Fluid imbalances

The fluid and protein shift into the abdomen (called third-spacing) may be so dramatic that circulating blood volume is decreased, which causes decreased cardiac output and hypovolemic shock. Accompanying fever, vomiting, or diarrhea may worsen the fluid imbalance. A reflex sympathetic response, manifested by sweating, tachycardia, and vasoconstriction, may be evident. With an inflamed peritoneum, bacteria and endotoxins are absorbed easily into the bloodstream (translocation), and this may result in septic shock. Other foreign substances present in the peritoneal cavity potentiate peritonitis, notably feces, dead tissues, barium, mucus, bile, and blood. 

At present it is not clear whether the same sequence of action is responsible for bromethalin s convulsive and paralytic actions observed at different doses however, it is likely that some areas of the brain would be more sensitive to ATP depletion and fluid imbalance than others. 

Patients with CF suffer from thick mucous secretions in the airways as well as the pancreas and Intestinal lining due to impaired chloride absorption and consequent fluid imbalance. 

The resulting failure ofG, to inhibit adenylate cyclase increases cyclic AMP in airway cells and leads to fluid imbalance and the severe, life-threatening congestion of whooping cough. 

Overdosage symptoms include moon face, central obesity, hypertension, diabetes, hyperlipidemia, peptic ulcer, increased susceptibility to infection, electrolyte and fluid imbalance, psychosis, and hallucinations. 

Ethacrynic acid (Edecrin) Potential for hypertension and fluid imbalances. Safer alternatives available. Low... 

The intense activity by ecstasy users at dance parties and raves contributes to the effect of the drug and results in profuse sweating and dehydration. A loss of bodily salt combined with rapidly drinking large quantities of water can result in a fluid imbalance that leads to epilepsy-like seizures or a compression of a part of the brain that regulates breathing or circulation. Salt and fluid depletion in combination with the intense activity and elevated body temperature often associated with... 

Administer IV fluids if the patient is dehydrated, caused by a fluid imbalance due to severe vomiting. 

Supportive pharmacotherapy in RDS is aimed at alleviating pain and discomfort, minimizing ventilator complications, and correcting any metabolic and/or fluid imbalance. 

Greater than 8000 From 30 minutes to 1 day severe and prolonged nausea, vomiting, fatigability, weakness, dizziness, disorientation, fluid imbalance, and headache. 

Clinical Perspective Oral Rehydration Therapy, above, describes one of the most lethal and pervasive examples of cellular fluid imbalance. 

Reflect and Apply Kwashiorkor is a protein-deficiency disease that occurs most commonly in small children, who characteristically have thin arms and legs and bloated, distended abdomens due to fluid imbalance. When such children are placed on adequate diets, they tend to lose weight at first. Explain this observation. 

Water is 60% of adult body weight. However, water is 45% to 55% of an older adult s body weight and as much as 70% to 80% of an infant s weight is water. This makes older adults and infants at high risk for fluid imbalance. Lean adults have more water than heavy adults because adipose cells (cells containing fat) contain less water than other cells. Water is the solvent that contain salts, nutrients, and wastes that are solutes dissolved in the water and transported by the water throughout the body. Salts are electrolytes. 

Distinguish between characteristics of fluid balance and fluid imbalance. 

Identify patients at high risk for fluid imbalance. Distinguish symptoms of mild to extreme fluid imbalances. 

Determine the nursing implications related to treatments for fluid imbalances. 

The pressures inside the blood cell are affected by the overall fluid volume in the body, as well as by the proteins in the body that keep fluid inside the blood vessels. Inadequate or excessive volume inside the blood vessels could hamper the circulation of fluid out to or in from the tissues. The inadequate circulation that results from fluid imbalance could cause irreversible cell damage and system failure. 

A loss of fluid from the body without loss of sodium can lead to hypovolemia and concentration of sodium and hypernatremia. Fluid then is hypertonic and can cause cellular shrinkage owing to fluids moving out of cells in an attempt to balance the hypertonic fluid. The symptoms of fluid imbalance can be accompanied by symptoms of electrolyte imbalance and shifts in other electrolytes that occur in an attempt to balance electrolytes. 

Treatment of one fluid imbalance could result in the opposite imbalance if care is not exercised. 

Intake and output are critical to detection of sodium and fluid imbalances and to implement interventions. 

Weights are also important as measures of fluid imbalance. 

Sodium is the primary positive ion in extracellular fluid and is a major determinant of fluid concentration or extracellular osmolality. Sodium is present in the body in a variety of forms and is stored in the bones and, more prevalently, in body fluids. Sodium is important for blood pressure maintenance, nerve impulse conduction, and circulation of nutrients into the cell. Thus sodium imbalance (outside the 135-145 mEq/L range) can result in fluid imbalance, as well as other electrolyte imbalances. 

Evaluate select conditions for risk factors related to fluid imbalance. 

Most conditions will cause an imbalance in more than just electrolytes. Fluid imbalance will follow certain electrolyte imbalances, and acid-base imbalance will result from certain electrolyte imbalances. As stated in previous chapters, acid-base... 

Assessment of fluid balance requires baseline historical data relative to edema present in the extremities prior to any suspected fluid imbalance. 

Decreased taste and decreased saUva (with accompanying difficulty swallowing) contribute to malnutrition, protein deficits, and accompanying fluid imbalance and anemia with circulatory and oxygenation concerns. 

The primary complication of pregnancy that places the mother at risk for fluid imbalance is preeclampsia or toxemia of pregnancy. This condition has been associated with abnormal development of the placental artery with thrombosis and maternal organ dysfunction. The primary offending elements in toxemia and symptoms noted are... 

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