Hypovolemia Sample Assignment

Hypovolemia

Causes:

• Decreased intake (r/t coma, gastric surgery, elderly ¯ in thirst mechanism)
• Diabetes Insipidus (polyuria)
• Abnormal loss of fluid (r/t wound drainage, gastric suction or third spacing)

What the body does:

• Aldosterone is secreted (from the adrenal cortex)
  • Stimulates Na+ reabsorption & water follows what is pulled from the cells into the ECF (blood vessels)

Clinical Manifestations: (1^st sign being neurological, then progressing)

• Neurological (assess LOC, orientation)
  • Thirst, confusion, restlessness, drowsiness, dizzy, seizures, comas
• Renal
  • Urine concentrated/dark, urine output ¯, specific gravity ­
• Respiratory
  • Respiratory rate ­ from trying to get more O2
• Cardiac
  • rapid, thread pulse (r/t trying to circulate O2), ­hematocrit (false reading), ­BUN, capillary refill takes longer

Geriatric Considerations:

• Low body water content
• Neurological changes (light headed, ¯blood flow to brain)
• Laxative & enema dependency (can make them dehydrated)
• At risk for injury (falls from orthostatic hypotension)

Nursing Interventions/Considerations:

• Replace fluids PO or IV (don’t want them to get hypernatremia as well)
• Do daily weight (same time, clothes, etc)
• Check mucous membranes (should be pink and moist, but won’t be w/ dehydration)
• Skin turgor (at sternum, back of hands)
• Eye socket (may be sunken in)
• Lung sounds