SIS - Hypovolemia and Nursing Interventions

Overview of Clinical Conditions and Nursing Considerations

SIS (Syndrome of Inappropriate Antidiuretic Hormone Secretion)

  • Related symptoms and concerns:

    • Dizziness

    • Tenting (potentially referring to skin tenting, a sign of dehydration)

    • Loss of Consciousness (LOC)

    • Tachycardia (increased heart rate)

    • Hypotension (low blood pressure)

    • Decreased skin turgor (indicates dehydration)

    • Muscle weakness and fatigue

    • Hemorrhages and Diarrhea

    • Vomiting

Risk Factors for Hypovolemia

  • Factors contributing to decreased blood volume:

    • Dehydration from various causes such as diarrhea, vomiting, or insufficient fluid intake.

    • Blood volume decrease due to lack of extracellular fluid.

Disease Processes Associated with Hypovolemia

  • Hypovolemia: A condition where the body has an abnormally low volume of blood circulating in the body.

Nursing Diagnoses Related to Hypovolemia

  • Fluid Imbalance due to decreased fluid volume (hypovolemia).

  • Risk for electrolyte imbalance due to fluid shifts or loss.

  • Cardiac output decreased due to fluid losses and potential complications from hypovolemia.

Common Etiologies of Hypovolemia

  • Addison's Disease: Adrenal insufficiency leading to inadequate hormone levels affecting fluid balance.

  • Chronic Kidney Disease (CKD) and Acute Kidney Disease (AKD): Conditions that can contribute to fluid and electrolyte disturbances.

Nursing Interventions for Managing Hypovolemia

  • Monitor vital signs and symptoms (VSS).

  • Encourage fluid intake (oral and IV fluids as applicable).

  • Input/Output (I&O) measurements: To assess fluid balance accurately.

  • Provide supplemental oxygen as needed (O2 PRN).

Treatment and Medications

  • Administer Red Blood Cells (RBC) as needed via transfusion for anemia associated with hypovolemia.

  • Provide intravenous (IV) fluids for rehydration and correction of fluid deficits.

  • Daily weights: To monitor fluid retention/loss.

Laboratory Tests to Monitor

  • Hemoglobin and Hematocrit (H&H): To assess for anemia.

  • Urine Specific Gravity: To evaluate kidney function and hydration status.

  • Kidney Function Tests: Including BUN (Blood Urea Nitrogen) and Creatinine (Cr).

  • Blood Osmolality: To assess concentration of solutes in blood.

  • Complete Blood Count (CBC) and Basic Metabolic Panel (BMP): To gauge overall health and kidney function.

Patient Teaching and Safety Considerations

  • Instruct on potential reactions to infusion therapy and how to manage them.

    • Monitor IV site integrity to prevent infiltration and other complications.

  • Importance of reporting dizziness and other symptoms.

  • Educate patients on recognizing signs of complications and importance of follow-up testing/labs to monitor their condition.