RN Nutrition Online Practice 2019 B Remediation

RN Nutrition Online Practice 2019 B Remediation

a.      Nutrition and Oral Hydration

a.      Fluid Imbalances: Identifying Manifestations of Fluid Overload

i.       Overhydration

1.      Too much fluid in the body from excessive intake or ineffective removal from the body

2.      Fluid overload is an excess of fluid or water, such as with water intoxication. This includes hemodilution, which makes the amount of blood components (blood cells, electrolytes) seem lower.

3.      Hypervolemia, or fluid volume excess, involves an excess of water and electrolytes, so that the two are still in the right proportions. For example, excessive sodium intake causes the body to retain water, so that there is too much of both.

4.      Clients who have fluid overload are at risk for developing pulmonary edema or congestive heart failure.

5.      In older adult clients, the risk of fluid imbalance is greater due to changes in the body with age (such as reduced kidney function).

ii.      HEALTH PROMOTION AND DISEASE PREVENTION

1.      When clients have known heart disease and impairment of kidney function, it important to instruct the client regarding the following.

2.      Consume a diet low in sodium. Consult with the provider regarding diet restrictions.

3.      Restrict fluid intake. Consult with provider regarding prescribed restrictions.

iii.      RISK FACTORS

1.      Causes of hypervolemia

2.      Compromised regulatory systems (heart failure, kidney disease, cirrhosis)

3.      Overdose of fluids (oral, enteral, IV) 4. Fluid shifts that occur following burns 5. Prolonged use of corticosteroids

6.      Severe stress

7.      Hyperaldosteronism

iv.      Causes of overhydration

1.      Water replacement without electrolyte replacement, excessive water intake (forced or psychogenic polydipsia)

2.      Syndrome of inappropriate antidiuretic hormone (SIADH)

3.      Excessive administration of IV D5W; use of hypotonic solutions for irrigations