- 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: (1st sign being neurological, then progressing)
- Neurological (assess LOC, orientation)
- Thirst, confusion, restlessness, drowsiness, dizzy, seizures, comas
- Urine concentrated/dark, urine output ¯, specific gravity
- Respiratory rate from trying to get more O2
- rapid, thread pulse (r/t trying to circulate O2), hematocrit (false reading), BUN, capillary refill takes longer
- 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)
- 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
This problem has been solved.
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