Fluid, electrolyte, and acid-base balance

  

1. You are a nurse who frequently cares for post-surgical patients in your hospital unit. Most of the medical-surgical patients have IV fluids infusing during their admission. Due to the frequent use of IV fluids on your floor, understanding fluid balance and electrolyte function is primary to your nursing practice. 

a. What conditions might lead to the development of hypovolemia?

b. How would the amount of patient fluid loss be determined?

c. Describe how hypovolemia and third-space fluid shifts correlate.

d. Outline the major difference between hypovolemia and third-space fluid shift.

e. Which conditions can result in third-space fluid shift?

2. You are a nurse in a nonsurgical cardiac unit caring for a 92-year-old patient who has two sons, 15 grandchildren, and 49 great-grandchildren. She lives in assisted living and has a history of congestive heart failure (CHF). She consistently struggles with balancing her fluids and electrolytes and has an affinity for dill pickles and sauerkraut. While hospitalized, she remains on a fluid restriction—much to her chagrin, as she loves ice cream. 

a. What within her history would indicate she was at risk for hypervolemia?

b. How would dill pickles and sauerkraut impact her fluid volume?

c. What body areas offer observational evidence of excessive interstitial extracellular fluid (ECF)?

d. Why would your patient be on a strict fluid restriction while hospitalized?

e. Outline nursing interventions used while a patient is on fluid restriction.

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