BSN Notes: Common Signs And Symptoms: Hypervolemia

HYPERVOLEMIA

Hypervolemia, or fluid overload, is the medical condition where there is too much fluid in the blood

Causes

·         Excessive IV fluid administration

·         Heart failure

·         Renal failure    

·         Primary polydipsia

·         SIADH

·         Cushing's syndrome

·         Long term use of corticosteroids

·         Cirrhosis of liver

Pathophysiology:

Fluid overload → increased hydrostatic pressure in arterial end of capillary → fluid movement into tissues →edema

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Increased peripheral vascular resistance

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Increased  left ventricular pressure

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Increased left arterial pressure

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Pulmonary edema

Clinical Features:

·         Head ache, confusion, lethargy

·         Peripheral edema

·         Distended neck veins

·         Bounding pulse. Increased BP and CVP

·         Polyuria

·         Dyspnea, cough, Crackles, pulmonary edema

·         Pleural effusion

·         Muscle spasm

·         Weight gain

·         Seizures, coma

Management

·         Identify the primary cause and treat

·         Fluid restriction

·         Promoting urine output - Diuretics

·         Restriction of sodium intake

·         Paracentesis     

·         Dialysis

Nursing intervention

·         Monitor BP

·         Assess intake and output at regular intervals to identify excessive fluid retention.  

·         Monitor weight daily and acute weight gain is noted. An acute weight gain of 0.9 kg represents a gain of approximately 1L of fluid.

·         Assess breath sounds at regular intervals in at-risk patients, particularly when parenteral fluids are being administered.   

·         Monitor the degree of edema

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