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Notes

NCLEX image.jpgFluid and Electrolytes

Normal Intake and Output
  • Intake: 1500-2500 mL over a 24-hr period.
  • CircleImage.pngA kilogram gained is a liter retained!
  • Output: 1500-2500 mL over a 24-hr period (40-80 mL/hr), which includes insensible losses.
  • Minimum urine output is 30 mL/hr.
  • Insensible loss (respiration, sweating, BM) is 500-1000 mL/d.
Fluid Volume Overload
  • General: Weight gain and edema.
  • Integumentary: Skin stretched and shiny.
  • CV: Decreased hematocrit, widened pulse pressure, emptying of hand veins >5 sec, pulmonary edema, congestive heart failure.
  • Urinary: Polyuria, dilute urine (decreased output in renal failure).
  • GI: Nausea and anorexia (edema of bowel).
  • CNS: Deteriorating confusion.
Fluid Volume Deficit
  • General: Weight loss.
  • Integumentary: Poor skin turgor, dry mucous membranes.
  • CV: Increased hematocrit, narrowing pulse pressure, filling of hand veins >5 sec, postural hypotension, tachycardia on standing.
  • Urinary: Oliguria, concentrated urine.
  • GI: Thirst, anorexia (decreased blood flow to intestine), longitudinal furrows on tongue.
  • CNS: Confusion and disorientation.