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Factors Affecting Body Fluid, Electrolyte Fluid Imbalances

Dehydration

  • Hyper-osmolar loss of only water leaving the client with excess sodium

Overhydration

  • Hypo-osmolar gain of only water leaving low osmolality and low serum sodium levels

Fluid volume overload

  • Bounding pulse

  • Distended neck & peripheral veins

  • Dyspnea; orthopnea

  • Pulmonary edema

  • Polyuria

  • Peripheral edema

  • Possible cerebral edema.

Figure 52-11: Evaluation of edema. B, Four-point scale for grading edema.

Fluid Volume Deficit

  • Poor skin turgor is associated with decreased urine output.

  • Sunken eyes In infants, sunken fontanels:

  • Low blood pressure Rapid heartbeat Rapid breathing

  • No tears when crying

  • Fever

Questions on Factors Affecting Body Fluid, Electrolyte Fluid Imbalances

Correct Answer is B

Explanation

<p>Increased capillary refill time is a finding of dehydration, as it indicates that the blood flow to the peripheral tissues is impaired due to low blood volume. Capillary refill time is the time it takes for the color to return to the nail bed after applying pressure. Normal capillary refill time is less than 3 seconds. When the body is dehydrated, the blood pressure drops and the heart rate increases to maintain adequate perfusion to vital organs, resulting in longer capillary refill time.</p>

Correct Answer is D

Explanation

<p>Urine specific gravity 1.005 is a sign of overhydration. Urine specific gravity measures the concentration of urine compared to water. Normal urine specific gravity ranges from 1.010 to 1.030. Overhydration causes urine specific gravity to decrease because of the excess water in the urine. This indicates that the kidneys are excreting more water than solutes.</p>

Correct Answer is A

Explanation

<p>Raise the client&#39;s legs. This is not the correct answer because raising the client&#39;s legs can worsen fluid overload by increasing venous return to the heart and lungs. The nurse should avoid this position for clients who have crackles in the lungs, dyspnea, and increased blood pressure, as these are signs of fluid volume excess.</p>

<p>Encouraging ambulation is not an appropriate intervention for a client who has overhydration because it may worsen the fluid overload and increase the risk of complications such as heart failure, pulmonary edema, or cerebral edema. The nurse should limit the client&#39;s physical activity and pro

<p>Using herbs and spices instead of salt to season food is the best dietary modification for a client who has fluid volume overload. This would help reduce the sodium intake and prevent or decrease fluid retention in the body. Herbs and spices can also add flavor and variety to the diet without add
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