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Hypervolemia

Hypervolemia: The opposite of hypovolemia: Would be: Fluid Volume Excess, which instead of hypo - we say hyper: For example: Hypervolemia Hypervolemia - is basically the gain of water and electrolytes mainly sodium in the intravascular fluid or blood. This excess of fluid can build up in spaces where there is usually not extra fluid: including, legs and arms which is called: (peripheral edema) The abdomen which is called ascites And potentially the lungs - which is called pulmonary edema Hypervolemia could be caused by: Over ingestion of sodium and fluid - eating a diet high in salt - Administration of IV fluids with high concentration of solutes like: sodium chloride, potassium chloride, glucose could also be a cause. · Also: Impaired fluid balance regulation by the body organs for example: Heart Failure - Due to the heart inability to circulate the fluid properly, causing a buildup of fluid. Renal Failure - due to the inability of the kidneys to filter the blood - again causing a buildup of fluids and cirrhosis of the liver - This is caused by the affected liver sending signals to the kidney to retain excess salt and water. Which accumulates in the tissues, increasing the volume. · So, let’s look at the …Clinical Manifestations or Signs and Symptoms: Fluid Volume Excess AKA Hypervolemia: · Monitor the daily weight and vital signs: Especially the blood pressure, and the pulse may be normal - however it could be bounding and also the respiratory rate. · Assess for edema - including checking the extremities, abdomen and lungs for signs of extra fluid volume. · Assess breath sounds - listen for crackles or wheezes · Monitor fluid intake and output · Monitor laboratory findings - including increase BUN or Creatinine levels - indicating renal impairment, also check BNP levels which can suggest heart failure and also check AST & ALT relating to the liver function. · Monitor level of consciousness and maintain client safety · Place in Fowler’s position - which means sitting position to assist with breathing. · Administer diuretics as ordered - including Lasix, aldactone and bumex · Restrict fluid intake if necessary · Restrict dietary sodium as ordered · Implement measures to prevent skin breakdown - due to excess fluids pooling in the extremities, which can decrease blood flow to that area and cause slow healing. · Support arm and legs to decrease dependent edema as appropriate Watch for critical complications like: Pulmonary Edema – which is fluid accumulation in the lungs, which collects in air sacs, making it difficult to breath. It leads to impaired gas exchange and may cause respiratory failure. Now lets go over some Nursing Exam or NCLEX style questions related to: Hypervolemia: 16. The nurse describes signs and symptoms of having fluid volume excess that needs the immediate attention of the physician. The following are correct signs of fluid volume excess, except? A. Pressure felt on the diaphragm B. Weight gain of 2 lbs per day C. Shortness of breath D. None of the above Ans.: D. all options are signs and symptoms of having fluid volume excess. 13. Which of the following are signs and symptoms of fluid volume excess? Select all that apply: A. Decreased blood pressure B. Edema C. Distended neck veins D. Crackles E. Bradycardia F. Shortness of breath Ans.: B, C, D, F can be noted in fluid volume excess, other signs and symptoms are increased blood pressure and tachycardia.