fluid balance Flashcards
Water is
Essential to nutrition
55 – 75% of body weight (more in males)
By-product of cell metabolism
Necessary for all chemical reactions in cells and maintain cell functions (respiration, digestion)
Carries nutrients and O2 to all parts of body
Removes wastes through sweat and urine
maintain normal temp
average adult requirement of water
2000 – 2500mls/day of fluids for normal fluid
balance
can look different for individuals with health conditions such
as CHF or kidney disease
Intake must equal output
Edema
Tissues swollen with water
Fluid intake > output
May indicate kidney or heart disease
Dehydration
Not enough water in body tissues
Causes:
loss of fluids from body greater than what is taken in
(intake < output)
Infants and young children have higher proportion of water
older adults have lower proportion
S/S of
Dehydration
Skin
Dry, warm
Dry oral mucosa
Poor turgor
Neurological
Confusion, disorientation
Change in affect
Seizures
Gastrointestinal (GI)
consipation
Genitourinary (GU)
Scant or concentrated urine
Dark colored urine
Strong ammonia odour
Cardiopulmonary
Weak, rapid pulse
Orthostatic hypotension
Altered respirations
Dehydration –
HCA Role
Report and record observations
Monitor skin and provide good skin care
Maintain in/out record if ordered
Encourage fluids for treatment and prevention
Age Related Changes
and Risk Factors
Mobility problems:
inability to access fluids
Confusion:
unaware of need to drink or sensation of thirst
General decrease in thirst sensation
Change in sleep patterns
day naps may lead to less intake
Incontinence
may decide to restrict fluids
Medications
diuretics, laxatives, side effects
Decreased peristalsis
full feeling
Type of fluid intake
alcohol, coffee, tea
Special Fluid
Orders
Orders to provide adequate fluid intake or to increase
fluid intake.
Examples:
* “push fluids”
* fluid restriction of ____ml
* fluids PRN
Ways to Encourage
Fluids
Assist with drinking PRN
Provide fluids regularly within reach of client
Offer frequent sips
Consider client preferences
Offer a straw if appropriate
Fluid Restrictions
Amount of fluid will be ordered
usually per 24 hours
Intake and output need to monitored and recorded
Ensure client and visitors are aware of this
Usually ordered for clients with renal failure, CHF, liver failure
NPO
Nothing By Mouth
clients:
pre and post surgery
certain blood tests and/or diagnostic tests
certain diseases
clients with tube feeds (aspiration risk)
Fluid
Restrictions –
HCA Role
Post signage (NPO sign or fluid restriction amount)
Intake and output need to monitored and recorded
Ensure client and visitors understand and are aware of
this
Remove fluids from bedside (no water pitchers)
Frequent oral care, NPO client not to swallow fluids
If NPO, ice chips may still be allowed (check with
nurse/supervisor)
