In terms of nursing care, we're going to want to weigh our patient on a daily basis. In terms of treatment, the go-to treatment for this is diuretics, and I have a whole video on diuretics in my pharmacology playlist. So we're going to have a decrease in urine specific gravity. So we're going to have a decrease in hemoglobin and hematocrit in the blood, and we're going to have a decrease in serum osmolarity. Here, with fluid-volume excess, everything is diluted. The blood and the urine were both concentrated. So in terms of labs, when we were talking about fluid-volume deficit, everything was concentrated. The fluid can also back up into the lungs, and that can cause dyspnea as well as crackles and tachypnea. So it will try to beat faster to compensate. It can also cause tachycardia because the heart is being overwhelmed with all this excess fluid. In terms of signs and symptoms, signs and symptoms of fluid-volume excess can include weight gain, edema, hypertension, bounding pulses, as well as jugular vein distension. Other risk factors include corticosteroids as well as cirrhosis. Heart failure is another key risk factor for fluid-volume excess because if the heart's not beating effectively, then fluid can back up. So if the kidneys aren't working properly, then that fluid can back up into the body. So the kidneys are supposed to get rid of excess fluid and electrolytes. So we have excessive intake of fluid or inadequate excretion of fluid. With fluid-volume excess, we have hypervolemia. And then, we're also going to want to implement fall precautions because the patient's going to be weak and more likely to fall. So we're definitely going to want to notify the provider if that urine output falls below 30. In terms of treatment, we're going to provide the patient with IV fluid replacement.Īnd then for nursing care, we're going to closely monitor the patient's I's and O's because if their urine output drops below 30 milliliters an hour, then that may be indicative of hypovolemic shock. So we're going to see an increase in urine specific gravity as well as urine as uring osmolarity. And then, our urine is going to be concentrated as well. So we're going to see an increase in hematocrit as well as serum osmolarity and BUN. So in terms of labs, we're going to have concentrated blood and concentrated urine. And then, we're also going to see flattened jugular veins. If the patient is dehydrated or lacking in fluid volume, they're not going to be peeing a lot. So that means not a lot of urine, which makes sense. In addition, we will see prolonged capillary refill time. We're also going to see weak, thready pulses when a patient has fluid-volume deficit. So you're going to have tachypnea and tachycardia. And then your body will try to compensate for this hypotension by increasing your respiration rate and your heart rate. In terms of signs and symptoms, when we have a lack of fluid volume, that's going to cause our blood pressure to drop. Risk factors associated with fluid-volume deficit include GI losses such as excess vomiting, diuretics, hemorrhaging, diabetes insipidus, as well as hyperventilation. With fluid-volume deficit, our fluid output exceeds our fluid intake, which causes hypovolemia. And if you have our cards, be sure to pull those out so you can follow along with me. So at the end of the video, I'm going to provide you guys a little quiz to test your knowledge of some of the key facts I'll be covering in this video. So if you have our medical-surgical nursing flashcards, definitely pay attention to that bold red text and review those items. You can see there's a lot of bold red text on these cards. In this video, I am going to talk about fluid-volume deficit and fluid-volume access.
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