NSG 119 Fluid and electrolyte summary

Signs and Sym
Sign ptom
ymp oms
s
System Hypovolemia (Dehydration) Hypervolemia (Fluid overload)
• Increase in HR • Increased pulse rate and bounding quality
• Decreased BP • Increased BP
Cardiovascular • Peripheral pulses are weak and difficult to find • Elevated central venous pressure
• Orthostatic hypotension • Distended neck and hand veins
• Neck and hand veins are flat when laying down and hands are
• Varicose veins
not above the heart • Weight gain

• Increase in RR • Increase in RR
Respiratory • Crackles

• Skin turgor is poor • Pitting edema
• Skin is dry and scaly • Skin pale and cool to touch
Skin • For older adults, pinch the skin over the sternum or on the • High risk for skin breakdown
forehead rather than the hand

• Changes in cognition • Altered level of consciousness
• Low-grade fever (it can also cause dehydration) • Headache
Neuromuscular/ • For every degree in Celsius increase in body temperature • Visual disturbances
neuromuscular above normal, 500 mL of body fluid is lost • Skeletal muscle weakness
• Paresthesias

• Concentrated urine with specific gravity of 1.03 • Increased motility
• Dark amber color • Enlarged liver
Kidney changes/ GI • Strong odor
function • Urine output of less than 500 mL for patients with kidney
disease is concerning

, In
Intter
ervventions – Flu
ons id imbala
Fluid nce
lan
System Hypovolemia (Dehydration) Hypervolemia (Fluid overload)
• Fluid replacement • Diuretics
• Depending on the cause, administer the • Sodium ad fluid restriction
following • Rapid weight gain is the best indicator of fluid
• Antidiarrheal retention and overload
• Antimicrobial • Call provider if more than 3-lb gain in a
• Antiemetics week or 2-lb gain in a day
Interventions • Antipyretics
• Desmopressin
• Preventing injury
• High risk for falls due to orthostatic
hypotension, dysrhythmias, muscle
weakness, and confusion