Dehydration and Fluid volume Excess (copy)

When dry (Dehydrated) what happens to urine specific gravity and Hematocrit?

They go Up

When overloaded what happens to urine specific gravity and Hematocrit?

They go Down

S/S of dehydration

• Poor skin turgor

• Hypovolemia

• Tachycardia

• Weak pulse

• Postural hypotension

• Confusion

• Dry skin

• Dry mucous membranes

• Weight loss

• Concentrated urine (Not in diabetes insipidus)

Dehydration can be caused by?

• Sodium loss

• Water loss

• Both

What would a nurse measure regarding I & Os for dehydration?

All fluids that enter and leave the body

What would a nurse check regarding Laboratory values for dehydration?

• Electrolytes

• CBC (Hematocrit)

• Urine-specific gravity

What would a nurse assess regarding Cardiovascular for dehydration?

• Hypotension

• Weak pulse

What would a nurse check regarding assessment for dehydration

• Orientation

• Vision

• Hearing

• Reflexes

• Muscle strength

What would a nurse check regarding Daily weights for dehydration?

Weight changes

What would a nurse check regarding oral and skin care for dehydration?

Skin breakdown

Good oral care

How much do we want adult Pt’s to pee an hour?

30ml/ hour

What would a nurse check regarding Fluid volume excess for Neurologic?

• LOC

• Confusion

• Headace

• Seizures

What would a nurse check regarding respiratory for Fluid volume excess?

Pulmonary congestion

What would a nurse check regarding Cardiovascular for Fluid volume excess?

• Bounding pulse

• High BP

• JVD

• S3

• Tachycardia

What would a nurse check regarding G.I. for Fluid volume excess?

• Anorexia

• Nausea

What assessment takes priority regarding Fluid volume excess?

Cardiovascular

Fluid volume excess medications?

• Loop diuretic (Furosimide)

• Thiazides (hydrochlorothiazide)

• Potassium sparing (Spironolactone) along with antihypertensive

Fluid volume excess position?

High-Fowlers

Normal intake oral fluids?

1.5 L

Normal intake food?

1 L

Normal output Urine?

1.5L

Normal output sweat?

Variable: up to 3L

What are the insensible outputs?

• Skin

• Lungs

• Stool

1 L of H2O = what?

1kg (2.2 lbs)

Hydration Assessment should include

• Present and past medical history

  • Cardiac disease

  • Diabetes

• Current Medications

• Physical assessment

  • Skin

  • Oral cavity

  • Mucous membranes

  • Eyes

  • Cardiovascular system

  • Respiratory system

What can make the BUN abnormal that doesn't involve kidney function?

• Rhabdomyolysis

• GI bleed

• Dehydration

• Increased protein intake

• Starvation

Men’s Hematocrit?

44-52%

Women’s Hematocrit?

39-47%

Data needed to monitor hydration status?

• Daily weights

• Vital signs

• Heart rate

• I/O

Risk factors for Dehydration

• Gastroenteritis

• Age related factors (infants and elderly)

• Diarrhea/Vomiting

• Kidney disease

• Diabetus

Primary prevention for dehydration?

• Adequate Fluid Intake

• Education for Early Recognition

• Include foods with high water content

Secondary prevention for dehydration?

• Regular Screening and Monitoring

• Prompt Fluid Replacement

• Education for Early Recognition

Tertiary prevention for dehydration?

• Medical Treatment

• Management of Underlying Causes

• Monitoring