What are potential causes of fluid volume deficit?
- isotonic loss - vomiting - diarrhea - GI suction - sweating - decreased intake - hemorrhage - third spacing
What are potential causes of fluid volume overload?
- isotonic gain, increased in interstitial compartment, intravascular compartment or both - CHF - renal failure - cirrhosis of the liver - excessive ingestion of sodium - excessive or too rapid intravenous infusion
What are nursing interventions for fluid volume deficit?
- force fluids - provide isotonic IV fluids (LR, .9%) - I and O, hourly outputs - daily weights (1 L = 1 kg) - check skin turgor - assess urine specific gravity
What are nursing interventions for fluid volume excess?
- administer diuretics - restrict fluids - sodium-restricted diet (6-15 g Na) - daily weights - assess breath sounds - check feet/ankle/sacral region for edema - Semi-Fowler's position if dyspneic
What is a normal central venous pressure reading?
What does a elevated CVP measurement indicate?
hypervolemia or poor cardiac contractility
What does a lowered CVP measurment indicate?
What are potential complications of CVP measuring?
- pneumothorax - air embolism - infection at insertion site
What is nursing managment for a CVP measurment?
- dry, sterile dressing - change dressing, IV fluid bag, manometer, and tubing every 24 hours - instruct pt to hold breath when tubing changed to prevent air embolism - check and secure all connections
What are examples of hypotonic IV fluids?
What are examples of hypertonic IV fluids?
- 10-15% dextrose in water - 3% NaCL - Sodium Bicarb 5% - 5% dextrose in .9% saline