Introduction
Fall prevention is a complex approach to minimizing health risks associated with circumstances where a patient is vulnerable to falls. In this case, the nursing diagnosis highlights that the patient is in a vulnerable position, as evidenced by an episode of syncope and dehydration. Syncope and dehydration can be correlated, as an individual with decreased liquid volume can faint. Three intervention measures are proposed to address the risk. Namely, the evidence-based elements to be implemented in the patient’s treatment plan include increasing fluid intake, frequent oral mucosa membrane assessments, and preventing electrolyte loss through medication that addresses vomiting, diarrhea, and diaphoresis.
Increasing Fluid Intake
As dehydration can lead to syncope and, consequently, increase the risk of falling, increasing fluid intake is a crucial step toward improving safety. The amount of fluid intake required varies depending on the severity of dehydration or the patient’s individual preferences. Sometimes, encouraging individuals to drink more fluids and consume water-rich products can help maximize positive outcomes.
Namely, researchers highlight that verbal encouragement increases fluid intake by 300mL per day (Bruno et al., 2021). In other cases, intravenous hydration may be necessary for water replenishment. As mentioned, falls occur more frequently when patients do not consume the necessary amount of liquids. Thus, an indirect approach to the risk correlates with efforts to maximize or consume water (Montero-Odasso et al., 2022). Syncope is also addressed, as dehydration is one of the main drivers for fainting.
Oral Mucous Membrane Assessment
As mentioned, the nursing diagnosis of dehydration was determined by assessing the oral mucous membrane. A similar examination will be performed frequently to determine whether additional measures are required to replenish hydration. Researchers highlight that the assessment method is effective in diagnosis (Fukushima et al., 2019). By addressing oral hygiene, nurses can effectively determine the state and severity of the condition. As a result, if the patient exhibits a severely dry mouth, fluid intake should be maximized to reduce the risk of falls, thereby addressing patient safety in the medical setting.
Prevention of Electrolyte Loss Through Diarrhea, Vomiting, and Diaphoresis Medication
Hydration is impaired if the patient exhibits symptoms such as diarrhea, vomiting, and intense diaphoresis (excessive sweating). Through conversations with the patients, nurses can determine whether the risks above can impair the patient’s safety regarding falls and syncope. Medication specifically can either increase or decrease adverse outcomes. For example, patients who are administered diuretics are more likely to experience dehydration and falls (Hamrick et al., 2020).
On the other hand, medications that treat symptoms of diarrhea and vomiting confront the possibilities above (Lerdal et al., 2018). Thus, antidiarrheal treatment and antipyretics maximize fluid retention, which leads to fall prevention.
Conclusion
While the nursing intervention is aimed towards fall prevention, the outcome can be achieved indirectly, as the leading cause was determined to be dehydration. Thus, the three evidence-based measures that can be implemented include maximizing fluid intake through drinks, nutrition, and intravenous fluid administration.
Moreover, it is essential to conduct daily assessments of the oral mucous membrane’s dryness. If it is dry, further interventions are required to rehydrate the body and prevent falls. Lastly, antidiarrheal treatment and antipyretics can increase fluid retention in patients exhibiting these symptoms.
References
Bruno, C., Collier, A., Holyday, M., & Lambert, K. (2021). Interventions to improve hydration in older adults: A systematic review and meta-analysis. Nutrients, 13(10), 3640. Web.
Fukushima, Y., Sano, Y., Isozaki, Y., Endo, M., Tomoda, T., Kitamura, T., Sato, T., Kamijo, Y., Haga, Y., & Yoda, T. (2019). A pilot clinical evaluation of oral mucosal dryness in dehydrated patients using a moisture‐checking device. Clinical and Experimental Dental Research, 5(2), 116–120. Web.
Hamrick, I., Norton, D., Birstler, J., Chen, G., Cruz, L., & Hanrahan, L. (2020). Association between dehydration and Falls. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 4(3), 259–265. Web.
Lerdal, A., Sigurdsen, L. W., Hammerstad, H., Granheim, T. I., & Gay, C. L. (2018). Associations between patient symptoms and falls in an acute care hospital: A cross-sectional study. Journal of Clinical Nursing, 27(9-10), 1826–1835. Web.
Montero-Odasso, M., van der Velde, N., Martin, F. C., Petrovic, M., Tan, M. P., Ryg, J., Aguilar-Navarro, S., Alexander, N. B., Becker, C., Blain, H., Bourke, R., Cameron, I. D., Camicioli, R., Clemson, L., Close, J., Delbaere, K., Duan, L., Duque, G., Dyer, S. M., … Rixt Zijlstra, G. A. (2022). World guidelines for falls prevention and management for older adults: A global initiative. Age and Ageing, 51(9). Web.