FVD, or hypovolemia, occurs when loss of extracellular fluid volume exceeds the intake of fluid.

It occurs
when water and electrolytes are lost in the same proportion as they exist in normal body fluids, thus,
the ratio of serum electrolytes to water remains the same. On the other hand, Hypovolemia or Fluid
Volume Excess(FVE) refers to an expansion of the extracellular fluid caused by the abnormal retention of
water and sodium in approximately the same proportions in which they normally exist in the
Extracellular Fluid Compartment(ECF).

DISEASE CAUSATION:

Causes of FVD or Hypovolemia include abnormal fluid losses, such as those resulting from vomiting,
diarrhea, GI Suctioning, decreased intake, as in nausea or lack of access to fluid from the vascular system
to other body spaces. Additional causes include diabetes insipidus, adrenal sufficiency, osmotic diuresis,
hemorrhage, and coma. On the other hand, Fluid Volume Excess(Hypervolemia) is caused by heart
failure, kidney dysfunction, and cirrhosis of the liver. Also the consumption of excessive amounts of
table or other sodium salts. Excessive administration of sodium- containing fluids in a patient with
impaired regulatory mechanisms may dispose them to a serious Fluid Volume Excess(FVE) as well.

SIGNIFICANT MANIFESTATIONS:

HYPOVOLEMIA:

 Headache
 Fatigue
 Weakness
 Thirst
 Dizziness

HYPERVOLEMIA

 Edema
 High blood pressure
 Shortness of breath
 Heart Problems

DEPENDENT AND INDEPENDENT INTERVENTION

HYPOVOLEMIA

INDEPENDENT INTERVENTION:

 Nurse monitors and measures fluid I&O.

 Vital signs should be closely monitored in a regular basis.
 Monitor daily body weight.
 Urine concentration must be closely monitored.

DEPENDENT:
  Administer Intravenous Fluids as prescribed by the physician.

HYPERVOLEMIA:

INDEPENDENT:

 Measure I&O at regular intervals to identify excessive fluid retention.

 Patient must be weighted and rapid weight gain is noted.
 Assess breath sounds.
 Monitor the degree of edema.
 Monitor Vital Signs.

DEPENDENT:

 Administer medications as ordered by the physician.

References:
Hinkle J et al., (2013) Brunner & Suddarth’s Textbook of Medical-Surgical Nursing.15 th ed.Pp.233-238.