Primary Nursing Diagnosis

Fluid volume deficit related to water loss and dehydration

OUTCOMES. Fluid balance; Electrolyte and acid-base balance; Hydration; Nutritional status: Food and fluid intake; Knowledge: Treatment regimen; Knowledge: Medication

INTERVENTIONS. Electrolyte management; Intravenous therapy; Electrolyte monitoring; Surveillance; Venous access device maintenance; Medication management; Nutrition management


Report any serum chloride levels greater than 108 mEq/L, and observe the patient for increases in serum potassium and sodium levels. Note any decrease in serum bicarbonate level, which indicates metabolic acidosis.

Severe hyperchloremia secondary to hypernatremia because of dehydration may require an intravenous (IV) solution of hypotonic saline, such as 0.45% sodium chloride (one-half normal saline). Infuse the solution cautiously because rapid infusion can cause a rapid shift of water into the cerebral cells, creating cerebral edema and the risk of death. Patients with hyperchloremia from metabolic acidosis may receive IV sodium bicarbonate; monitor them closely for overcor-rection (metabolic alkalosis and respiratory depression). Dietary changes are seldom necessary;

however, for severe conditions, a low-sodium diet prevents further accumulation of chloride and sodium.

Pharmacologic Highlights

Medication or Drug Class




Sodium bicarbonate

IV 2-5 mEq/kg over 4-8 hr

Alkalinizing agent

Corrects metabolic acidosis;

Gaining Weight 101

Gaining Weight 101

Find out why long exhausting workouts may do more harm than good. Most of the body-building workout and diet regimens out there are designed for the guys that gain muscle and fat easily. They focus on eating less and working out more in order to cut the excess fat from their bodies while adding needed muscle tone.

Get My Free Ebook

Post a comment