Hypovolemia and Hypervolemia

Instructor

Balance of fluids inside the body is maintained through means of input and output. The body also has several means like diffusion, osmosis, active transport, and filtration of maintaining the fluids’ homeostasis. Some of the common fluid imbalances can either be due to excess fluid volumes or fluid deficits. Hypovolemia is a state at which the body experiences Fluid Volume Deficits (FVD). Causes of hypovolemia include gastrointestinal losses from vomiting and diarrhea, hemorrhages, abnormal renal losses like renal disease or diabetes insipidus, and abnormal skin losses like diaphoresis. The condition can also be due to dehydration from diabetic ketoacidosis, hyperventilation, or intravenous feeding methods without enough water. Symptoms of this condition include loss of weight, weakness, fatigue, thirst, nausea, confusion, flattened neck veins, dizziness and sunken eyeballs. A nurse can diagnose hypovolemia by checking a patient’s vital signs for a thready pulse, tachycardia, hypotension, increased respiration rate, hyperthermia, decreased pressure in veins, and hypoxia. Severe cases of hypovolemia can lead to hypovolemic shock.

Hypervolemia is due to a case of Fluid Volume Excess (FVE). This state can be caused by excessive intake of sodium, cardiovascular and renal changes due to age, intestinal to plasma fluid shifts, replacing water without replacing electrolytes, heart failure, cirrhosis, and abnormal renal functions leading to reduced sodium and water excretion.  Symptoms of this condition manifest through weight gain, pale cool skin, edema, diminished breath sounds, distended veins in the neck, muscle weakness, headaches, and confusion. Nurses diagnose this condition by assessing vital signs for signs of tachycardia, tachypnea, increased intravenous pressure, and a bounding pulse. Chronic cases of hypervolemia can lead to heart failure and edema. Patients are advised to reduce sodium and fluid intake.