Fluid
Volume Excess
(_)Actual (_)
Potential
(_) Decreased cardiac output (_) Low protein intake (_) Liver disease (_) Inflammatory process |
(_) Medications:_______________________ (_) Excess fluid intake (_) Sodium intake more than adequate (_) Other:_____________________________ ____________________________________ |
Major: (Must be present) |
(_) Edema (_) Taught, shiny skin |
Date & Sign. |
Plan and Outcome [Check those that apply] |
Target Date: |
Nursing Interventions [Check those that apply] |
Date
Achieved: |
The patient will: (_) (_) Other: |
(_) Reduce or eliminate causative contributing factors:_________ ________________________ (_) Assess location and severity of (_) Measure intake and (_) Measure edematous (_) Daily weights each (_) Elevate _______ (_) Passive/active (_) Avoid constrictive (_) Explore with (_) ________________________ |
__________________________
Patient/Significant other signature
__________________________
RN signature