24 Questions
What interventions are recommended for controlling hypervolemia?
Promoting rest, restricting sodium intake, monitoring parenteral fluid therapy, and administering appropriate medications
What is the mechanism related to the diuresis of fluid during bed rest?
Diminished venous pooling and subsequent increase in effective circulating blood volume and renal perfusion
Why are regular rest periods beneficial for patients with hypervolemia?
Bed rest favors diuresis of fluid
What is a common cause of increased extracellular fluid (ECF) volume?
Sodium retention
What can cause a change in the capillary membrane, leading to edema?
Increased formation of interstitial fluid or decreased removal of interstitial fluid
What is a type of edema in which fluid accumulates in the peritoneal cavity?
Ascites
What is the goal of treatment for edema?
Preserve or restore the circulating intravascular fluid volume
Which system increases sodium and water retention in response to decreased cardiac output?
Renin–angiotensin–aldosterone system
What should be monitored for patients with fluid volume overload?
Response to diuretics and rate of parenteral fluids
What should be emphasized when educating patients about edema?
Recognizing symptoms and understanding its importance
What should be considered when identifying medications that could cause edema?
Thorough medication history
What is a condition associated with increased interstitial fluid volume?
Burns
How does the nurse assess for fluid volume excess (FVE)?
By measuring intake and output at regular intervals
What is a method for assessing pitting edema?
Pressing a finger into the affected part and evaluating the pit on a scale of 1+ to 4+
What is a recommended intervention for preventing hypervolemia?
Encouraging adherence to a sodium-restricted diet
How should patients be advised regarding over-the-counter (OTC) medications?
To avoid them without first checking with a health care provider
How should the nurse monitor peripheral edema?
By measuring the circumference of the extremity with a tape measure marked in millimeters
In which body parts should the nurse monitor the degree of edema in ambulatory patients?
Feet and ankles
How is rapid weight gain indicative of fluid volume excess?
It indicates excessive fluid retention
What should be considered if fluid retention persists despite adherence to a prescribed diet?
Hidden sources of sodium, such as the water supply or use of water softeners
Why should patients avoid over-the-counter (OTC) medications without consulting a health care provider?
Because they may contain sodium
What part of the body should be assessed for edema in patients confined to bed?
Sacral region
What should be done if breath sounds are assessed at regular intervals in at-risk patients?
Particularly if parenteral fluids are being given
Why are most patients instructed to avoid over-the-counter (OTC) medications?
Because they may contain sodium
Study Notes
Controlling Hypervolemia and Edema
- Interventions for controlling hypervolemia include reducing sodium intake, promoting diuresis, and administering diuretics.
- During bed rest, the body's natural response to a decrease in hydrostatic pressure leads to increased sodium and water retention, which can cause fluid accumulation and edema.
- Regular rest periods are beneficial for patients with hypervolemia as they help reduce fluid accumulation and edema.
Causes of Edema
- A common cause of increased extracellular fluid (ECF) volume is excessive sodium and water retention.
- Changes in the capillary membrane, such as increased permeability, can lead to edema.
- Ascites is a type of edema where fluid accumulates in the peritoneal cavity.
Treatment and Monitoring
- The goal of treatment for edema is to reduce fluid volume excess and alleviate symptoms.
- The renin-angiotensin-aldosterone system (RAAS) increases sodium and water retention in response to decreased cardiac output, exacerbating edema.
- Patients with fluid volume overload should be monitored for signs of edema, such as weight gain, peripheral edema, and breath sounds.
Patient Education
- Patients should be educated on the importance of adhering to a low-sodium diet and avoiding over-the-counter (OTC) medications that can exacerbate edema.
- Patients should be advised to monitor their body weight and report any rapid weight gain to their healthcare provider.
Assessment and Intervention
- Nurses assess for fluid volume excess (FVE) by checking for signs of edema, such as pitting edema, and monitoring weight gain.
- A method for assessing pitting edema is to press firmly on the patient's skin with their thumb for 5-10 seconds.
- To prevent hypervolemia, patients should be advised to limit sodium intake and stay physically active.
- Patients confined to bed should be assessed for edema in their sacrum, hips, and ankles.
- Ambulatory patients should be monitored for edema in their feet, ankles, and legs.
Test your knowledge of nursing management for fluid volume excess (FVE) with this quiz. Topics covered include assessing for FVE, measuring intake and output, monitoring weight gain, and assessing breath sounds and edema in at-risk patients.
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