Fluid Volume Excess Nursing Cheat Sheet

Fluid Volume Excess

Description

• Fluid intake or fluid retention exceeds the fluid needs of the body.
• Fluid volume excess is also called overhydration or fluid overload.
• The goal of treatment is to restore fluid balance, correct electrolyte imbalances if present, and eliminate or control the underlying cause of the overload.

Types

1. Isotonic overhydration

• Known as hypervolemia, isotonic overhydration results from excessive fluid in the extracellular fluid compartment.
• Only the extracellular fluid compartment is expanded, and fluid does not shift between the extracellular and intracellular compartments.
• Isotonic overhydration causes circulatory overload and interstitial edema; when severe or when it occurs in a client with poor cardiac function, heart failure and pulmonary edema can result.

2. Hypertonic overhydration

• The occurrence of hypertonic overhydration is rare and is caused by an excessive sodium intake.
• Fluid is drawn from the intracellular fluid compartment; the extracellular fluid volume expands, and the intracellular fluid volume contracts.

3. Hypotonic overhydration

• Hypotonic overhydration is known as water intoxication.
• The excessive fluid moves into the intracellular space, and all body fluid compartments expand.
• Electrolyte imbalances occur as a result of dilution.

Causes

1. Isotonic overhydration

• Inadequately controlled IV therapy
• Kidney disease
• Long-term corticosteroid therapy

2. Hypertonic overhydration

• Excessive sodium ingestion
• Rapid infusion of hypertonic saline
• Excessive sodium bicarbonate therapy

3. Hypotonic overhydration

• Early kidney disease
• Heart failure
• Syndrome of inappropriate antidiuretic hormone secretion
• Inadequately controlled IV therapy e. Replacement of isotonic fluid loss with hypotonic fluids
• Irrigation of wounds and body cavities with hypotonic fluids

Nursing Interventions:

• Prevent further fluid overload and restore normal fluid balance.
• Administer diuretics; osmotic diuretics may be prescribed initially to prevent severe electrolyte imbalances.
• Restrict fluid and sodium intake as prescribed.
• Monitor intake and output; monitor weight.
• Monitor electrolyte values and prepare to administer medication to treat an imbalance if present.