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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