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Fluid Volume Disturbances 2
Fluid Volume Disturbances 2
Fluid Volume Disturbances 2
CLINICAL INSTRUCTOR:
B
Fluid Volume Deficit by: Ivy Mancera, RN, MSN
CARDIOVASCULAR S/SX
• Thready and increased pulse rate
• Decreased blood pressure and orthostatic (postural)
hypotension
• Flat neck and hand veins in dependent positions
• Diminished peripheral pulses
CLINICAL INSTRUCTOR:
IVY M. MANCERA, RN, CNN, MSN
INTRODUCTION
• Fluid intake or fluid retention exceeds the fluid needs in the body
• Fluid volume excess is also called overhydration or fluid overload
• The goal of treatment is to restore fluid balance, correct electrolyte
imbalances if present, and eliminate or control the underlying cause
of the overload
• Types of overhydration
• Isotonic overhydration
• Hypertonic overhydration
• Hypotonic overhydration
A Fluid Volume Deficit by: Ivy Mancera, RN, MSN
ISOTONIC OVERHYDRATION
• Known as hypervolemia, isotonic overhydration results from excessive fluid in the
extracellular fluid compartment
• Only the extracellular fluid compartment is expanded, and fluid does not shift
between the extracellular and intracellular compartments
• Isotonic overhydration causes circulatory overload and interstitial edema; when
severe or when it occurs in a client with poor cardiac function, congestive heart
failure and pulmonary edema can result
• Causes:
• Inadequate controlled IV therapy
• Renal failure
• Long – term corticosteroid therapy
A Fluid Volume Deficit by: Ivy Mancera, RN, MSN
HYPERTONIC OVERHYDRATION
• Occurrence of hypertonic overhydration is rare and is caused by
an excessive sodium intake
• Fluid is drawn from the intracellular fluid compartment; the
extracellular fluid volume expands, and the intracellular fluid
volume contracts
• Causes:
• Excessive sodium ingestion
• Rapid infusion of hypertonic saline
• Excessive sodium bicarbonate therapy
A Fluid Volume Deficit by: Ivy Mancera, RN, MSN
HYPOTONIC OVERHYDRATION
• Hypotonic overhydration is known as water intoxication
• The excessive fluid moves into the intracellular space, and all body fluid
compartments expand
• Electrolyte imbalances occur as a result of dilution
• Causes:
• Early renal failure
• Congestive heart failure
• Syndrome of inappropriate antidiuretic hormone secretion
• Inadequately controlled IV therapy
• Replacement of isotonic fluid loss with hypotonic fluids
• Irrigation of wounds and body cavities with hypotonic fluids