Hypervolemia (Fluid overload)

Hypervolemia(Fluid Overload) by En Martinar and EN Evitha from Villa Francis Home for the Aged

1. HYPERVOLEMIA FLUID OVERLOAD By: EN Martinar EN Evitha Villa Francis Home for the Aged

2. Case Study Name : Mr S Age : 67 yrs DOB : 11/01/1951 Race : Chinese Dialect : Cantonese Religion : Buddhism Date of Admission : 17.07.2017

3. Case Study (cont.) PAST MEDICAL HISTORY 2015 IHD s/p Percutaneous Coronary Intervention 2016 Hypt , Hyperlipidemia , DM, Anaemia secondary to Vitamin B1deficiency Vitamin D deficiency, Severe Osteoporosis Previous Multifocal SAH 2017 Hypernatremia, Hypokalemia likely secondary to Frusemide , Fluid Overload b/g ischemic CMP , Right Epididymo-orchitis , Symptomatic Postural Hypotension secondary to DM autonomic dysfunction, CCF , NCNC Anaemia, CVRF

4. Current Medications Aspirin 100mg OM Bisoprolol 1.25mg OM Midodrine 10mg TDS Iron Polymaltose complex 50mg/ml(20drops) Senna 15 mg ON Glipizide 10mg OM, 7.5mg ON Spirinolactone 25mg OM Metformin 500mg BD Frusemide 20mg EOD Simvastatin 40mg ON Lactulose 20mls BD Nitroglycerin (GTN) 0.5mg/tab one tab SL PRN Bisacodyl Suppository 10mg OM/PRN (to give if 3 days BNO)

5. Objectives What is Hypervolemia? Etiology or causes Common Signs and Symptoms How to Diagnose ? Complications Treatment and Management Palliative Management and Nursing Intervention

6. What is Hypervolemia? Hypervolemia is a condition in which there is too much fluid in the blood which is also known as fluid overload. U sually a result of an underlying health problem.

7. Etiology : H eart failure Cirrhosis K idney failure Nephrotic syndrome Excessive IV Fluids Hormones – PMS, pregnancy Medications Eating too much salt

8. Most common symptoms include: Edema esp lower extremities as well as anywhereas there is tissue Tiredness High BP Bounding pulse, Tachycardia SOB , Rales or rhonchi Heart problems eg ; palpitation Abdomen distension Pitting edema

9. Signs and Symptoms

10. Comprehensive check-up To look for underlying conditions, such as heart failure , kidney problems and liver disease .

11. Physical exam: Check for any edema Listen to the lungs - for signs of fluid.

12. Lab test: Urine Test Blood test

13. Complications Pericarditis , or swelling of the heart tissues Heart failure Delayed wound healing Tissue breakdown Decreased bowel function

14. Treatment and Management Diuretics Medications Hydralazine and Captopril Renal replacement therapies Continuous arteriovenous and venovenous hemoinfiltrations

15. Management

16. Palliative management Anti-embolism stockings Oxygen inhalation Bed rest Treatment of underlying cause of hypervolemia

17. Nursing Care includes Monitor the patient’s response to diuresis weight Intake and output Advocate patient of avoiding food with high Na content. Review with doctor whenever necessary

18. Questions and Answers Do you think hypervolemia is treatable ? Often treatable if caught early, but the underlying cause of hypervolemia should be addressed to keep it from recurring.

19. Consequences of Hypervolemia in tissues

20. https:// www.chf-solutions.com/fluid-overload https:// www.medicalnewstoday.com/articles/320339.php https:// www.nursingtimes.net/Journals/1/Files/2011/8/1/Fluid%20balanceCorr.pdf.pdf http:// nursing-concept.blogspot.sg/2009/02/nursing-care-plans-for-excess-fluid.html

21. Thank You