Nursing Care Plan (NCP) for Fluid Volume Deficit

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Hi everyone. Today, we're going to be creating a nursing care plan for fluid volume deficit. So let's get started. First, we're going to be going over the pathophysiology. So fluid volume deficit or dehydration is a state or condition where the fluid output exceeds the fluid intake. Nursing considerations: we're going to monitor vital signs, full head to toe assessment, monitor I&Os, lab values, administer IV fluids, and educate the patient on prevention. Desired outcomes: the patient will have normal vital signs, demonstrate adequate lifestyle changes to avoid dehydration, and the patient will have normal urine output. 

So if we're going to go ahead and dive into the care plan, we're going to be writing out some subjective data and some objective data. So, what are we going to see with these patients? Some subjective data could be weakness and dizziness. Some objective data that we'll see: maybe some weight loss, hypotension, maybe concentrated urine. Some other things you'll see are extreme thirst in these patients and alteration in their mental status. There'll be a decreased urine output, dry mucous membranes, and sunken in eyes and cheeks. 

So interventions: we want to make sure that we're going to monitor and document vital signs. So we're always going to be checking those vital signs. We're going to be looking for their blood pressure and their heart rate. And orthostatics. So, for orthostatic blood pressure, 20 millimeter drop in systolic and 10 millimeter drop in diastolic is what you're looking for. Decrease in blood volume can cause hyper or hypotension and tachycardia. Another thing we want to do is we want to make sure we're getting proper health history from the patient. So we want to make sure we're getting a history. Do they have such factors as GI losses? Are they diabetic? Are they on any sort of diuretic therapies that would cause them to be losing so much fluid? We want to make sure we're going to be monitoring their I&Os. We're going to make sure that we're encouraging fluid intake and making sure we're monitoring their urine output, noting the urine characteristics and the amount. Is it clear? Is it cloudy? We want to make sure patients are taking in an adequate amount of fluids - concentrated or decreased urine can indicate dehydration. We want to make sure we're going to monitor lab values. So we want to see such things as elevated BUN or Creatinine. So these are further kidney functions. There are a lot of others such as potassium and magnesium going to be looking for. We're also going to be looking for hematocrit. With hematocrit, if there is no change in the hemoglobin, this can also reflect fluid volume deficit. We want to make sure that we're giving IV fluids or isotonic solutions such as normal saline or lactated ringers or 5% dextrose in water. We want to make sure that we're giving these solutions and able to help rehydrate these patients and make sure we're getting daily weights. We want to make sure we're doing this at the same time as this is the best way of showing any sort of fluid volume and balance. And we want to make sure that we're educating the patient and the family on prevention and any signs and symptoms that they need to be reporting to the physician. The patient should know how to prevent dehydration and know when they should be concerned and contact the physician as needed. 

Okay, we're going to go over some key points here. So fluid volume deficit is a condition where the fluid output exceeds the intake. Decreased fluid intake, bleeding, diarrhea, increased metabolic rate, and third spacing are common causes. Some subjective and objective data we're looking at the patient could be complaining of weakness, extreme thirst, dizziness, any sort of alterations in their mental status. They've got weight loss, concentrated urine, decreased urine output, and dry mucous membranes. We’re going to monitor their vital signs, do a full assessment, make sure we're monitoring their I&Os, their lab values, and administering those fluids. Make sure we're doing daily weights and educating the patient on preventing dehydration. And there we have a completed care plan. 

Awesome job guys. We love ya. Go out and be your best self today and as always happy nursing.

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