FVD - Amy Rangel PDF

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Summary

Amy Rangel...

Description

Etiology § §

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FVD is defined as decreased intravascular, interstitial, and/or intracellular fluid. (Dehydration) FVD is a state or condition where fluid output exceeds the fluid intake. It happens when water and electrolytes are lost as they exist in normal body fluids. (hypovolemia) Most common cause is excessive loss of GI fluids from vomiting, diarrhea, intestinal fistulas & intestinal damage. Other causes include diuretics, renal deficits, endocrine disorders, excessive fluid loss r/t exercise, heat, hemorrhage, abuse of laxatives Third spacing: shift of fluid from vascular system into areas where it is not available to the body to use. Common after severe burns

Signs & Symptoms in Children § § § § § § §

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Vital signs: hypothermia (hypovolemia) or hyperthermia (dehydration), tachycardia, thready pulse, hypotension, decreased central venous pressure, tachypnea (increased respirations), hypoxia Neuromusculoskeletal: dizziness, syncope, confusion, weakness, fatigue, seizures (rapid/severe dehydration) GI: thirst, dry mucous membranes, dry furrowed tongue, nausea, vomiting, anorexia, acute weight loss Renal: oliguria (decreased urine production) Other findings: decreased capillary refill, cool clammy skin, diaphoresis, sunken eyeballs, decreased skin turgor, flattened neck veins, absence of tears

Risk Factors Excessive GI loss: vomiting, nasogastric suctioning, diarrhea Excessive renal system losses : diuretic therapy, kidney disease, adrenal insufficiency Third spacing: burns Hemorrhage or plasma loss Altered intake : anorexia, nausea, impaired swallowing, confusion, nothing by mouth (NPO) (decreases intake of water & sodium Excess xcessiv iv ivee skin loss: diaphoresis (sweating) w/out water and sodium replacement

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Nursing Care

Diagnosis

Expected Findings in Adults §

Fewer wet diapers No tears when crying (if older than 2-3 months) Mucous membranes dry/sticky High pitched cry/irritability Difficulty in awakening Increased resp rate or difficulty breathing Sunken fontanel/abnormal skin color/temp/dryness

Fluid Volume Deficit (FVD)

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(Hypovolemia)

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Labs § § § § §

Hct Blood osmolarity Urine specific gravity Blood sodium BUN

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Measure all fluids that enter & leave the body. (strict I&O’s) Check electrolytes, CBC, & urine specific gravity (Laboratory values) Encourage fluids, as tolerated o Continue breastfeeding, Pedialyte for children Fluid replacement by IV, as needed Monitor respiratory rate, effort, & oxygen saturation Measure clients weight weight daily at same time of day using the same scale Observe for nausea & vomiting Monitor LOC & ensure client safety...