Case Study Analysis: NANDA Nursing Diagnosis of Fluid Volume Deficit

This case study focuses on a 78-year-old patient admitted with pneumonia and dehydration, presenting with symptoms like fever, productive cough, and low blood pressure. The paper centers on the NANDA nursing diagnosis of "Deficient Fluid Volume," detailing the rationale behind this diagnosis, supported by literature highlighting factors contributing to dehydration in pneumonia patients. A SMART nursing plan is outlined, including specific interventions such as regular vital sign assessments, monitoring of mucous membranes, and collaboration for antiemetics and antipyretics, with measurable outcomes and a timeframe for intervention. The assignment incorporates relevant references to support the analysis and proposed nursing interventions, offering a comprehensive approach to managing fluid volume deficit in a patient with pneumonia.

Running Head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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Introduction
The paper deals with the case study of a 78-year-old patient who was admitted from
home with a medical diagnosis of pneumonia and dehydration. The handover details indicate the
patient to be out of the bed 3 times a day and must be given regular diet as tolerated. The patient
must be administered with oxygen 2LPM per nasal canula. The vital sign report shows
Temperature of 100.8 F, heart rate 88, respiratory rate 18, BP100/68, with oxygen saturation of
91% and tenting at the clavicle. The patent has been reported with productive cough with green -
yellow sputum. The paper will focus on the NANDA nursing diagnosis “Deficient of fluid
volume”.
Nursing diagnosis
The three nursing diagnoses for this case study are- ineffective airway clearance, activity
intolerance, and deficient in fluid volume. The chosen nursing diagnosis for discussion in this
paper is fluid deficient volume.
Deficient of fluid volume- Nursing three part diagnosis statement
The problem of the fluid volume deficiency due to dehydration in the patient is evident
from the excessive fluid loss from the vomiting, urination, fever, shortness of breath, and
low blood pressure. The patient is moving out of bed three times a day and is no able to tolerate
the food as physician as instructed to provide him diets that can be tolerated. The evidence
pertaining to the situation is collected from literature that supports the chosen diagnosis and is
discoursed in subsequent sections.

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Rationale
The case study of the patient inform of pneumonia and dehydration. According to
Gathara et al. (2013), the factors that increase the dehydration are vomiting, diarrhoea, rapid
breathing, infection, excessive urination. In the given case study, the above-mentioned symptoms
have been noticed. During pneumonia, the patient suffers from low oxygen level and requires the
oxygen until the pneumonia is cleared. Dehydration is common in pneumonia occurring from
fever, decreased appetite and thirst, requiring administration of the extra fluids intravenously
(Simonetti et al., 2014). Fever increases the metabolic rate and thus loss of fluid occurs through
evaporation.
Nursing plan for this patient involves SMART framework and is given below
In order to gain this Specific plan of action (Davis, 2015) is -
 Regular assessment of the vital signs as increase in temperature will increase the
dehydration
 Regular assessment of the mucous membrane moisture and skin turgor as they
directly indicate the strength of the fluid volume
 Record the frequency of nausea and vomiting as indicated by the oral input
 Collaboration of the anti-emetics, and antipyretics as they are useful for
decreasing the fluid loss
The measurable outcome- can be the patient demonstrating adequate fluid volume upon
assessment (Gathara et al., 2013).
These objectives are Attainable by toe nurse as per the scope of practice and the nursing
goals are Relevant to deficient fluid volume.

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Time frame- The assessment can be completed in 24 hours that would decrease
vomiting. In this case study, half of the fluid deficit can be replaced within the first 24 hours. The
remaining loss of fluid can be restored in the 48-72 hours. The fever may be reduced within 24
hours. The interventions can be adjusted as per the response from the patient in next 24 hours
(Rabelo‐Silva et al., 2017).

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References
Davis, H. (2015). Nursing care. Veterinary Clinics: Small Animal Practice, 45(5), 1029-1048.
Gathara, D., Irimu, G., Kihara, H., Maina, C., Mbori-Ngacha, D., Mwangi, J., ... & English, M.
(2013). Hospital outcomes for paediatric pneumonia and diarrhoea patients admitted in a
tertiary hospital on weekdays versus weekends: a retrospective study. BMC
pediatrics, 13(1), 74.
Rabelo‐Silva, E. R., Dantas Cavalcanti, A. C., Ramos Goulart Caldas, M. C., Lucena, A. D. F.,
Almeida, M. D. A., Linch, G. F. D. C., ... & Müller‐Staub, M. (2017). Advanced Nursing
Process quality: Comparing the International Classification for Nursing Practice (ICNP)
with the NANDA‐International (NANDA‐I) and Nursing Interventions Classification
(NIC). Journal of clinical nursing, 26(3-4), 379-387.
Simonetti, A. F., Viasus, D., Garcia-Vidal, C., & Carratalà, J. (2014). Management of
community-acquired pneumonia in older adults. Therapeutic advances in infectious
disease, 2(1), 3-16.