Quiz 52: Fluid, Electrolyte, and Acidbase Balance


Mrs. Chapman is suffering from weakness with malaise along with some flu-like symptoms. Because of nausea and vomiting, she is not able to retain fluid. This implies that she is suffering from fluid volume deficit. The client should be provided with fresh water and oral fluids. The intake should be distributed over the entire 24 hours of the day. The likelihood that the client will maintain the prescribed oral intake can be enhanced by providing preferred beverages and snacks. Since, in fluid volume deficit, most of the fluid is lost from the gastrointestinal (GI) path. Thus, the GI system is preferred to rest before resuming oral intake. Frequent oral hygiene should be provided atleast twice a day. This will decrease the unpleasant tastes in the mouth and will enhance client's response to the thirst. Acute diarrhea and vomiting can be treated by oral replacement therapy with glucose electrolyte solution. This solution enhances the digestion and absorption ability of the intestine and hence, it can correct the deficiency of the fluid volume.

Symptoms such as increased blood pressure, moist mucous membrane and distention of jugular vein are characteristic of fluid volume excess. Fluid volume excess or hypervolemia occurs when the amount of fluid in the blood is in excess. It may occur due to increased sodium content of the body which causes increased extracellular body water. Hence, the options 1, 3 and 4 are incorrect. A person who has not eaten and drunk anything for several days and is admitted to hospital must be suffering from fluid volume deficit or hypovolemia. This condition is characterized by weak and rapid pulse rate. Hence, the correct answer is option img .

Patients with dehydration or fluid and electrolyte imbalance are needed to be assessed regularly. Acute changes in the weight of a person are a good indicator of his or her hydration status. Regular weight assessment is important for those clients who are involved in extended care facilities and communities as they are at higher risk of encountering fluid imbalance. Measuring of intake and output is practically not possible in such cases. Regular weighing of the patient provides a relatively accurate assessment of the fluid status of the person. Acute fluid changes can be indicated by significant changes in the weight such as more than 1 kg (kilograms) in a day or more than 2.3 kg in a week over a period. Rapid gain or loss of more than 6% to 9% of weight indicates moderate to severe fluid volume excess or deficit. The weight assessment of the fluid balance can be enhanced by performing the measurement at the same time of the day by using the same scales regularly. The monitoring and assessment of the body weight is interlinked to the measurement of the urinary output of the patient. Hence, both recordings are considered and combined for the end review for the treatment.

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