In severe and intractable fluid volume deficit a central venous catheter may be used to evaluate the extent of fluid loss and to guide replacement therapy.Įxcess fluid volume a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as increased isotonic fluid retention see also fluid volume. Intravenous administration of fluids, especially isotonic saline, may be necessary if oral replacement is not possible. Explanations about the importance of an adequate fluid intake and assuring the availability of fresh water and fluids attractive to the patient can help reach the desired goal. The goal of oral fluid intake should be about 2000 ml per day. Measures to improve hydration status should take into account the patient's ability to drink and retain fluids by mouth, preferences for certain fluids, and whether hot or cold drinks are preferred. Patients at risk for profound and potentially fatal fluid volume deficit, as in severe burns, should be assessed frequently for mental acuity status and orientation to person, place, and time. The patient may complain of thirst and the body temperature may be elevated. The mucous membranes are dry, as is the skin, which loses its turgor. Other objective assessment data include hypotension and a decrease in venous filling and in pulse volume and pressure. The urine appears concentrated and is usually well below the criterion of 50 ml of output per hour. If there is a fluid volume deficit, intake and output measurements can give evidence of fluid imbalance. Recording daily weight gives information about the amount of water gained or lost each day. In the absence of other problems, the serum sodium should remain within normal limits. Assessment of the patient's hydration status includes monitoring lab data for such signs as increased packed red blood cell volume, increased plasma protein level, elevated specific gravity of urine, and increased blood urea nitrogen (BUN) out of proportion to a change in serum creatinine. Insufficient intake of water can be caused by nausea, immobility with inaccessibility of water, and lack of knowledge about the necessity of adequate fluid intake. Etiologic factors include active loss through vomiting, diarrhea, gastric suctioning, drainage through operative wounds and tubes, burns, fistulas, hypermetabolic states, and drug-induced diuresis. The lungs excrete about 400 ml per day.Ī deficit of fluid volume occurs when there is either an excessive loss of body water or an inadequate compensatory intake. About 300 ml of water diffuse through the epithelial cells daily.
Volumetrix medical skin#
The remaining 700 ml are lost through what is called insensible water loss, which takes place by diffusion through the skin and by evaporation from the lungs. About 1400 ml are lost in urine, 200 ml in feces, and 100 ml in sweat. When a person engages in normal physical activity and the environmental temperature is 20☌ (68☏), the body loses about 2400 ml of water in 24 hours. This refers to dehydration, water loss alone without change in sodium. Deficient fluid volume a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as decreased intravascular, interstitial, and/or intracellular fluid.
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