With which client should the nurse be most alert for the development of overhydration?
Definition/Description[edit | edit source]Fluid excess can occur in two main ways in the body, water intoxication and edema. [1] Show
[2] Prevalence[edit | edit source]Water intoxication is seen in a variety of situations, but most commonly occurs in:
In a study by Almond et al. of the 2002 Boston Marathon it was found that: [4]
In a study by Speedy et al. of athletes who finished an ultramarathon, it was found that: [4]
Characteristics/Clinical Presentation[edit | edit source]Water Intoxication Clinical S&S: [1] Water intoxication presents with symptoms that are largely neurologic due to the shifting of water into brain tissues and resultant dilution of sodium in the vascular space.
In severe imbalances:
Edema Clinical Signs and Symptoms: [1]
Associated Co-morbidities [1][edit | edit source]
Medications[edit | edit source]
Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]Below are some of the most common laboratory tests that are used to assess a person’s hydration status:
- Osmolality decreases with overhydration [10]
- Hyponatremia (low amounts of sodium in the blood) results from overhydration [10]
- Hematocrit decreases with overhydration [10]
- BUN decreases with overhydration [10] Etiology/Causes[edit | edit source]Due to the etiologic complex, symptoms, and outcomes that are related to the two major forms of fluid excess being substantially different, they will be broken down individually. [1]
Systemic Involvement[edit | edit source]
Medical Management[edit | edit source]
Physical Therapy Management[edit | edit source]Physical therapy management is largely responsible for patient education and edema control in these individuals. Below are some common physical therapy treatment strategies: Education on fluid consumption: [17]
Managing edema: [17] [18]
Note: Some of the strategies to
reduce edema may be contraindicated in CHF Differential Diagnosis[edit | edit source]The following are some of the most common diagnoses that present with similar signs and symptoms of excess fluid/intoxication:
Case Reports/ Case Studies[edit | edit source]Forensic aspects of water intoxication: Four case reports and review of relevant literature Resources[edit | edit source]Hyperhydration? Hyponatremia Caused by Polydipsia Fried or Soaked? Strange but True: Drinking Too Much Water Can Kill References[edit | edit source]
For which client is it most important to check frequently for hydration?Which client is at greatest risk for dehydration? Older adults, because they have less total body water than younger adults, are at greater risk for development of dehydration.
Which client is at greatest risk for dehydration?Who is at risk for dehydration?. Older adults. ... . Infants and young children, who are more likely to have diarrhea or vomiting.. People with chronic illnesses that cause them to urinate or sweat more often, such as diabetes, cystic fibrosis, or kidney problems.. People who take medicines that cause them to urinate or sweat more.. Which of the following client is at risk for developing fluid volume deficit?Cardiac and older patients are often susceptible to fluid volume deficit and dehydration due to minor changes in fluid volume. They also are susceptible to the development of pulmonary edema.
Which assessment would be most appropriate for monitoring a client's state of hydration?Changes in body weight, haematological and urine parameters, bioelectrical impedance, skinfold thickness, heart rate and blood pressure changes are among these indices. Plasma osmolality, urine osmolality and urine specific gravity are the most widely used markers of hydration.
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