Lesson 3 Fluid Volume Changes

Fluid volume deficit

Condition resulting from excessive fluid loss or inadequate fluid intake leading to decreased intravascular, interstitial, and intracellular fluid

Fluid volume deficit gastrointestinal causes

Fluid loss through diarrhea, vomiting, GI suction, bowel preparation procedures, and NPO status

Fluid volume deficit renal causes

Fluid loss through excessive diuresis caused by diuretic medications

Fluid volume deficit vascular causes

Fluid loss through hemorrhage or bleeding

Fluid volume deficit skin causes

Fluid loss through burns that damage skin integrity

Fluid volume deficit cardiovascular manifestations

Weak thready pulse, diminished pulse quality, decreased blood pressure, orthostatic hypotension, and flat neck veins

Fluid volume deficit neuromuscular manifestations

Altered mental status ranging from lethargy to coma, skeletal muscle weakness, and fever

Fluid volume deficit respiratory manifestations

Decreased respiratory rate and dyspnea due to decreased fluid volume

Fluid volume deficit renal manifestations

Decreased urine output as kidneys attempt to conserve fluid

Fluid volume deficit integumentary manifestations

Decreased skin turgor and dry mucous membranes indicating dehydration

Fluid volume deficit GI manifestations

Diminished bowel sounds and constipation due to decreased fluid in gastrointestinal tract

Increased serum osmolality in fluid deficit

Elevated concentration of solutes in blood due to decreased water volume making blood more concentrated

Increased hematocrit in fluid deficit

Elevated percentage of red blood cells in blood due to hemoconcentration from fluid loss

Increased BUN level in fluid deficit

Elevated blood urea nitrogen indicating concentrated blood and possible decreased kidney perfusion

Increased serum sodium level in fluid deficit

Elevated sodium concentration due to loss of water exceeding sodium loss, causing hemoconcentration

Increased urine specific gravity in fluid deficit

Elevated concentration of urine as kidneys conserve water and produce more concentrated urine

Fluid volume overload

Condition resulting from excessive fluid retention causing increased intravascular and interstitial fluid volume

Fluid volume overload cardiac cause

Heart failure causing decreased cardiac output and fluid accumulation in body tissues

Fluid volume overload hepatic cause

Liver cirrhosis causing decreased protein production and fluid retention with ascites

Fluid volume overload renal cause

Kidney failure causing inability to excrete excess fluid and sodium properly

Fluid volume overload dietary cause

Excessive sodium intake from foods causing water retention

Fluid volume overload medication cause

Corticosteroids and other drugs that promote sodium and water retention

Fluid volume overload stress cause

Severe physiologic stress triggering hormonal responses that promote fluid retention

Fluid volume overload cardiovascular manifestations

Bounding increased pulse, elevated blood pressure, and distended neck veins from increased blood volume

Fluid volume overload respiratory manifestations

Increased respiratory rate and crackles in lungs from pulmonary fluid accumulation

Fluid volume overload neuromuscular manifestations

Altered level of consciousness, headache, visual disturbances, and skeletal muscle weakness from cerebral edema

Fluid volume overload renal manifestations

Increased urine output as kidneys attempt to excrete excess fluid, or decreased output if kidney damage is present

Fluid volume overload integumentary manifestations

Pitting edema in dependent areas and pale cool skin from fluid accumulation in tissues

Fluid volume overload GI manifestations

Increased intestinal motility, diarrhea, liver enlargement, and ascites from fluid accumulation

Decreased serum osmolality in fluid overload

Reduced concentration of solutes in blood due to excess water diluting the blood

Decreased hematocrit in fluid overload

Reduced percentage of red blood cells due to hemodilution from excess fluid volume

Decreased BUN level in fluid overload

Reduced blood urea nitrogen due to dilution from excess fluid in bloodstream

Decreased serum sodium level in fluid overload

Reduced sodium concentration due to dilution from excess water retention

Decreased urine specific gravity in fluid overload

Reduced concentration of urine as kidneys excrete excess water producing more dilute urine