Concept Map: dehydration & fluid volume excess?

[Arianna727]

Yes, I know... many concept map questions coming about now that we are nearing the end of the semester!

I just need help wording part of mine. One of my nursing dx is Fluid Volume, Excess. I know this is wrong, and after proof readng, I realized how little sense it made.

This is how I put in it my concept map: FVE r/t Dehydration (fluid overload) a/e/b edema in upper/lower extremities, bounding 4+ pulse, tachycardia (150 bpm).

I KNOW FVE and dehydration are polar opposites

BUT, due to this pts.' dehydration, (I think this is why...bc this is what the patient told me LOL; mind you she is a BSN RN), they infused fluids via IV too rapidly/too much (d/t dehydration) causing FVE.

It [FVE r/t Dehydration (fluid overload)] sounds stupid, or wrong, correct? Is there a better (or right) way to word it?

Thanks for the help guys!

[EricJRN, MSN, RN]

The dehydration started the whole thing, but that's not the immediate cause of this problem. Look in a nursing diagnosis reference at the related factors for this nursing diagnosis. One of the related factors for FVE describes exactly what happened to your patient. That related factor can be inserted right after the R/T.

[Arianna727]

The dehydration started the whole thing, but that's not the immediate cause of this problem. Look in a nursing diagnosis reference at the related factors for this nursing diagnosis. One of the related factors for FVE describes exactly what happened to your patient. That related factor can be inserted right after the R/T.

I actually don't have a reference book (I know, I need to get one!) and the one in the library has been checked out for weeks .

So, are you suggesting:

FVE r/t fluid overload by rapid/excessive fluid administration via IV secondary to dehydration a/e/b blah blah blah?

Does the secondary to part even belong/make sense there? Does anyone think I should just omit the whole dehydration thing (it is in the main medical diagnosis on my map) and just write:

FVE r/t fluid overload by rapid/excessive fluid administration via IV a/e/b blah blah blah?

I think the last one sounds best. What do you guys say? Any suggestions? Is that even correct?

Thanks all and thanks a lot EricJRN! :redbeathe

[NCRNMDM, ASN, RN]

I actually don't have a reference book (I know, I need to get one!) and the one in the library has been checked out for weeks .

So, are you suggesting:

FVE r/t fluid overload by rapid/excessive fluid administration via IV secondary to dehydration a/e/b blah blah blah?

Does the secondary to part even belong/make sense there? Does anyone think I should just omit the whole dehydration thing (it is in the main medical diagnosis on my map) and just write:

FVE r/t fluid overload by rapid/excessive fluid administration via IV a/e/b blah blah blah?

I think the last one sounds best. What do you guys say? Any suggestions? Is that even correct?

Thanks all and thanks a lot EricJRN! :redbeathe

Fluid volume excess r/t rapid IV fluid administration secondary to dehydration AEB whatever evidence you have. The way you worded it sounds fine.

[Esme12, ASN, BSN, RN]

The patient has fluid volume imbalance because she has fluid overload in one compartment and deficient in another. Have you guys went through fluids and electrolytes yet? It would help if you can review it. We have intracellular fluids and extracellular fluids, the extracellular is divided into 2 , intravascular and interstitial. When we have edema, the fluid from extracellular is leaking into interstitial spaces and thats when we get edema,ascites, etc. When intravascular fluid is leaking out to the interstitial spaces, we're losing fluids in our intravascular compartment and this is where we get dehydrated, we're losing blood volume-- therefore you get fluid volume decifit and the r/t is the cause. Why is she getting dehydrated? Is it because she's not able to drink fluids? Is she on fluid restriction?

I would also add as my nursing dx, risk for impaired skin integrity, when you have edema like your pt has, she's at risk for skin breakdown. I hope this helps.