Page 241 - Saunders Comprehensive Review For NCLEX-RN

If the client has a fluid or an electrolyte imbalance, the nurse must closely

monitor the client’s cardiovascular, respiratory, neurological, musculoskeletal, renal,
integumentary, and gastrointestinal status.
III. Fluid Volume Deficit
A. Description
1. Dehydration occurs when the fluid intake of the body
is not sufficient to meet the fluid needs of the body.

2. The goal of treatment is to restore fluid

volume, replace electrolytes as needed, and eliminate
the cause of the fluid volume deficit.
B. Types of fluid volume deficits
1. Isotonic dehydration
a. Water and dissolved electrolytes are
lost in equal proportions.
b. Known as hypovolemia, isotonic
dehydration is the most common type
of dehydration.
c. Isotonic dehydration results in
decreased circulating blood volume
and inadequate tissue perfusion.
2. Hypertonic dehydration
a. Water loss exceeds electrolyte loss.
b. The clinical problems that occur result
from alterations in the concentrations
of specific plasma electrolytes.
c. Fluid moves from the intracellular
compartment into the plasma and
interstitial fluid spaces, causing
cellular dehydration and shrinkage.
3. Hypotonic dehydration
a. Electrolyte loss exceeds water loss.
b. The clinical problems that occur result
from fluid shifts between
compartments, causing a decrease in
plasma volume.
c. Fluid moves from the plasma and
interstitial fluid spaces into the cells,
causing a plasma volume deficit and
causing the cells to swell.
C. Causes of fluid volume deficits
1. Isotonic dehydration
a. Inadequate intake of fluids and

solutes
b. Fluid shifts between compartments

241