NRS 312 Study Guide - Final Guide: Xeroderma, Palpation, Cardiac Output
Fluid volume Deficit
• High specific gravity
• Low output
• Dry mucous membranes
• Vomiting/diarrhea
• Headache
• Tenting: assess for in the back of the
hand is normal. Best place in elderly
is on the chest because they are often
dehydrated.
• High HCT
• Low BP
• Hemorrhage
• High Na+, low K+
• Weakened pulse
• Dehydration weight loss
• Dry skin
• Dizziness
• Weakness
• +1 pulse strength
• More/increased wrinkles
• Increase in Respiratory rate
• Increase in heart rate
• Decrease in level of consciousness
• Constipation
• Dark, concentrated urine
• Cap refill is greater than 3 seconds
• Cold pallor
• Low output in relation to low intake
• Risk for imbalanced electrolytes
Fluid volume Excess
• Edema in face arms and legs
• Changes in LOC are possible but not
as prominent
• Dyspnea, shortness of breath,
crackles in the lungs
• Adventitious lung sounds
• Increased blood pressure
• Increased cardiac output
• JVD
• S3 lung sounds
• Increase preload
• Palpation, dysrhythmia
• Heart trys to manage a high volume
of blood
o Could see a decrease in
cardiac output if we see
edema
• Weight changes: increase.
• Pitting edema
• I/O: either or. If problem is heart
failure and patient is on a diuretic,
expect a high output if it is being
managed
o Low output because the body
is holding on to fluid
• Low specific gravity or high specific
gravity: if they are holding on to
fluid
• Low HCT, excess fluid changes ratio
• Potentially a low BUN or GFR
• Bounding pulses
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Document Summary
Fluid volume deficit: high specific gravity, low output, dry mucous membranes, vomiting/diarrhea, headache, tenting: assess for in the back of the hand is normal. Fluid volume excess: edema in face arms and legs, changes in loc are possible but not as prominent, dyspnea, shortness of breath, crackles in the lungs, adventitious lung sounds. Increased cardiac output: jvd, s3 lung sounds. Increase preload: palpation, dysrhythmia, heart trys to manage a high volume of blood, could see a decrease in cardiac output if we see edema, weight changes: increase, pitting edema.
