Every week we’ll choose a practice article and pose a few questions for debate, post your questions or answers below …
- Measuring and managing fluid balance
- Author: Alison Shepherd is a tutor in nursing, department of primary care and child health, Florence Nightingale School of Nursing and Midwifery, King’s College London.
- Fluid balance is a term used to describe the balance of the input and output of fluids in the body to allow metabolic processes to function;
- To make a competent assessment of fluid balance, nurses need to understand the fluid compartments within the body and how fluid moves between these compartments;
- Dehydration is defined as a 1% or greater loss of body mass as a result of fluid loss. Physical symptoms of dehydration include impaired cognitive function, headaches, fatigue and dry skin. Severe dehydration can lead to hypovolaemic shock, organ failure and death;
- The three elements to assessing fluid balance and hydration status are clinical assessment, including vital signs, body weight and urine output, review of fluid balance charts, and review of blood chemistry;
- Fluid balance recording is often inadequately or inaccurately completed. Reasons identified for inappropriate completion of fluid balance charts include staff shortages, lack of training, and lack of time.
- Why are fluid balance charts notoriously difficult to maintain accurately?
- What role should healthcare assistants play in fluid balance monitoring and assessing patients’ hydration needs?
- In the clinical situation are signs of dehydration and fluid overload easy to identify? When do you find it challenging?
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