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Hypovolemia Sample Assignment

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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: (1st 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

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