Chapter 42: Fluid, Electrolyte and Acid-Base Balance Flashcards
Risk for fluid volume imbalance
-Loss of blood and fluids during a major surgical procedure
-Infectious process
-Burns
-Poor oral intake
-Vomiting and diarrhea
-Renal failure
-Heart failure
Impaired Fluid Intake:
-Isotonic fluid deficit
-Hypertonic fluid deficit
-Dry mucous membranes
-Weight loss of greater than 2.2 lb (1 kg) in 24 hours
-Thirst
-Orthostatic hypotension
-Prolonged capillary refill
-History of vomiting
-Output greater than input
Fluid volume excess:
-Isotonic fluid excess
-Hypotonic fluid excess
-Dependent edema
-Weight gain of greater than 2.2 lb (1 kg) in 24 hours
-Jugular venous distension
-Crackles in lungs
-Dyspnea
-Intake greater than output
Expected outcome for Risk for fluid volume imbalance
The patient will achieve fluid balance as evidenced by daily weight stability and urine output greater than 30 mL/hour.
these states can decrease cardio output for the patient
Impaired Fluid Intake and fluid volume excess
Expected outcome for Impaired Fluid Intake
The patient will achieve fluid balance as evidenced by daily weight stability, urine output greater than 30 mL/hour, and systolic blood pressure greater than 90 mm Hg
Expected outcome for Fluid volume excess
The patient will achieve fluid balance as evidenced by resolution of edema, daily weight stability, resolved dyspnea, and output equal to intake