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Fluid Volume Excess and Deficit (Fluid Volume Excess assessment (CV…
Fluid Volume Excess and Deficit
Excess
Hypertonic Overhydration
Is a rare occurance caused by excess Na+ intake
Fluid from ICF to ECF compartment
ECF compartment expands/ ICF compartment shrinks
Fluid intake/retention exceeds the needs of the body
Isotonic overhydration
Only ECF compartment is expanded
Fluid does not shift between ECF and ICF compartments
Causes a circulatory overload and interstitial edema
Occurs in clients w/ poor cardiac function, HF, and PE
Hypotonic Overhydration
AKA: water intoxication
Excessive fluid (ingested) moves into intracellular space and body compartments
Causes dilution of electrolytes, thus imbalances
Deficit
Hypotonic dehydration
Electrolyte loss exceeds water loss
fluid moves from plasma (ECF) to into cells (ICF), causing plasma volume deficit and cell swelling
Dehydration. When fluid intake is not sufficient to meet the needs of the body
Isotonic dehydration
Water and electrolyte lost in equal proportions
Decreased blood volume and inadequate tissue perfusion
AKA hypovolemia, is the most common type of dehydration
Hypertonic dehydration
water loss exceeds electrolyte loss
fluid moves from ICF compartment into plasma and interstitial fluid space, causing cellular dehydration (shrinkage)
Fluid Volume Excess assessment
CV
Respiratory
NM
Renal
Integumentary
GI
LABS
Decrease serum osmolality
Decreased hematocrit
Decreased BUN
Decreased serum Na
Decreased urine specific gravity
Increased motility
diarrhea
increased body weight
liver enlargement (hepatomegaly)
Ascites
Pitting edema in dependent areas (gravity related swelling)
cool, pale skin
increased urine output if kidneys can compensate
Decreased urine output if kidney damage is the cause
Altered LOC
headache
visual disturbances
skeletal muscle weakness
increased RR/shallow resps
Dyspnea
Moist crackles via auscultation
Bounding/>pulse
Increased BP
Distended neck/hand veins
/> central venous pressure
Dysrhythmias