Review
Assessment of fluids and electrolytes
Heidi Nebelkopf Elgart. AACN Clin Issues. 2004 Oct-Dec.
Abstract
Bedside evaluation of a patient's intravascular volume status is challenging, even for the seasoned practitioner. There is no single diagnostic test to determine whether a patient is hypovolemic, hypervolemic, or euvolemic. Often, underlying or concomitant disease states, medications, and other therapeutics can make available data difficult to interpret. Therefore, a combination of clinical evaluation, laboratory studies, and other diagnostics are required to make a clinical judgment regarding volume status. Patients who demonstrate alterations in their volume status are likely to have electrolyte abnormalities as well, and assessment of serum electrolyte values and potential therapeutic interventions is a vital piece in caring for critically ill patients.
Similar articles
Reading central venous pressure--1.
Sheppard M. Sheppard M. Nurs Times. 2000 Apr 27-May 3;96(17):43-4. Nurs Times. 2000. PMID: 11961779 No abstract available.
Urine Electrolytes in the Intensive Care Unit: From Pathophysiology to Clinical Practice.
Umbrello M, Formenti P, Chiumello D. Umbrello M, et al. Anesth Analg. 2020 Nov;131(5):1456-1470. doi: 10.1213/ANE.0000000000004994. Anesth Analg. 2020. PMID: 33079869 Review.
Pediatric fluid and electrolyte balance: critical care case studies.
Roberts KE. Roberts KE. Crit Care Nurs Clin North Am. 2005 Dec;17(4):361-73, x. doi: 10.1016/j.ccell.2005.07.006. Crit Care Nurs Clin North Am. 2005. PMID: 16344206 Review.
The critically ill patient: identification and initial stabilization.
Elnour S, Shankar-Hari M. Elnour S, et al. Br J Hosp Med (Lond). 2011 Sep;72(9):M138-40. doi: 10.12968/hmed.2011.72.sup9.m138. Br J Hosp Med (Lond). 2011. PMID: 22053338 No abstract available.
Fluids and electrolytes.
Heisey M, Hedrick C. Heisey M, et al. J Intraven Nurs. 2001 May-Jun;24(3):157-8. J Intraven Nurs. 2001. PMID: 11530360 No abstract available.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
- Ovid Technologies, Inc.
- Wolters Kluwer
Medical
- MedlinePlus Health Information
Chapter11:AssessmentandCareofPatientswithFluidandElectrolyte
Imbalances
MULTIPLECHOICE
1.Anurseteachesclientsatacommunitycenteraboutrisksfordehydration.Whichclientisatgreatestriskfor
dehydration?
a.A36-year-oldwhoisprescribedlong-termsteroidtherapy
b.A55-year-oldreceivinghypertonicintravenousfluids
c.A76-year-oldwhoiscognitivelyimpaired
d.An83-year-oldwithcongestiveheartfailure
ANS:C
Olderadults,becausetheyhavelesstotalbodywaterthanyoungeradults,areatgreaterriskfordevelopment
ofdehydration.Anyonewhoiscognitivelyimpairedandcannotobtainfluidsindependentlyorcannotmakehis
orherneedforfluidsknownisathighriskfordehydration.
DIF:Understanding/ComprehensionREF:168
KEY:Hydration
MSC:IntegratedProcess:NursingProcess:Assessment
NOT:ClientNeedsCategory:PhysiologicalIntegrity:BasicCareandComfort
2.Anurseiscaringforaclientwhoexhibitsdehydration-inducedconfusion.Whichinterventionshouldthe
nurseimplementfirst?
a.Measureintakeandoutputevery4hours.
b.Applyoxygenbymaskornasalcannula.
c.IncreasetheIVflowrateto250mL/hr.
d.Placetheclientinahigh-Fowlersposition.
ANS:B
Dehydrationmostfrequentlyleadstopoorcerebralperfusionandcerebralhypoxia,causingconfusion.
Applyingoxygencanreduceconfusion,evenifperfusionisstilllessthanoptimal.IncreasingtheIVflowrate
wouldincreaseperfusion.However,dependingonthedegreeofdehydration,rehydratingtheclienttoorapidly
withIVfluidscanleadtocerebraledema.Measuringintakeandoutputandplacingtheclientinahigh-Fowlers
positionwillnotaddresstheclientsproblem.
DIF:Applying/ApplicationREF:168
KEY:Hydration
MSC:IntegratedProcess:NursingProcess:Implementation
NOT:ClientNeedsCategory:PhysiologicalIntegrity:PhysiologicalAdaptation
3.Afterteachingaclientwhoisbeingtreatedfordehydration,anurseassessestheclientsunderstanding.
Whichstatementindicatestheclientcorrectlyunderstoodtheteaching?
a.Imustdrinkaquartofwaterorotherliquideachday.
b.IwillweighmyselfeachmorningbeforeIeatordrink.
c.Iwilluseasaltsubstitutewhenmakingandeatingmymeals.
d.Iwillnotdrinkliquidsafter6PMsoIwonthavetogetupatnight.
ANS:B
Oneliterofwaterweighs1kg;therefore,achangeinbodyweightisagoodmeasureofexcessfluidlossor
fluidretention.Weightlossgreaterthan0.5lbdailyisindicativeofexcessivefluidloss.Theotherstatements
arenotindicativeofpracticesthatwillpreventdehydration.
DIF:Analyzing/AnalysisREF:168
KEY:Hydration
MSC:IntegratedProcess:Teaching/Learning
NOT:ClientNeedsCategory:HealthPromotionandMaintenance
TestBank-Medical-SurgicalNursing:ConceptsforInterprofessionalCollaborativeCare9e68