Fluid and Electrolyte Imbalances in Renal Disorders
Patients with renal disorders commonly experience fluid and elec-trolyte imbalances and require astute assessment and close mon-itoring for signs of potential problems. The fluid intake and output record, a key monitoring tool, is used to document important fluid parameters, including the amount of fluid taken in (orally or parenterally), the volume of urine excreted, and other fluid losses (diarrhea, vomiting, diaphoresis).
These records and changes in the patient’s weight are essential for determining the daily fluid allowance and indicating signs of fluid overload or deficit. The patient whose fluid intake exceeds the ability of the kidneys to excrete fluid is said to have a fluid overload. If fluid intake is inadequate, the patient is said to be vol-ume-depleted and may show signs and symptoms of fluid volume deficit.
The signs and symptoms of common fluid and electrolyte dis-turbances that can occur in patients with renal disease are listed in Table 44-1, as are general management strategies. The nurse should continually assess, monitor, and inform appropriate mem-bers of the health care team if the patient exhibits any of these signs.
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