Exam 2 Nursing 113
FVE (Fluid Volume Excess) HYPERVOLEMIA
Fluid intake or retention exceeds the body's fluid needs
Also called overhydration, fluid overload, circulatory overload. Involves retention of both water and electrolytes (especially sodium). There is usually an increase in the serum sod...
exam 2 nursing 113 fve fluid volume excess hypervolemia fluid intake or retention exceeds the bodys fluid needs also called overhydration
circulatory overload involves retentio
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Exam 2 Nursing 113
FVE (Fluid Volume Excess) HYPERVOLEMIA
Fluid intake or retention exceeds the body's fluid needs
Also called overhydration, fluid overload, circulatory overload. Involves retention of both
water and electrolytes (especially sodium). There is usually an increase in the serum
sodium which causes water retention.
FVE Causes
Overhydration with IV fluids
Kidney damage
Heart failure
Long-term use of corticosteroids
Excessive sodium ingestion
Syndrome of inappropriate antidiuretic hormone
Irrigation of wounds or body cavities with hypotonic fluids
Cirrhosis of the liver
Cushing's syndrome
FVE signs and symptoms
cough and dyspnea
lung crackles
increased respirations and heart rate
increased blood pressure and bounding pulse
pitting edema
weight gain, increased abdominal girth
neck and hand vein distention
increased urine output if kidneys can compensate; decreased if kidney damage is the
cause
confusion
decreased hematocrit level
FVE management/treatment
limnit fluid intake, using clinical situation as guide
diuretics to promote fluid and sodium loss
restrict sodium intake to reduce thirst
FVD (Fluid Volume Deficit) HYPOVOLEMIA
Dehydration occurs when the body fluid intake is not sufficient to meet the body's fluid
needs. Reduction of circulating blood volume. Not the same as dehydration. The body
will attempt to conserve water and sodium to increase the circulating blood volume, but
the low volume that exists will result in the common symptoms of FVD.
FVD causes
vomiting and/or diarrhea
blood loss
reduced fluid intake
continuous GI irrigation
GI suctioning
Ileostomy or colostomy drainage
,Draining wounds, burns, or fistulas
Increased urine output from the use of diuretics
FVD signs and symptoms
urine output <30mL/hr
Thirst
poor skin turgor and dry mucous membranes
increased HR, thready pulse, dyspnea, and postural hypotension
weight loss
flat neck or hand veins
dizziness or weakness
decrease in urine volume and dark, concentrated urine
increased specific gravity of the urine
confusion
increased hematocrit level
FVD management/treatment
determine renal function (may use fluid challenge test)
isotonic electrolyte solutions (LR), followed by a hypotonic solution (1/2NS)
continue with fluids, evaluate lung sounds and blood pressure
Potassium
3.5 - 5.0
ICF
< 3.5 = hypokalemia
> 3.5 = hyperkalemia
Hypokalemia Causes
use of potassium losing diuretics
diarrhea
vomiting
inadequate intake of potassium
excessive gastric suction
excessive fistula drainage
Cushings syndrome (increased secretion of aldosterone)
chronic use of corticosteroids or laxatives
kidney disease
parenteral nutrition
uncontrolled diabetes
alkalosis
Hypokalemia signs and symptoms
leg and abdominal cramps
lethargy and weakness
shallow respirations and thready pulse
confusion
decreased or absent reflexes
hypoactive bowel sounds and ileus
orthostatic hypotension
shallow, flat or inverted T waves; depressed ST segment and prominent U waves
Hyperkalemia causes
, kidney failure
intestinal obstruction
cell damage
excessive oral or parenteral administration of potassium; potassium-retaining (sparing)
diuretics
Addison's disease
excessive use of potassium-based salt substitutes
transfusion of stored blood (the breakdown of older red blood cells releases potassium)
acidosis
Hyperkalemia signs and symptoms
muscle weakness
paresthesia
hypotension
diarrhea
hyperactive bowel sounds
flat P waves; widened QRS complex; prolonged PR interval; and tall, peaked T waves
Sodium
135-145
ECF
< 135 = hyponatremia
> 145 = hypernatremia
Hyponatremia causes
inadequate sodium intake (nothing by mouth)
gastrointestinal suction
excessive intake of water
irrigation of gastrointestinal tubes with plain water
diuretics
increased perspiration
draining skin lesion(s)
burn(s)
nausea and vomiting
diabetic ketoacidosis
syndrome of inappropriate antidiuretic hormone secretion
retention of fluid, such as with kidney or heart failure
Hyponatremia signs and symptoms
rapid, thready pulse
postural blood pressure changes
weakness
abdominal cramping
poor skin turgor
muscle twitching and seizures
apprehension
confusion
Hypernatremia causes
decreased water intake
fever
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