. and Whitehead, H., 2022. Racial discrepancy in pulse oximeter accuracy in preterm infants. Journal
of Perinatology, 42(1), pp.79-85.
Warren, J., Nanayakkara, S., Andrianopoulos, N., Brennan, A., Dinh, D., Yudi, M., Clark, D., Ajani, A.E., Reid, C.M., Selkrig, L. and Shaw, J.,
2019. Impact of pre-procedural blood pressure on long-term outcomes following percutaneous coronary intervention. Journal of the
American College of Cardiology, 73(22), pp.2846-2855.
Whelan, A. and Johnson, M.I., 2018. Lysergic acid diethylamide and psilocybin for the management of patients with persistent pain: a potential
role?. Pain management, 8(3), pp.217-229.
Zeidman, L.A. and Kubicki, K., 2021. Clinical features and treatment response in immune-mediated small fiber neuropathy with trisulfated
heparin disaccharide or fibroblast growth factor receptor 3 antibodies. Journal of Clinical Neuromuscular Disease, 22(4), pp.192-199.

Online:
Colon Cancer and Hydration: Keeping Well, Staying Healthy, 2017 [Online] Available through:
https://www.ccalliance.org/blog/prevention/colon-cancer-hydration-keeping-well-staying-healthy
Low blood pressure (hypotension), 2020 [Online] Available through: https://www.mayoclinic.org/diseases-conditions/low-blood-pressure/
diagnosis-treatment/drc-20355470
Emotional Stress: Warning Signs, Management, 2020 [Online] Available through:<https://my.clevelandclinic.org/health/articles/6406-
emotional-stress-warning-signs-management-when-to-get-help>