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Interventions for deficient fluid volume or fluid volume excess.
Terms in this set (21)
Fluid Volume Deficit
Isotonic Fluid Loss: Water and electrolytes lost in same proportion as body fluids.
Causes of Fluid Volume Deficit
Gastrointestinal loses diaphoresis, diuretics, hemorhage, fever, plasma lose through burn injuries and other injuries.
NOT THE SAME AS FLUID DEFICIT. Definition: Water lose with increase in Na levels. Example: Diabetic Ketoacidosis and Diabetes Insipidus.
Increase in blood sugar. More concentration in the blood stream.
Shifting in fluid balance.
Pulling from molecules drawing fluid inside the cell and vascular.
3% Sodium Chloride is:
Very concentrated and hypertonic.
Symptoms of hypovolemia:
Thirst, Dry oral mucosa
Increased: Temp, Heart Rate
Decreased: Urine output, Arterial venous pressure, orthostatic hypotension.
Confusion or lethargy, Headache, Delayed Capillary refill, Poor skin turgor, cool/clammy/pale skin on arms and legs.
Decreased Urine Output:
Decreased Oliguria=Acute weight loss.
1 liter of fluid loss = 1 kg of body weight.
Lab Results revealing hypovolemia:
Increased urine specific gravity-Normal 1.003-1.025
Nursing Diagnosis for Hypovolemia
Risk for/ Actual: Nausea, Diarrhea, Deficit Fluid Volume
Interventions for hypovolemia:
Physician Initiated- IV Fluids, Give Potassium/IV Piggy Back, Give plasma.
Nurse Initiated- Drink fluids, Monitor I&O, Teach family about recording I&O, weigh patient daily, Vital signs every four hours.
IV Fluid for Hypovolemia
Isotonic 0.9% Normal Saline
IV Fluid for dehydration
Hypotonic 0.4% Solution-Causing fluid to shift from intravascular to cells.
Fluid Volume Excess
Isotonic expansion of extracellular fluid with abnormal retention of water and sodium in same proportions in extracellular fluid.
Causes of Hypervolemia:
Too much IV fluids, Diminished homeostatic mechanisms (CHF,Renal Failure, Cirrhosis of the liver.
Increased Serum aldosteronee and steroid levels. Aldosterone comes from adrenal glands and when increased there is too much retention.
Math Question for Hypervolemia:
Patient with anasarca weighed 186 lbs this morning. After giving furosemide 8 mg iv push, you notice significan diuresis. The next morning he weighs 178 pounds. How much output in mL did he excrete?
8lbs(how much was lost) x 500mL (500mL=1pd)Divided by 1 lb= 4000mL is how much output patient excreted.
Fluid Volume Excess Signs and Symptoms
Confusion, Blurred Vision, Papilledema, rapid weight gain, edema, distended neck veins, increased urine output.
Respiratory Signs of Fluid Volume Excess
Crackles, Shortness of Breath, Wheezing, Chest Xray revealing pulmonary congestion.
Cardiovascular Signs of Fluid Volume Excess
Tachycardia, Increased BP, Increased Pulse Pressure, Increases Cardiovasular Pressure.
Labs revealing Hypervolemia
Decreased in BUN levels
Deacrease in Hematocrit
Nursing Interventions for Hypervolemia
Monitor I&O, Place patient in semifowlers during rest periods, Turn every 2 hours, Daily weight measurement, Observe for edema.
Physician Initiated: Dialysis in severe renal failure.
THIS SET IS OFTEN IN FOLDERS WITH...
Intravenous Water and Electrolyte Solutions
fluid volume deficit and fluid volume excess
Electrolyte Imbalances Potassium
Electrolyte Imbalances -Calcium
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