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Hypovolemia and Hypervolemia

This document describes the clinical manifestations, assessment findings, and interventions for hypovolemia and hypervolemia. Hypovolemia is characterized by acute weight loss, thirst, nausea, muscle weakness and other symptoms. Laboratory tests may show increased BUN, creatinine, and hematocrit. Interventions focus on rapidly administering IV fluids like normal saline or lactated ringers to restore circulating blood volume. Hypervolemia presents with edema, distended neck veins, crackles, tachycardia and other signs. Tests may reveal decreased BUN and hematocrit. Interventions include monitoring vitals, CVP, I&O and encouraging coughing and deep breathing.

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443 views4 pages

Hypovolemia and Hypervolemia

This document describes the clinical manifestations, assessment findings, and interventions for hypovolemia and hypervolemia. Hypovolemia is characterized by acute weight loss, thirst, nausea, muscle weakness and other symptoms. Laboratory tests may show increased BUN, creatinine, and hematocrit. Interventions focus on rapidly administering IV fluids like normal saline or lactated ringers to restore circulating blood volume. Hypervolemia presents with edema, distended neck veins, crackles, tachycardia and other signs. Tests may reveal decreased BUN and hematocrit. Interventions include monitoring vitals, CVP, I&O and encouraging coughing and deep breathing.

Uploaded by

czeremar chan
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Hypovolemia

Clinical Manifestations:
 acute weight loss
 thirst
 nausea
 muscle weakness
 decreased skin turgor
 oliguria
 concentrated urine
 postural hypotension
 weak, rapid heart rate
 flattened neck veins
 increased temp
 decreased central venous pressure
 cramps

Assessment and Diagnostic Findings:

BUN – increase due to dehydration and increased renal perfusion


N=5-20mg/dl
Creatinine – increase N=0.6- 1.2mg/dl
Hematocrit – increase
Na and K – decrease
Urine Specific Gravity – increase due to kidneys attempt to conserve water

Subjective Data:
 Weakness
 Anxiety or restlessness
 Report of vomiting or diarrhea
 Report of rectal or vaginal bleeding
Objective Data:
 Measured fluid loss > 1500 mL
 Hemorrhage or Burn
 ↑ HR
 ↑ RR
 ↓ BP
 ↓ CVP
 ↓ CO
 ↑ SVR
 ↓ LOC
 ↓ Urine output
 Cool, pale, clammy skin

Interventions:

 Assess for Risk


o bleeding risk
o burns
o GI/GU losses
  Causes of shock include:
 Blood loss from:
o Traumatic injuries
o Internal bleeding, such as a GI bleed or surgical complication
o Postpartum hemorrhage
 Fluid loss from:
o Burns
o Diarrhea
o Vomiting
 Assess and monitor VS and LOC
 Monitor Hemodynamics
o MAP
o CVP
o CO
o SVR
Prepare for procedures
 Arterial Line or Central Line Placement
o Gather all supplies
o Ensure consent is obtained by the provider
o Explain procedure to patient/family
o Prep fluids or tubing
o Ensure all monitoring equipment is available
 Intubation
o Notify Respiratory Therapist and Charge Nurse for support
o Suction and Ambu Bag at the bedside
o Gather supplies
o Ensure all monitoring equipment is available
 OR
o Follow facility procedures
o Remove all personal clothes, jewelry, etc.
o Ensure informed consent is obtained by the provider
o Facilitate transport
 RAPID IV Bolus Fluids
  Fluids should be given as soon and as fast as possible to restore circulating blood volume.
 Crystalloid – to replace fluid loss from sources other than bleeding/hemorrhage
o Normal Saline
o Lactated Ringers
 Colloid to replace lost blood volume from hemorrhage
 Administer Blood Products
o Obtain Consent
o Send Type & Crossmatch
o Monitor per protocol
o Packed Red Blood Cells
o Fresh Frozen Plasma
o Massive Transfusion Protocol – used to prevent clotting problems when patients
receive multiple units of blood.

Hypervolemia

Clinical Manifetations:
 Edema
 distended neck veins
 crackles (abnormal lung sounds)
 tachycardia
 elevated blood pressure, pulse pressure
 inc. CVP
 increased urine output
 shortness of breath and wheezing

Assessment and Diagnostic Findings:


 BUN decrease
 Hematocrit levels- decrease
 Chest Xray - reveal pulmonary congestion
 CVP- increase

Interventions:

•Monitor vital signs as well as central venous pressure.

• Auscultate lung and heart sounds.

•Maintain adequate I&O. Note decreased urinary output and positive fluid balance on 24-hour

calculations.

•Weigh as indicated. Be alert for sudden weight gain.

•Encourage coughing and deep breathing exercises.

•Maintain semi-fowler’s position.

•Turn or reposition and provide skin care at regular intervals.

• Encourage bed rest.

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