Fluid Volume Deficit/Dehydration
It occurs when the body loses both water and electrolytes from the ECF in similar proportions. Common sources of fluid loss are the gastrointestinal tract, polyuria, and increased perspiration. Risk factors for FVD are as follows: vomiting, diarrhea, GI suctioning, sweating, decreased intake, nausea, inability to gain access to fluids, adrenal insufficiency, osmotic diuresis, hemorrhage, coma, third-space fluid shifts, burns, ascites, and liver dysfunction. Fluid volume deficit may be an acute or chronic condition managed in the hospital, outpatient center, or home setting.
Unlike medical diagnoses, which typically identify the specific medical condition at issue (i.e. diabetes, bronchitis, celiac disease), nursing diagnoses describe the more immediate and ongoing physical and psychological needs of the patient. According to the standards set by NANDA International, a nursing diagnosis is typically written in a three-part manner: first the diagnosis, then what the diagnosis is related to (its direct cause), and finally the evidence for that diagnosis. You can reference the common direct causes and diagnostic signs and symptoms of fluid volume deficit as noted above for help creating your diagnostic statement. An example fluid volume deficit nursing diagnosis statement might look something like this: “Fluid volume deficit related to diarrhea and vomiting secondary to gastroenteritis as evidenced by decreased skin turgor, low blood pressure, and decreased urine output.” “Risk for fluid volume deficit” or “risk for deficient fluid volume” is a slightly different nursing diagnosis that can be used to describe patients who, while not yet exhibiting serious signs of fluid volume deficit, are at particular risk of developing the issue. A risk nursing diagnosis only has two parts: the diagnosis (“risk for fluid volume deficit”) is related to whatever the cause of the potential future issue is (“diarrhea and vomiting”). So the risk diagnosis would be “risk for fluid volume deficit related to diarrhea and vomiting.”
Freda BJ, Davidson MB, Hall PM. Evaluation of hyponatremia: a little physiology goes a long way. Cleve Clin J Med. 2004;71:639–650. [PubMed]
Ritz P Source Study. Bioelectrical impedance analysis estimation of water compartments in elderly diseased patients: the source study. J Gerontol A Biol Sci Med Sci. 2001;56:M344–M348.
O'Brien C, Baker-Fulco CJ, Young AJ, Sawka MN. Bioimpedance assessment of hypohydration. Med Sci Sports Exerc. 1999;31:1466–1471.
Olde Rikkert MG, Deurenberg P, Jansen RW, van't Hof MA, Hoefnagels WH. Validation of multi-frequency bioelectrical impedance analysis in detecting changes in fluid balance of geriatric patients. J Am Geriatr Soc. 1997;45:1345–1351.
Feig PU, McCurdy DK. The hypertonic state. N Engl J Med. 1977