Nursing 101 HESI Saunders Fluid and Electrolytes- Nicholls State University

Signs and symptoms of fluid-volume deficit

 Increased temperature

 Thready, rapid pulse

 Decreased blood pressure and postural hypotension

 Increased rate and depth of respirations

 Dryness, poor turgor, and tenting of skin

 Thirst

 Decreased urine output with increased specific gravity

 Diminished peripheral pulses

 Flat neck and hand veins

 Altered level of consciousness

 Decreased central venous pressure


Signs and symptoms of fluid-volume excess
 Bounding, rapid pulse
 Increased blood pressure
 Increased respiratory rate (shallow)
 Dyspnea
 Moist crackles
 Pitting edema
 Ascites
 Distended veins
 Altered LOC
 Increased central venous pressure

Causes of sodium imbalance

Hyponatremia

 Inadequate sodium intake

 Vomiting or diarrhea

 Excessive diaphoresis

 Use of diuretics

 Gastrointestinal suctioning



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,  Wound drainage

 Renal disease

 Congestive heart failure

 Syndrome of inappropriate ADH secretion

Hypernatremia

 Decreased sodium excretion, which can occur with the use of corticosteroids or in conditions
such as Cushing syndrome, renal failure, and hyperaldosteronism

 Excessive oral sodium ingestion or excessive administration of sodium-containing IV fluids

 Decreased water intake

 Increased water loss, which may occur with an increased rate of metabolism, fever,
hyperventilation, infection, excessive diaphoresis, or watery diarrhea



Assessment Findings: Hyponatremia
 Tachycardia; pulse may be thready and weak or bounding, depending on cause
 Postural (orthostatic) hypotension or hypertension, depending on cause
 Shallow respirations
 Generalized muscle weakness
 Headache, apathy, confusion
 Nausea, abdominal cramps, diarrhea; hyperactive bowel sounds
 Increased urine output with decreased specific gravity

Assessment Findings: Hypernatremia
 Heart rate and blood pressure changes in response to vascular volume status
 Signs of pulmonary edema if hypervolemia is present
 Presence or absence of edema, depending on fluid-volume changes
 Muscle twitching progressing to muscle weakness
 Diminished deep tendon reflexes or an absence of these reflexes
 Altered cerebral function: agitation, confusion, seizures, lethargy, stupor, coma
 Extreme thirst; dry skin and mucous membranes
 Decreased urine output with increased specific gravity

Causes of potassium imbalance
Hypokalemia

 Excessive use of diuretics

 Vomiting, diarrhea

 Wound drainage, particularly that involving gastrointestinal wounds

 Renal disease




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https://www.coursehero.com/file/35468162/HESISaunders-Fluid-and-Electrolytesdocx/