When caring for a patient with a diagnosis of congestive heart failure (CHF), liver failure, pulmonary edema, kidney disease, low cardiac ejection fraction (EF), dilated cardiomyopathy, or severe cardiovascular disease, closely monitor for signs of fluid volume overload and cardiac distress (see Proceed with caution). Keep in mind that patients with certain acute or chronic diseases may have difficulty safely accommodating the addition of I.V. In acute or emergent situations, such as when the patient's heart rate, BP, breathing, and mental status are altered, more aggressive treatment, such as administration of I.V. Fluid can be replaced by encouraging patients to increase their oral fluid intake in nonemergent situations. If you suspect volume depletion or volume overload, immediately consult with the medical team to ensure the patient is quickly evaluated and treatment initiated. * increased pulmonary capillary wedge pressure (PCWP) * tachypnea (increased respiratory rate of greater than 20/minute)
* decreased urine output (for example, infants who have no wet diapers for more than 3 hours or children, teens, and adults who have no urine output for more than 8 hours) When the fine balance of water is either depleted or overloaded, the body can respond by causing cardiac symptoms, such as abnormal heart rhythms or an elevated or low heart rate or BP (see Understanding fluid balance). The adult body comprises 60% water infants, 80%. We make up 60% of the adult body, and 80% of the infant body! In this article, we'll review the basics of current fluid management practices.įigure. * administration of nephrotoxic medications.
Common conditions that require fluid replacement include: Facing Ethical Challenges with Strength and Compassionįluid management is a primary treatment option for managing patients with acute, chronic, or critical illnesses.
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