Fluid and Electrolytes: Hypervolemia Flashcards
What are some conditions that can cause retention of both sodium and water?
- HF
- Cirrhosis of the liver
- Renal failure
- Adrenal gland disorders
- Corticosteroids
- Stress conditions
What are some other causes of hypervolemia?
- excessive intake of sodium-containing foods
- Drugs that cause sodium retention
- Excess amounts of sodium-containing IV fluids
What are some risk factors for fluid volume excess?
- preeclampsia in pregnancy
- heart disease
- Kidney dysfunctions
- Diabetes with peripheral vascular disease
- Hypertension
- IV therapy
What are some ways to prevent fluid volume excess?
- focus on disease states leading to overload
- Diuretics, antihypertensive meds to keep fluids in balance
- Weighing daily to identify early signs
- Careful intake of sodium
- Elevate lower extremities when sitting
What are the clinical manifestations of Fluid volume excess?
- full, bounding pulse
- distended neck, and peripheral pulses
- Increased CVP
- Cough, dyspnea, orthopnea
- Moist crackles
- Polyuria
- Ascites
- Peripheral edema or anasarca
- Decreased hematocrit and BUN
- Cerebral edema
What diagnostic tests may be used to determine fluid volume excess?
- serum electrolytes
- Serum osmolality
- Serum hematocrit and hemoglobin
- Tests of renal and liver function may help to determine the cause of FVE
What medications can be used for fluid volume excess?
- loop diuretics
- thiazide-type diuretics
- potassium-sparing diuretics
What is the purpose of fluid management?
- fluid intake may need to be restricted
- amount of fluid allowed is prescribed by a PCP
- All fluid intake must be calculated (fluid at meals, fluid used to administer meds, and fluid content of foods to be considered)
What kind of diet would someone have if they had fluid volume excess?
sodium-restricted diet
Why might pregnant women be at risk for fluid volume excess?
pregnancy-induced hypertension, preeclampsia, and eclampsia
What are the manifestations that a pregnant woman might be experiencing issues with fluid volume?
- increased peripheral edema with pitting
- increased proteinuria
- hypertension
What are the Interventions for Fluid volume excess?
- daily weight, I&O
- Administer oral fluids carefully
- oral hygiene every 2 hours
- Teach about sodium-restricted diet
- Administer meds, monitor response
- Report significant changes in serum electrolytes, osmolality
- safe diuretic use
- reposition every 2 hours, reduce skin shearing or friction, provide low-pressure alternative mattress, foot cradle, or heel protectors
- fowler position, monitor O2
- evaluate edema if possible
- assess for cultural practices that may effect dietary practices
