hypovolemia

patient teaching

- 8-10 glasses of fluid per day - avoid alc, caffeine b/c make you pee - DO NOT restrict salt or sodium - rise slowly - monitor pulse and uring output when rehydrating - increase intake during exercise or extreme perspiration

Nursing management

- mental status exam - examine pee, look for dark concentrated urine and a specific gravity of 1.020 - monitor blood for hemoconcetration -record I & O - observe strength/swallowing ability - look for source of fluid loss -WEIGH patient, report loss of 2 lbs or more in 24 hours. *this equals 1 L lost - look at meds - monitor vitals

causes:

- not enough fluid intake - increase Gi Output = n/v/d, overuse of laxative, fistula drainage or tubes - increased renal output : from diuretics or adrenal insufficiency - loss of blood/plasma from hemorrhage or burns -massive sweating w/o water and salt replacement - third spacing

S/S

- thirst, early symptom - sudden rapid weight loss -sunken eyes, no tear -poor skin tugor, dry mucous membranes, furrows in tongue -weakness, confusion, sleep -low BP, elevated pulse, elevated temp, rapid shallow respirations -flat jugular vein -hypotension

medical management

- treat prob - increase oral or Iv fluids - control fluid loss with antidiarrheas and anti emetics -antibitoics

Hypovolemia

-dehydrated - not enough fluid in the extracellular space

labs

-elevated hematocrit and blood levels (besides hemorrhage) -elevated specific of gravity -elevated BUN

Risk factors:

lethargic depressed dementia fever difficulty swallowing poor eating use of diuretics tube feedings with no water elderly

oral hydration

orolyte pedialyte