Hypovolemia/Fluid Volume Excess

Question 1

In Hypovolemia, what is the big time deficit ?

Answer 1

Shock

Question 2

What are causes of Hypovolemia/Fluid volume Deficit ?

Answer 2

• Loss of fluid from anywhere
  (ex: Thoracentesis, paracentesis, vomiting, diarrhea, hemorrhage, NG suction)
• Third spacing (when fluid is in a place that does you no good)
  * WANT fluid in our vascular space!*
  - -> examples: Burns, Ascites
• Diseases with Polyuria (Ex: Diabetes Mellitus)
  polyuria - think shock 1st
  polyuria –> Oliguria–>Anuria
  (renal failure)

Question 3

Signs/symptoms of Hypovolemia/FVD ?

Answer 3

• Decreased weight
• Decreased or slowed skin turgor
• Dry mucous membranes
• Decreased urine output
• Decreased BP
• Increased pulse
• Increased respirations
• Decreased CVP
• Peripheral & neck veins vasoconstriction (become very tiny)
• Cool extremities
• Increased urine specific gravity

Question 4

What is Ascites ?

Answer 4

Fluid in the peritoneal cavity

• the abdomen is big so theses clients will look they have fluid volume excess, bu they actually have a fluid volume deficit because the fluid is in the tissues (third spacing) and not in the vascular space
• Potential for breathing problems also

Question 5

Why would a person with Hypovolemia have decreased urine output ?

Answer 5

B/c the kidneys either aren’t being perfused OR they are trying to hold onto the fluid (compensate)

Question 6

Why would a client with FVD have a decreased BP ?

Risk for ?

Answer 6

B/c Less volume = less pressure

• Risk for: Orthostatic Hypotension

Question 7

Why would a client with FVD have an increased pulse ?

What would the pulse feel like ?

Answer 7

B/c the heart is trying to pump what little fluid is left

Weak and thready

Question 8

Why would this client have increased respirations ?

Answer 8

B/c they are hypoxic

Question 9

Why would the CVP be decreased in FVD ?

Answer 9

Less volume = less pressure

Question 10

Why would a client with FVD have cool extremities ?

Answer 10

D/t peripheral vasoconstriction, in an effort to shunt blood to the vital organs

Question 11

Would would a clients urine specific gravity be high with FVD ?

Answer 11

If putting out any urine at all, it will be concentrated

Increased sodium & hematocrit

Question 12

What is the Treatment for Hypovolemia/FVD ?

Answer 12

• Prevent further losses
• Replace volume
  Mild deficit = PO fluids
  Severe deficit = IV fluids
• Safety precautions
  high risk for falls
  monitor for Fluid volume overload with IV fluid replacement