What is hypervolemia? Show
Hypervolemia, also called fluid overload, is the condition of having too much water in your body. While the body normally has a certain amount of fluids in it, too much fluid can damage your health. The signs of hypervolemia include:
Often, it’s problems with your kidneys that cause hypervolemia. This is because the kidneys normally balance the amount of salts and fluids in your body. When they retain salt, they increase the body’s total sodium content, which increases your fluid content. The most common causes of hypervolemia include:
If you believe you’re experiencing hypervolemia, visit your doctor. They can determine if you’re experiencing this condition. First, your doctor will conduct a physical exam. The key diagnostic signs of hypervolemia include weight gain and swelling. One or more parts of your body may appear swollen, depending on whether or not you have been sitting, lying, or standing before your visit. Your doctor is also likely to perform a blood test to check your sodium levels. While your body’s total sodium levels will be increased if you have hypervolemia, your sodium levels in the blood work may be high, normal, or low. Performing a sodium test on your urine can help determine if your kidneys are causing your hypervolemia or if there is another cause. For renal failure, urinary sodium content is typically greater than 20 milliequivalents per liter (mEq/L), while in cases of heart failure, cirrhosis, and nephrotic syndrome it will be less than 10 mEq/L. Untreated hypervolemia can cause several complications, some of which are life-threatening. These include:
Treatment of hypervolemia differs from person to person depending on the cause of the condition. Generally, all people with hypervolemia receive a round of diuretics, which are medications that remove excess fluid. In extreme cases, a doctor will recommend dialysis (fluid removal through the kidneys) and paracentesis (fluid removal through the belly). Your doctor will also require you to restrict your dietary sodium intake. While you recover from hypervolemia, it’s essential to weigh yourself daily to ensure you’re expelling the excess fluid in your body. Most people who stick to their doctor’s treatment plans make a full, quick recovery. This important for preventing complications, which can harm your health. Besides monitoring your weight, you can prevent a recurrence of fluid overload by:
Fluid and electrolyte balance is a dynamic process that is crucial for life and homeostasis.
HomeostasisHomeostasis is the dynamic process in which the body maintains balance by constantly adjusting to internal and external stimuli. Negative and Positive Feedback
Systems Involved in Feedback The major systems involved in feedback are the nervous and endocrine systems.
Body FluidsFluids make up a large portion of the body, which is approximately 50%-60% of the total body weight. Location of Fluids
Fluid Regulation Mechanisms
Normal Intake and Output
Overhydration and Edema
Dehydration
ElectrolytesAn electrolyte is a substance that will disassociate into ions when dissolved in water.
Fluid and Electrolyte TransportTotal electrolyte concentration affects the body’s fluid balance.
Permeability of Membranes
Passive Transport
Active Transport
Fluid and Electrolyte BalanceFluid and electrolyte balance is vital for proper functioning of all body systems.
Acid-Base BalanceAcid-base balance is another important aspect of homeostasis. Acid, Bases, and Salts
Potential of Hydrogen
Buffers
ClassificationThere are different fluid volume disturbances that may affect an individual.
Disturbances in electrolyte balances are common in clinical practice and must be corrected.
PathophysiologyNurses need an understanding of the pathophysiology of fluid and electrolyte balance to anticipate, identify, and respond to possible imbalances.
CausesCauses of fluid and electrolyte imbalances are discussed below in general.
Clinical ManifestationsSigns and symptoms that occur in fluid and electrolyte imbalances are discussed below.
ComplicationsFluid and electrolyte imbalances could result in complications if not treated promptly.
Assessment and Diagnostic FindingsThe following are laboratory studies useful in diagnosing fluid and electrolyte imbalances:
Medical ManagementTreatment of fluid and volume imbalances needs accuracy to avoid consequences that can result in complications.
Pharmacologic therapy
Nursing ManagementNurses may use effective teaching and communication skills to help prevent and treat various fluid and electrolyte disturbances. Nursing AssessmentClose monitoring should be done for patients with fluid and electrolyte imbalances.
DiagnosisThe following diagnoses are found in patients with fluid and electrolyte imbalances.
Nursing Care Planning & GoalsMain Article: 10 Fluid And Electrolyte Imbalances Nursing Care Plans Planning and goals for fluid and electrolyte imbalances include:
Nursing InterventionsThere are specific nursing interventions for fluid and electrolyte imbalances that can aid in alleviating the patient’s condition.
EvaluationEvaluation of the care plan can check the effectiveness of the treatments. The interventions are deemed effective if the client has:
Discharge and Home Care GuidelinesAfter hospitalization, treatment and maintenance of the condition must continue at home.
Documentation GuidelinesData should be documented for future medical and legal references. The nurse must document:
Practice Quiz: Fluids and ElectrolytesHere’s a 10-item quiz about the study guide. Please visit our nursing test bank page for more NCLEX practice questions. 1. ECF is primarily composed of: A. Aqueous fluid and lymphatic fluid. 2. A chemical set up to resist changes, particularly in the level of pH, is: A. A base. 3. Water moves across a semipermeable membrane via which process? A. Active transport. 4. To balance water output, an average adult must have daily fluid intake of approximately: A. 500-900 ml. 5. The primary organs involved in pH regulation are: A. Kidneys and lungs. 6. A clinical manifestation not found in hypokalemia is: A. Muscle weakness 7. The nurse should expect that a patient with mild fluid volume excess would be prescribed a diuretic that blocks sodium reabsorption in the distal tubule, such as: A. Bumex 8. Nursing intervention for a patient with a diagnosis of hyponatremia includes all of the following except: A. Assessing for symptoms of nausea and malaise. 9. To supplement a diet with foods rich in potassium, the nurse should recommend the addition of: A. Fruits such as bananas and apricots 10. The most characteristic manifestation of hypocalcemia and hypomagnesemia is: A. Anorexia and nausea. Answers and Rationale 1. Answer: C. Interstitial and intravascular fluids.
2. Answer: B. A buffer.
3. Answer: D. Osmosis.
4. Answer: C. 2,000-3,000 ml.
5. Answer: A. Kidneys and lungs.
6. Answer: B. Oliguria
7. Answer: D. Lasix
8. Answer: B. Encouraging the intake of low-sodium liquids such as coffee or tea.
9. Answer: A. Fruits such as bananas and apricots
10. Answer: D. Tetany
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[sc name=”Affiliate_MedicalSurgical”] Which daily assessment data is necessary to determine changes in the client's Hypervolemia status?Which daily assessment data is necessary to determine changes in the client's hypervolemia status? Rationale: Daily weight provides the ability to monitor fluid status. A 2-lb (0.9 kg) weight gain in 24 hours indicates that the client is retaining 1 L of fluid. Also, the loss of weight can indicate a decrease in edema.
Which of the following is a factor affecting an increase in urine osmolality?The following are associated with increased urine osmolality: Dehydration. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) Adrenal insufficiency.
Which of the following electrolytes is the primary determinant of extracellular fluid ECF osmolality quizlet?Explanation: Sodium is the primary determinant of ECF osmolality. Sodium plays a major role in controlling water distribution throughout the body because it does not easily cross the intracellular wall membrane and because of its abundance and high concentration in the body.
When evaluating arterial blood gases ABGS which value is consistent with metabolic alkalosis?The PaCO2 is elevated, indicating respiratory acidosis, and the HCO3 is elevated, indicating a metabolic alkalosis. The value consistent with the pH is the PaCO2.
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