Domain 2. Nutrition
Class 5. Hydration
Diagnostic Code: 00027
Nanda label: Deficient fluid volume
Diagnostic focus: Fluid volume
Fluid volume deficit (FVD) is a nursing diagnosis that refers to an abnormally low amount of fluid in the body. It can be caused by a decrease in fluid intake, an increase in fluid output, or both. When a client has an FVD, they may have a variety of symptoms including dehydration, weakness, dizziness, and decreased urinary output. Understanding the factors and criteria associated with this nursing diagnosis can help healthcare professionals maintain the patient’s health and well-being.
NANDA Nursing Diagnosis Definition
According to the North American Nursing Diagnosis Association (NANDA), a nursing diagnosis is defined as “A clinical judgment about individual, family, or community responses to actual or potential health problems and life processes”. NANDA defines deficient fluid volume as “A state in which an individual has insufficient circulating fluid volume relative to physiologic needs”.
There are several defining characteristics associated with this diagnosis that should be considered when assessing a patient’s condition. The following are some common indicators for an FVD:
- Complaints of dry mouth/tongue
- Increased heart rate
- Decreased capillary refill time
- Decreased urine output
- Decreased pulse pressure
- Decreased mucous membrane hydration
There are a few different factors that may lead to deficient fluid volume. These include decreased fluid intake, excessive fluid output, electrolyte imbalances, and certain medical conditions or treatments.
- Decreased Fluid Intake: This can happen if a patient isn’t taking enough fluids, either orally or intravenously. It can also occur due to nausea, vomiting, or fever.
- Excessive Fluid Output: This can be caused by diuretics, medications, high-output states such as heat stroke, dialysis, and other causes.
- Electrolyte Imbalances: Electrolyte imbalances can cause the body to retain or lose water, resulting in a fluid volume deficit.
- Medical Conditions/Treatments: Certain medical conditions or treatments may lead to reduced fluid intake or increased fluid output, causing a FVD.
At Risk Population
Certain populations are more likely to develop a FVD than others. People who are more at risk include:
- Elderly: The elderly often have reduced appetite and thirst, which can lead to inadequate fluid intake.
- Chronic Illness: Those with chronic illnesses such as kidney disease, diabetes, and congestive heart failure can have disturbed fluid balance due to medications or other treatments.
- Burn Patients: Burn patients are at particularly high risk of FVD due to increased fluid requirements, poor intake, and increased evaporative losses.
Suggestions for Use
To effectively diagnose and manage FVD, healthcare professionals should take into account the patient’s subjective and objective information as well as associated medical conditions or treatments. Blood tests, urine output measurements, and other laboratory tests may also be useful.
Suggested Alternative NANDA Nursing Diagnoses
In some cases, a patient may not meet the criteria for a FVD but still require intervention. In these cases, a healthcare professional may consider the following alternative diagnoses:
- Fluid Volume Excess: A state in which an individual has a greater circulating fluid volume relative to physiologic needs.
- Imbalanced Nutrition: Less than Body Requirements: Refers to inadequate intake of nutrients necessary for the maintenance of health.
- Ineffective Tissue Perfusion: Refers to the inability of oxygen-rich blood to reach the tissues, leading to impaired cellular metabolism.
When managing FVD, it is important to monitor the patient closely. Thus, it is important to re-evaluate the patient’s condition on an ongoing basis. Monitor the patient for signs of dehydration and changes in fluid balance.
The Nursing Outcome Classification (NOC) system is used to measure desirable outcomes for patients. Here are some NOC outcomes that may be associated with FVD:
- Fluid Balance: Monitoring how much fluid a patient is taking in and releasing each day to ensure optimal balance.
- Hydration Status: Identification of the amount of water in the body and whether it is adequate.
- Monitor Electrolytes: Assessing specific minerals and salts in the bloodstream and ensuring they are balanced.
- Nutrition Status: Assessing the patient’s nutritional needs and providing the appropriate nutritional support.
Evaluation Objectives and Criteria
Evaluation objectives and criteria are used to assess a patient’s progress towards meeting the initial treatment goals. Here are some evaluation objectives and criteria that may be used to gauge the effectiveness of interventions for treating FVD:
- Increase intake of fluids: Patient is able to drink or take in fluids in an appropriate amount and frequency.
- Decrease urine output: Patient’s urine output decreases to an appropriate level.
- Improve electrolytes: Patient’s sodium, potassium, and other electrolytes are within normal limits.
- Improve Hydration Status: Patient’s total body water is restored to an appropriate level.
- Maintain Nutritional Status: Patient is able to maintain sufficient intake of nutrients to remain healthy.
The Nursing Interventions Classification (NIC) system is used to define nursing interventions. Here are some NIC interventions that may be used when treating FVD:
- Fluid Intake Assessment: Assessing the patient’s fluid intake and ensuring it is sufficient for their needs.
- Fluid/Electrolyte Monitoring: Monitoring a patient’s fluid and electrolyte levels to make sure they are within optimal levels.
- Nutrition Education: Educating a patient on the importance of optimal nutrition and ways to maximize their dietary intake.
- Oral Hygiene: Teaching proper oral hygiene techniques, such as brushing and flossing.
When managing FVD, there are a few nursing activities that should be done on a regular basis. The following are some recommended nursing activities:
- Monitor intake and output: Measuring the amount of fluids a patient is taking in and releasing on a daily or hourly basis.
- Observe for signs of dehydration: Observing the patient for any signs of dehydration, such as dry mouth or decreased urine output.
- Encourage fluid intake: Urging the patient to drink fluids in appropriate amounts to prevent dehydration.
- Administer medications: Administering any necessary medications to help restore fluid volume.
Fluid volume deficit (FVD) is a common nursing diagnosis that can have serious implications for patient health and well-being. It is important to recognize the symptoms and risk factors associated with this diagnosis, as well as to understand the methods used to diagnose and treat FVD. With the proper assessment and intervention, a client can achieve successful outcomes and improved overall health.
- What is Fluid Volume Deficit?
- Fluid Volume Deficit (FVD) is a nursing diagnosis that refers to an abnormally low amount of fluid in the body. It can be caused by a decrease in fluid intake, an increase in fluid output, or both. Symptoms of FVD include dehydration, weakness, dizziness, and decreased urinary output.
- What are the Related Factors Associated with FVD?
- There are a few different factors that may contribute to FVD. These include decreased fluid intake, excessive fluid output, electrolyte imbalances, and certain medical conditions or treatments. Decreased fluid intake can be caused by decreased appetite or thirst. Excessive fluid output can be caused by diuretics, medications, high output states such as heat stroke, dialysis, and other causes. Electrolyte imbalances can lead the body to retain or lose water, leading to a FVD. Certain medical conditions or treatments can also cause a reduction in fluid intake or an increase in fluid output, leading to a FVD.
- What are some Nursing Interventions for FVD?
- When managing FVD, it is important to monitor the patient closely. Thus, it is important to re-evaluate the patient’s condition on an ongoing basis. Nursing interventions for FVD include monitoring water intake and output, observing for signs of dehydration, encouraging fluid intake, and administering medications.
- What are Some NOC Outcomes for FVD?
- The Nursing Outcome Classification (NOC) system is used to measure desirable outcomes for patients. NOC outcomes that may be associated with FVD include fluid balance, hydration status, monitoring electrolytes, and nutrition status.
- What are the Evaluation Objectives and Criteria for FVD?
- Evaluation objectives and criteria are used to assess a patient’s progress towards meeting the initial treatment goals. Evaluation objectives and criteria that may be used to gauge the effectiveness of interventions for treating FVD include increasing fluid intake, decreasing urine output, improving electrolytes, restoring hydration status, and maintaining nutritional status.