Fluid & Electrolyte Q 119

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Jomarick is diagnosed with FVD; which of the following nursing diagnoses might apply to his condition?

  

    A. Altered urinary elimination

    B. Decreased cardiac output

    C. Increased cardiac output

    D. Vomiting

    

    

Correct Answer: B. Decreased cardiac output

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Decreased cardiac output is a nursing diagnosis associated with isotonic FVD. Decrease in circulating blood volume can cause hypotension and tachycardia. Alteration in HR is a compensatory mechanism to maintain cardiac output. Usually, the pulse is weak and may be irregular if electrolyte imbalance also occurs. Hypotension is evident in hypovolemia. Other appropriate nursing diagnoses include altered tissue perfusion, potential for injury, and ineffective breathing pattern.

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Option A: Assess color and amount of urine. Report urine output less than 30 ml/hr for 2 consecutive hours. A normal urine output is considered normal not less than 30ml/hour. Concentrated urine denotes fluid deficit. Teach family members how to monitor output in the home. Instruct them to monitor both intake and output.

Option C: Cardiac alterations like dysrhythmias may reflect hypovolemia and/or electrolyte imbalance, commonly hypocalcemia. Note: MI, pericarditis, and pericardial effusion with/ without tamponade are common cardiovascular complications.

Option D: Monitor active fluid loss from wound drainage, tubes, diarrhea, bleeding, and vomiting; maintain accurate input and output record. Fluid loss from wound drainage, diarrhea, bleeding, and vomiting causes decreased fluid volume and can lead to dehydration.

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