Definition/Description[edit | edit source]Fluid excess can occur in two main ways in the body, water intoxication and edema. [1] Show
[2] Prevalence[edit | edit source]Water intoxication is seen in a variety of situations, but most commonly occurs in:
In a study by Almond et al. of the 2002 Boston Marathon it was found that: [4]
In a study by Speedy et al. of athletes who finished an ultramarathon, it was found that: [4]
Characteristics/Clinical Presentation[edit | edit source]Water Intoxication Clinical S&S: [1] Water intoxication presents with symptoms that are largely neurologic due to the shifting of water into brain tissues and resultant dilution of sodium in the vascular space.
In severe imbalances:
Edema Clinical Signs and Symptoms: [1]
Associated Co-morbidities [1][edit | edit source]
Medications[edit | edit source]
Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]Below are some of the most common laboratory tests that are used to assess a person’s hydration status:
- Osmolality decreases with overhydration [10]
- Hyponatremia (low amounts of sodium in the blood) results from overhydration [10]
- Hematocrit decreases with overhydration [10]
- BUN decreases with overhydration [10] Etiology/Causes[edit | edit source]Due to the etiologic complex, symptoms, and outcomes that are related to the two major forms of fluid excess being substantially different, they will be broken down individually. [1]
Systemic Involvement[edit | edit source]
Medical Management[edit | edit source]
Physical Therapy Management[edit | edit source]Physical therapy management is largely responsible for patient education and edema control in these individuals. Below are some common physical therapy treatment strategies: Education on fluid consumption: [17]
Managing edema: [17] [18]
Note: Some of the strategies to
reduce edema may be contraindicated in CHF Differential Diagnosis[edit | edit source]The following are some of the most common diagnoses that present with similar signs and symptoms of excess fluid/intoxication:
Case Reports/ Case Studies[edit | edit source]Forensic aspects of water intoxication: Four case reports and review of relevant literature Resources[edit | edit source]Hyperhydration? Hyponatremia Caused by Polydipsia Fried or Soaked? Strange but True: Drinking Too Much Water Can Kill References[edit | edit source]
Which daily assessment data is necessary to determine changes in the client's Hypervolemia status?Which daily assessment data is necessary to determine changes in the client's hypervolemia status? Rationale: Daily weight provides the ability to monitor fluid status. A 2-lb (0.9 kg) weight gain in 24 hours indicates that the client is retaining 1 L of fluid. Also, the loss of weight can indicate a decrease in edema.
Which findings indicate that a patient may have Hypervolemia?The signs of hypervolemia include: swelling, also called edema, most often in the feet, ankles, wrists, and face. discomfort in the body, causing cramping, headache, and stomach bloating. high blood pressure caused by excess fluid in the bloodstream.
Which of the following is a clinical manifestation of fluid volume excess FVE )? Select all that apply?Which of the following is a clinical manifestation of fluid volume excess (FVE)? Select all that apply. Explanation: Clinical manifestations of FVE include distended neck veins, crackles in the lung fields, shortness of breath, increased blood pressure, and tachycardia.
Which of the following is a factor affecting an increase in urine osmolality?The following are associated with increased urine osmolality: Dehydration. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) Adrenal insufficiency.
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