Medical Conditions: Hypovolemia, Hypervolemia, etc. PDF

# Hypovolemia - **Patho:** Fluid volume deficit from loss of body fluids and decreased fluid intake - **Signs and Symptoms:** - Decreased skin turgor - Dark-amber colored urine - Prolonged capillary refill (>3 seconds) - Hypotension - Flattened neck veins - Dizzy/weak -...

# Hypovolemia - **Patho:** Fluid volume deficit from loss of body fluids and decreased fluid intake - **Signs and Symptoms:** - Decreased skin turgor - Dark-amber colored urine - Prolonged capillary refill (>3 seconds) - Hypotension - Flattened neck veins - Dizzy/weak - Thirsty - Confusion - Tachycardia - Decreased temperature - Cool, clammy, pale skin - Dry mucous membranes - Small and furrowed tongue # Fluid Imbalance Interventions - Monitor I&O's, daily weights - Improving or worsening fluid balance - Administer fluids as ordered - Increase fluid volume - Provide frequent mouth care - Comfort for dry mouth - Provide warm blanket/environment - Provide comfort for low temperature # Hypervolemia - **Patho:** Abnormal retention of water and sodium - **Signs and Symptoms:** - Peripheral edema - Ascites - JVD - Crackles in lungs - Shortness of breath - Cough - Hypertension - Bounding pulse - Tachypnea - Increased urine output # Fluid Imbalance Interventions - I&O, daily weight documentation - Improving or worsening - Elevate extremities for edema - Promote venous return - Elevate head-of-bed - Promote lung expansion - Administer diuretics as ordered - Remove excess fluid - Initiate restriction of fluid and sodium as ordered - Prevent further fluid retention # Gastritis - **Patho:** Inflammation of the gastric or stomach mucosa - **Signs and Symptoms:** - Abdominal pain/distention - Nausea - Vomiting (coffee ground) - Loss of appetite - Feeling of fullness - Heartburn (acid reflux) - Indigestion - Burping, belching - Black, tarry stools - Fatigue # Impaired Gastrointestinal Function Interventions - Administer antacids, H2 antagonist, and PPIs as ordered - Reduce stomach acid - Encourage small frequent meals - Prevent irritation and overloading the stomach - Avoid spicy, acidic, and fried foods - Can exacerbate symptoms - Administer IV fluids - Prevent dehydration # Anemia - **Patho:** Inadequate amount of RBCs in the blood - **Signs and symptoms:** - Pale skin - Shortness of breath - Fatigue - Tachycardia - Cold hands and feet - Headache - Weakness - Brittle nails - Restless legs # Inadequate Tissue Perfusion Interventions - Administer iron supplement as ordered - Increase iron levels # UTI - **Patho:** Invasion of pathogenic microorganisms in the urinary tract - **Signs and symptoms:** - Burning with urination - Frequency (voiding more than every hour) - Urgency - Nocturia (waking up at night to urinate) - Incontinence - Suprapubic/pelvic pain - Malaise - Foul-smelling urine - Fever - Confusion (especially older adults) # Infection Interventions - Administration of antibiotics & antipyretics as ordered - Treat infection and fever - Encourage fluid intake to flush bacteria from urinary tract - Frequent voiding assistance - Reduce urinary stasis # Hypoglycemia - **Patho:** Inadequate blood glucose levels - **Signs and Symptoms:** - "He is tired" - Headache - Irritability - Sweating/shaky - Tachycardia - Increased confusion - Restlessness - Excessive hunger - Dizziness # Altered Blood Glucose Level Interventions - Check BG level - Confirm hypoglycemia (<70) - Administer 15g of fast-acting carbs quickly raise BG - After 16 minutes, recheck BG - To see if another dose is necessary - Educate on signs and symptoms of hypoglycemia and interventions - Prevent future occurrences # Hyperglycemia - **Patho:** Elevated blood glucose levels due to insufficient insulin - **Signs and Symptoms:** - Polyuria - Polyphagia - Polydipsia - Fatigue - Weakness - Dry skin/mouth - Blurry vision - Slow wound healing - Confusion # Altered Blood Glucose Level Interventions - Monitor BG levels every 4 hours - Establish trends (worse, better) - Administer insulin as ordered - Keep BG in normal range - Encourage adequate fluid intake - Prevent dehydration - Encourage relaxation techniques (deep breathing) - Stress can increase BG # Hypothyroid - **Patho:** Suboptimal levels of thyroid hormone - **Signs and Symptoms:** - Intolerance to cold (temperature low) - Fatigue - Weight gain - Dry skin - Constipation (reduced bowel movements) - Menstrual changes (irregular, heavy) - Thick tongue - Depression - Apathy, Irritability - Hair thinning or loss - Muscle weakness - Joint Pain - Bradycardia - Facial/eyelid edema - Memory problems/cognitive impariment - Hypotension # Impaired Endocrine Function Interventions - Administer levothyroxine as ordered - Thyroid Replacement - Monitor TSH, T3, T4 labs - Ensure medication dose is adequate - Provide warm blanket/environment - Comfort for cold intolerance - Educate on medication adherence - Missing doses can exacerbate symptoms # Hyperthyroidism - **Patho:** Excessive synthesis or excretion of thyroid hormone - **Signs and Symptoms:** - Tachycardia - Weight loss - Anxiety/Restlessness - Heat intolerance - Sweating - Fatigue - Menstrual changes (light, amenorrhea) - Thin skin and hair - Hypertension (especially systolic) - Weakness - Tremors/shaking - Sleep disturbances (difficulty falling/staying asleep) - Goiter (enlarged thyroid) - Exophthalmos (bulging eyes) - Brittle nails - Mental confusion # Impaired Endocrine Function Interventions - Administer methimazole or PTU as ordered - Block thyroid hormone production - Encourage rest and provide a calm/quiet environment - Reduce stress and fatigue - Avoid iodine-containing foods (seafood) - Avoid exacerbation - Monitor ECG continuously - Tachycardia and Hypertension