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| Question | Answer |
| Fluid Loss risk factors | Strenuous exercising Caffeine/ alcohol Living at high elevations or in dry climates Older adults |
| Hypovolemia vital sign findings | Tachycardia (in an attempt to maintain normal b/p) thready pulse hypotension orthostatic hypotension decreased central venous pressure tachypnea hypoxia |
| Hypovolemia neuromusculoskeletal assessment findings | Dizziness syncope confusion weakness fatigue |
| Hypovolemia GI assessment findings | Thirsty Acute wt. loss dry furrowed tongue nausea vomiting anorexia |
| Hypovolemia Renal assessment findings | Oliguria |
| Hypovolemia/hypernatremia assessment findings | Extreme Thirst dry/flushed skin postural hypotension Fever Confusion/agitation Coma/seizures can occur b/c onset of fluid imbalance is rapid |
| Hypovolemia assessment image | |
| Hypovolemia Labs | Hematocrit (Hct): Increased BUN: Greater than 25mg/dl Urine specific gravity: Greater than 1.030 Serum sodium: Greater than 145meq/l Serum osmolality: Greater than 295 mOsm/kg |
| Hypovolemia nursing care What to monitor | I/O Vitals/ Orthostatic measurement Changes in mentation/ confusion (condition is worsening) Monitor wt q8hr during fluid replacement |
| Hypovolemia treatment | IV fluids O2 management |
| What type of precautions should be implemented when pt. is hypovolemic? | Fall precautions. Assess gait stability and encourage call light use |
| Hypovolemia client education | Drink plenty of fluids Educate patient about causes of hypovolemia (N/V) Change positions slowly |
| Diminished capillary refill, cool clammy skin, diaphoresis, sunken eyeballs, flattened neck veins, poor skin turgor, wt loss, low central venous pressure are signs and symptoms of Hypervolemia or Hypovolemia? | Hypovolemia |
| Complications associated with hypovolemia | Hypovolemic shock |
| Hypovolemic shock nursing actions | -Administer/monitor O2 (<70% is a medical emergency) -stay with the unstable client -monitor vitals q15min -provide fluid replacement with colloids/crystalloids -Administer vasoconstrictors, agents to improve myocardial perfusion, and/or positive inotropic medications -Perform hemodynamic monitoring |
| 4 examples of colloids | whole blood, packed RBCs, plasma, synthetic plasma expanders |
| 2 examples of crystalloids | lactated ringers normal saline |
| 3 examples of vasoconstrictors | dopamine norepinephrine phenylephrine |
| Sodium nitroprusside dobutamine milrinone | improves myocardial perfusion |
| what is hemodynamic monitoring | measures the blood pressure inside the veins, heart, and arteries. It also measures blood flow and how much oxygen is in the blood. It is a way to see how well the heart is working. |
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