Fluid Volume Deficit

Question 1

How does dehydration occur?

Answer 1

Dehydration occurs when the fluid intake of the body is not sufficient to meet the fluid needs of the body.

Question 2

What is the goal of treatment for dehydration? (3)

Answer 2

The goal of treatment is to

1: restore fluid volume
2: replace electrolytes as needed
3: eliminate the cause of the fluid volume deficit

Question 3

What are the types of fluid volume deficits? (3)

Answer 3

Isotonic dehydration
Hypertonic dehydration
Hypotonic dehyration

Question 4

What is isotonic dehydration?

Answer 4

Water and dissolved electrolytes are lost in equal proportions.
Also known as hypovolemia.
Most common type of dehydration.

Question 5

What are the results of isotonic dehydration on the body?

Answer 5

Isotonic dehydration results in decreased circulating blood volume and inadequate tissue perfusion.

Question 6

What is hypertonic dehydration?

Answer 6

Water loss exceeds electrolyte loss.

Question 7

What occurs in the body during hypertonic dehydration? (Where do the fluids shift, what is the effect?)

Answer 7

Fluid moves from the intracellular compartment into the plasma and interstitial fluid spaces, causing cellular dehydration and shrinkage.

Question 8

What is hypotonic dehydration?

Answer 8

Electrolyte loss exceeds water loss.

Question 9

Why does hypertonic dehydration cause clinical problems?

Answer 9

Results in clinical problems due to alterations in concentrations of specific plasma electrolytes.

Question 10

Why does hypotonic dehydration result in clinical problems?

Answer 10

Clinical problems occur as a result of fluid shifts between compartments, causing a decrease in plasma volume.

Question 11

What occurs in the body during hypotonic dehydration? (Where do the fluids shift, what is the effect?)

Answer 11

Fluid moves from the plasma and interstitial fluid spaces into the cells, causing a plasma volume deficit and causing the cells to swell.

Question 12

What are the causes of isotonic dehydration? (3)

Answer 12

Inadequate intake of fluids and solutes.
Fluid shifts between compartments.
Excessive losses of isotonic body fluids.

Question 13

What are the causes of hypertonic dehydration? (Give 7 examples)

Answer 13

Conditions that increase fluid loss, such as:
Excessive perspiration
Hyperventilation
Ketoacidosis
Prolonged fevers
Diarrhea
Early-stage kidney disease
Diabetes insipidus

Question 14

What are the causes of hypotonic dehydration? (4)

Answer 14

Chronic illness
Excessive fluid replacement (hypotonic)
Kidney disease
Chronic malnutrition

Question 15

Which body systems are the most important to assess in cases of dehydration?

Answer 15

Cardiovascular
Respiratory
Neuromuscular
Renal
Integumentary
Gastrointestinal

Question 16

What are the cardiovascular signs and symptoms of fluid volume deficit? (6)

Answer 16

Thready, increased pulse rate.
Decreased blood pressure and orthostatic hypotension.
Flat neck and hand veins in dependent positions.
Diminished peripheral pulses.
Decreased central venous pressure.
Dysrhythmias.

Question 17

What are the respiratory signs and symptoms of fluid volume deficit? (2)

Answer 17

Increased rate and depth of respirations.

Dyspnea

Question 18

What are the neuromuscular signs and symptoms of fluid volume deficit? (3)

Answer 18

Decreased CNS activity, from lethargy to coma.
Fever, depending on the amount of fluid loss.
Skeletal muscle weakness.

Question 19

What is the renal symptom of fluid volume deficit?

Answer 19

Decreased urine output.

Question 20

What are the integumentary symptoms of fluid volume deficit? (3)

Answer 20

Dry skin
Poor turgor, tenting
Dry mouth

Question 21

What are the gastrointestinal symptoms of fluid volume deficit? (4)

Answer 21

Decreased motility and diminished bowel sounds.
Constipation.
Thirst.
Decreased body weight.

Question 22

What are the laboratory findings that indicate fluid volume deficit? (5)

Answer 22

Increased serum osmolality
Increased hematocrit
Increased BUN
Increased serum sodium level
Increased urine specific gravity

Question 23

What are the interventions the nurse should implement when caring for a patient with fluid volume deficit?
(7)

Answer 23

1. Monitor cardio, resp, neuromuscular, renal, integumentary, and gastro status.
2. Prevent further fluid losses and increase fluid compartment volumes to normal range.
3. Provide oral rehydration therapy (or IV if severe or oral not possible.
4. Monitor ins and outs.
5. Administer meds as prescribed (antidiarrheal, antimicrobial, antiemetic, antipyretic, etc)
6. Administer oxygen PRN
7. Monitor electrolyte values and prepare to administer medication to treat an imbalanace if present.