Deficient fluid volume related to persistent vomiting from probable gastroenteritis as evidenced by the client’s report of vomiting for the past 2 days, minimal to no oral intake, and coworkers being similarly ill. Continue to monitor intake and output, vital signs, mucous membranes, skin turgor, and urine specific gravity at least every 2 hours. Client reports ability to tolerate approximately 2 to 3 ounces of fluid over the past hour with decreased complaints of thirst. Continue to advance oral intake and diet, as ordered, offering small amounts of full liquids and then diet as tolerated, as ordered. Sodium (Na+), as the main extracellular ion, induces water movement between ICF and ECF to help achieve homeostasis of water within those compartments. In some individuals, especially the elderly, the thirst sensation may be diminished or depressed.
Edema is swelling that is triggered by extra fluid which has become trapped in the tissues of the body.
Edema may be the effect of any underlying medical problem, different drugs as well as pregnancy. Identifying the cause and treating the underlying reason for edema is the major method of its control. Any individual should see their primary care physician if any symptoms or signs of excessive swelling or edema occurs.
Immediate medical attention should be sought if the individual has any symptoms or signs of edema or excessive swelling in the lungs – known as pulmonary edema. Excessive swelling or edema happens when the minuscule blood vessels of the body known as capillaries, seep fluid.
There are some cases of swelling where the edema is a symptom of an underlying medical problem that is more serious.

This condition creates scarring of the liver that restricts liver functioning, causing deviations in the chemicals and the hormones that manage the fluid in the body, and increases stress inside the portal or large blood vessel that carries the blood from the spleen, intestine and pancreas to the liver. When either one or both of the lower chambers of the heart lose the ability to pump blood effectively – as happens with congestive heart failure – the blood can start backing up in the ankles, legs, as well as the feet, causing edema or excessive swelling. If an individual has kidney disease, the kidneys are not able to remove enough sodium and fluid from the blood.
Injury to the tiny blood vessels of the kidneys known as glomeruli that normally filters waste and excess water from the blood may trigger nephrotic syndrome. CVI or chronic venous insufficiency is a medical problem where the veins as well as the valves in the veins of the legs are damaged or weakened to the point where they cannot pump adequate blood back to the heart. This edema is quite serious and occurs when there is excess fluid in the tissues surrounding the lungs.
For the physician to make a determination on what is causing the edema, the individual will need to have a physical exam with medical history.
Diuretics may not be suitable to treat edema in some individual, especially thoses with chronic venous insufficiency or in most women who are pregnant. This website is for informational purposes only and Is not a substitute for medical advice, diagnosis or treatment.
Dehydration refers to a decreased volume of water, but it does not occur without electrolyte changes.
Younger and older clients are at the highest risk for dehydration because of inadequate oral fluid intake. Monitor the client’s level of hydration and observe for fluid volume deficit in all clients.
The severity of symptoms seen with imbalances of sodium concentration is most greatly affected by the cause of the problem, the speed at which the change takes place, and the degree of change in the sodium level.

Individuals with impaired sensations, altered mental status, or communication difficulties may be unable to perceive, communicate, or respond to thirst. Water retention in excess of salt retention may be caused by an excess production of antidiuretic hormone (ADH), owing to pulmonary disorders such as pneumonia, asthma, oat cell carcinoma, or acute respiratory failure; or to malignancies, such as lymphomas, leukemia, or Hodgkin’s disease. An effect of nephrotic syndrome is lower levels of albumin in the blood leading to accumulation of fluid that often leads to edema. When checking skin turgor, if the skin remains elevated, as in a tent, the condition can be described as tenting.
Rationale: IV fluid replacement therapy is needed to prevent further fluid imbalance that could have an impact on renal function. Rationale: Offering ice chips and small amounts of clear fluids gradually helps to re-establish oral intake without over-stressing the GI tract. Check mucous membranes and skin turgor Rationale: Parameters, such as weight, intake and output, mucous membranes, skin turgor, and laboratory test results, are reliable indicators of fluid balance. Less commonly, it results from sodium gain that cannot be dissolved in the body’s water, such as through excess IV or oral intake.
Sodium loss may occur because of diuretic therapy, renal disease, adrenal insufficiency, or loss of gastrointestinal (GI) fluids owing to vomiting or GI suction. Sodium deficiencies because of inappropriate intake may be seen with a low-sodium diet, or inappropriate oral or IV fluid (10% dextrose in water [D10W]) intake of water.

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