Fluid and electrolyte imbalance care plan

Manifestations of CKD result from loss of the renal regulatory functions of filtering metabolic waste products and maintaining fluid and electrolyte balance. These laboratory results indicate CKD, but the most significant result is the potassium level. The normal range of potassium is between 3.5 and 5.0 mEq/L.

o Electrolyte imbalances (deficit or excess) can occur alone or with ECV and/or osmolality imbalance. The primary electrolytes to focus on are: Sodium: Key electrolyte in maintaining fluid balance; found primarily within extracellular space Potassium: Cardiac rhythm, muscle contraction; found primarily within intracellular spaceElectrolyte imbalances are common in older adults as well as people with a history of kidney disease, heart failure, acute pancreatitis, respiratory failure, eating …Use this nursing diagnosis guide to develop your fluid volume deficit care plan equipped help on nursing interventions, symptoms, and more. Assessment. Necessary Signs: Vital signs represent important indexes of fluid press electrolyte imbalances. Temperature, breathing rate, pulse, as well such blood pressure ought all be monitored.Hypokalemia Nursing Care Plan. By. RNspeak. -. May 22, 2018 Modified date: July 17, 2021. Hypokalemia is a serum potassium level less than 3.5 mEq/L or 3.5 mmol/L. This indicates depletion in the normal potassium levels in the body, a potential life-threatening emergency and can be fatal. Potassium helps in utilizing carbohydrates and protein ...November 7, 2020 Modified date: July 24, 2021. This Fluids and Electrolytes practice test aims to help nurses refresh knowledge on normal values of electrolytes, implications for care, and management of patients with alterations in fluid and electrolyte balance. Included in this practice test are multiple-choice and innovative response questions.Medicare provides health coverage to millions of people around the United States. It covers a variety of expenses you might incur while you’re in the hospital or seeing your primar...Your body needs the right amount of fluids to function but drinking too much of it can lead to overhydration. Drinking fluids to excess can cause serious harm to your health, espec...The plan of care includes assessment of specific gravity every four hours. The results of this test will allow the nurse to assess which aspect of the client's health? A. Nutritional status B. Potassium balance C. Calcium balance D. Fluid volume status, The nurse is caring for a client admitted with a diagnosis of acute kidney injury.

Expert-verified. Electrolyte Imbalance: Fluid Volume Deficit: Care plan: - Check patient vitals every 4 hours.. - Check patient weight for any weight loss -Encourage fluid intake and fruits intake to the patient.. - Assess the patient skin for dehydration.. ….Study with Quizlet and memorize flashcards containing terms like Differentiate between osmosis, diffusion, filtration, and active transport., Describe the role of the kidneys, lungs, and endocrine glands in regulating the body's fluid composition and volume., Identify the effects of aging on fluid and electrolyte regulation and more.4 days ago · Hypernatremia can cause dehydration and increase the risk of skin damage, making it essential to promote optimal skin care and repositioning to prevent further harm. 4. Teach the client to avoid foods high in sodium such as regular canned vegetables and vegetable juices, processed foods, snack foods, and condiments. There are five potential factors for the occurrence of electrolyte imbalance as; the causative disease process, endorgan injury, fluid and electrolyte interventions, use of medications with the ...Prompt recognition of these disruptions is essential to the care of these patients. This article provides an overview of the principles of fluid and electrolyte balance in the critically ill ...

The nurse is creating a plan of care for a client with hypokalemia. Which interventions should be included in the plan of care? Select all that apply. 1. Ensure adequate fluid intake 2. Implement safety measures to prevent falls 3. Encourage low-fiber foods to prevent diarrhea 4. Instruct the client about foods that contain potassium 5 ...Abstract. Maintaining the balance of fluid and electrolytes is crucial to the care of patients across the continuum. To do this, a practitioner must be cognizant of key monitoring and assessment parameters. Key electrolytes, their function within the body, normal values, signs and symptoms of imbalances, key treatment modalities, and other ...Oct 17, 2023 ... What are the treatments for electrolyte imbalances? ... The treatment for an electrolyte imbalance depends on which electrolytes are out of ...Fluid and Electrolyte Imbalance. 37 terms. VolticBat__ Preview. ATI cumulative exams. 48 terms. greatEmmajane20. ... Which components are appropriate to include in the nursing care plan? (Select all) a. ... The health care provider has ordered 5% dextrose in water as a maintenance fluid for the patient. The nurse is assessing the patient at the ...The goal of nursing care for individuals with acute kidney injury is to address or eliminate any causes that can be reversed. Prompt diagnosis of AKI’s underlying causes, correcting fluid and electrolyte imbalances, acid-base balance stabilization, proper nutrition, and preventing complications are all part of patient care.

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During the postoperative care of a 76-year-old patient, the nurse monitors the patient's intake and output carefully, knowing that the patient is at risk for fluid and electrolyte imbalances primarily because a. older adults have an impaired thirst mechanism and need reminding to drink fluids. The types of fluid and electrolyte imbalances that are observed in a client with cancer depend on the type and progresion of the cancer, client with cancer at risk for fluid and electrolyte imbalances related to the side effects, e.g. diarrhea, and anorexia of their chemoterapeutic and radiological treatments. Electrolyte Imbalance. An electrolyte imbalance occurs when certain mineral levels in your blood get too high or too low. Symptoms of an electrolyte imbalance vary depending on the severity and electrolyte type, including weakness and muscle spasms. A blood test called an electrolyte panel checks levels. Contents Overview Possible Causes Care ... Disturbances in fluid and electrolytes are among the most common clinical problems encountered in the intensive care unit (ICU). Recent studies have reported that fluid and electrolyte imbalances are associated with increased morbidity and mortality among critically ill patients. To provide optimal care, health care providers should be familiar ...F b._____ Major tissue damage that causes release of intracellular electrolytes into extracellular fluid will cause hypernatremia. T c._____ A cell surrounded by a hypo-osmolar fluid will shrink and die as water moves out of the cell. F d._____ Third spacing refers to the abnormal movement of fluid into nonfunctional spaces. T; e._____ DIF: Understanding TOP: Integrated Process: Nursing Process: Evaluation KEY: Fluid and electrolyte imbalances, Potassium imbalances MSC: Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies. A nurse develops a plan of care for an older client who has a fluid overload.

UNIVERSITY OF CEBU - BANILAD College of Nursing NURSING CARE PLAN Patient's Name: N.S. Hospital No.: T1989V Age: 34 yo Room No.: 102723 Impression/Diagnosis: Fluid and Electrolyte Imbalance Physician: Dr. Taylor Alison Swift Nurse's Name & Signature: Zeith Danielle Manigos, SN CLINICAL REPORT PERTINENT DATA 1. Assessment (general impression from head to toe) Upon initial assessment of the ...Imbalance of activity; Inadequate blood glucose monitoring; ... The major goals for a client who developed complications from hyperglycemia include maintenance of fluid and electrolyte balance, increased knowledge about diabetes basic skills and self-care, decreased anxiety, and absence of complications. ... This care plan handbook uses an … NURSING CARE PLAN Deficient Fluid Volume ASSESSMENT DATA NURSING DIAGNOSIS DESIRED OUTCOMES* Nursing Assessment Merlyn Chapman, a 27-year-old sales clerk, reports weakness, malaise, and flu-like symptoms for 3–4 days. Although thirsty, she is unable to tolerate fluids because of nausea and vomiting, and she has liquid stools 2–4 times per day. Fluid, electrolyte, and nutrition management is important because most infants in a neonatal intensive care unit (NICU) require intravenous fluids (IVFs) and have shifts of fluids between intracellular, extracellular, and vascular compartments. Therefore, careful attention to fluid and electrolyte balance is essential.There are many nursing diagnoses applicable to fluid, electrolyte, and acid-base imbalances. Review a nursing care planning resource for current NANDA-I approved nursing diagnoses, related factors, and defining characteristics. See Table 15.6c for commonly used NANDA-I diagnoses associated with patients with fluid and electrolyte imbalances. [12]When fluids or electrolytes become imbalanced, individuals are at risk for organ system dysfunction. If an imbalance goes undetected and is left untreated, organ systems cannot function properly and ultimately death will occur. ... Based on the assessment information that has been gathered, the nurse creates the following nursing care plan for ...Abstract. Because of the role of the kidneys in maintaining homeostasis in the body, kidney failure leads to derangements of fluid, electrolyte, and acid-base balance. The most effective therapy of a uremic crisis is careful management of fluid balance, which involves thoughtful assessment of hydration, a fluid treatment plan personalized for ...Electrolyte imbalance may cause dysrhythmias or other pathological states. 12. If possible, use a fluid warmer or rapid fluid infuser. ... Use crystalloid solutions for adequate fluid and electrolyte balance. ... This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. ...

FLUIDS AND ELECTROLYTES INTRODUCTION. Learning Objectives. Describe variables that influence fluid and electrolyte balance. Identify …

Abstract. Maintaining the balance of fluid and electrolytes is crucial to the care of patients across the continuum. To do this, a practitioner must be cognizant of key monitoring and assessment parameters. Key electrolytes, their function within the body, normal values, signs and symptoms of imbalances, key treatment modalities, and other ...Bowel Obstruction Nursing Care Plan 3 Imbalanced Nutrition: Less Than Body Requirements. ... WBC and RBC counts, serum electrolytes. ... providing supportive care, administering IV fluids and electrolytes, monitoring laboratory values, and preparing the patient for diagnostic and therapeutic procedures. ...INTRODUCTION. Fluid balance is critical in health[] and disease[2,3].Its management is required in a variety of instances. These include stress that healthy individuals may experience at certain times, e.g., during intense exercise[], development of various acute or chronic diseases[5-7], and complication of the course of several diseases[3,8,9]. ...Advertisement The basic idea of an aerosol can is very simple: One fluid stored under high pressure is used to to propel another fluid out of a can. To understand how this works, y...V4Veeru25. common sign symptoms , causes, management & nursing management of fluid & eletrolyte imbalance. Healthcare. 1 of 47. Fluid and Eletrolyte …Answer Key to Chapter 15 Learning Activities. Scenario A Answer Key: Interpret Mr. Smith's ABG result on admission. The pH is low indicating acidosis. The elevated PaCO2 indicates respiratory acidosis, and the normal HCO3 level indicates is it uncompensated respiratory acidosis. Explain the likely cause of the ABG results.Principles and protocols for intravenous fluid therapy. Assess patients’ fluid and electrolyte needs following Algorithm 1: Assessment. If patients need IV fluids for resuscitation, follow Algorithm 2: Resuscitation. If patients need IV fluids for routine maintenance, follow Algorithm 3: Routine maintenance.Nursing Care Plan for Nausea and Vomiting 1. Cancer with Ongoing Chemotherapy. ... Timely assessment may prevent complications brought about by this condition, i.e. dehydration, electrolyte imbalance, and nutritional deficiencies. ... This may include the administration of intravenous fluids and electrolytes:Fluid And Electrolyte Imbalances: Nursing Care Plans. Nursing care plans include diagnosis, intervention, and rationale. Keywords: hypervolemia, nursing care …

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Prompt recognition of these disruptions is essential to the care of these patients. This article provides an overview of the principles of fluid and electrolyte balance in the critically ill ...Testing or stool examinations will distinguish infectious or parasitic organisms, bacterial toxins, blood, fat, electrolytes, white blood cells, and potential etiological organisms for diarrhea. 4. Determine tolerance to milk and other dairy products. Diarrhea is a typical indication of lactose intolerance.Prompt diagnosis of AKI’s underlying causes, correcting fluid and electrolyte imbalances, acid-base balance stabilization, proper nutrition, and preventing …Manage the care of the client with a fluid and electrolyte imbalance. Evaluate the client's response to interventions to correct fluid or electrolyte imbalance. …As well as checking levels of electrolytes in the blood, an electrolyte panel (a group of specific blood tests) can also be used to find out if there's an acid-base imbalance (a normal arterial blood pH range is 7.35 to 7.45). An electrolyte test can also be used to monitor the effectiveness of treatment for an imbalance that affects how well ...D) Keep client on complete bed rest. A) Monitor fluid intake and output. A 25-year-old client is admitted to a healthcare facility with complaints of fever, vomiting, and watery diarrhea for 2 days. On examination, the client has dry skin, delayed skin turgor, and hypotension. During the postoperative care of a 76-year-old patient, the nurse monitors the patient's intake and output carefully, knowing that the patient is at risk for fluid and electrolyte imbalances primarily because a. older adults have an impaired thirst mechanism and need reminding to drink fluids. Advertisement The basic idea of an aerosol can is very simple: One fluid stored under high pressure is used to to propel another fluid out of a can. To understand how this works, y...Hyponatremia and Hypernatremia Nursing Care Plan 1. Nursing Diagnosis: Electrolyte Imbalance related to hyponatremia as evidenced by nausea, vomiting, serum sodium level of 100 mEq/L, irritability, and fatigue. Desired Outcome: Patient will be able to re-establish a normal electrolyte and fluid balance. ….

UNIVERSITY OF CEBU - BANILAD College of Nursing NURSING CARE PLAN Patient's Name: N.S. Hospital No.: T1989V Age: 34 yo Room No.: 102723 Impression/Diagnosis: Fluid and Electrolyte Imbalance Physician: Dr. Taylor Alison Swift Nurse's Name & Signature: Zeith Danielle Manigos, SN CLINICAL REPORT PERTINENT DATA 1. Assessment (general impression from head to toe) Upon initial assessment of the ...Fluid and electrolyte balance play a vital role in maintaining homeostasis, helping to regulate and maintain cellular function, control tissue perfusion and maintain acid-base balance. In normal healthy individuals, intake and output are maintained at a steady state, and the main role of the kidneys is the regulation of water balance in the body.Surgery. HESI-Part 2 Fluid, Electrolyte, and Acid-Base Imbalances. 32. After a third hospitalization 6 months ago, a client is admitted to the hospital with ascites and malnutrition. The client is drowsy but responding to verbal stimuli and reports recently spitting up blood.Risk for electrolyte imbalance r/t dehydration aeb fast HR, low BP, low O 2 saturation, low K+ and high Cl- levels Planning/Measurable Outcome: -improve pt.’s hydration status with fluid therapyStarting a business is an exciting endeavor, but it requires careful planning and preparation. One of the most crucial steps in the process is creating a comprehensive business pla...There are many nursing diagnoses applicable to fluid, electrolyte, and acid-base imbalances. Review a nursing care planning resource for current NANDA-I approved nursing diagnoses, related factors, and defining characteristics. See Table 15.6c for commonly used NANDA-I diagnoses associated with patients with fluid and electrolyte imbalances. [12]Nursing Care Plan for: Fluid Volume Excess, Fluid Overload, Congestive Heart Failure, Pulmonary Edema, Ascites, Edema, and Fluid and Electrolyte Imbalance. If you want to view a video tutorial on how to construct a care plan in …About Open RN. Table 15.6d. Interventions for Imbalances. Nursing Diagnosis. Interventions. Excessive Fluid Volume. Administer prescribed diuretics to eliminate excess fluid as appropriate and monitor for effect. Monitor for side effects of diuretics such as orthostatic hypotension and electrolyte imbalances. Position the patient with the head ...Nursing Care Plan for SIADH 1. Nursing Diagnosis: Electrolyte Imbalance ( Hyponatremia) related to the disease process of SIADH as evidenced by nausea, vomiting, serum sodium level of 160 mEq/L, irritability, and fatigue. Desired Outcome: Patient will be able to re-establish a normal electrolyte and fluid balance.Welcome to our Fluid and Electrolyte NCLEX Quiz. This specialized quiz is designed to assist nursing students and professionals in mastering the complexities of fluid and electrolyte management, a critical component of patient care and a significant section of the NCLEX examination. Our quiz offers a comprehensive review of fluid balance, electrolyte levels, and their implications for patient ... Fluid and electrolyte imbalance care plan, Starting a daycare business can be an exciting and rewarding venture. However, like any other business, it requires careful planning and preparation. One of the most crucial steps ..., Developing a nursing care plan for electrolyte imbalance is crucial to assess, manage, and prevent the consequences of disturbances in electrolyte levels. Electrolytes, including sodium, potassium, calcium, magnesium, and phosphate, play essential roles in maintaining proper cellular function, nerve conduction, muscle contractions, and fluid ..., Identify evidence-based practices. The human body maintains a delicate balance of fluids and electrolytes to help ensure proper functioning and homeostasis. When fluids or electrolytes become imbalanced, individuals are at risk for organ system dysfunction. If an imbalance goes undetected and is left untreated, organ systems cannot function ..., F b._____ Major tissue damage that causes release of intracellular electrolytes into extracellular fluid will cause hypernatremia. T c._____ A cell surrounded by a hypo-osmolar fluid will shrink and die as water moves out of the cell. F d._____ Third spacing refers to the abnormal movement of fluid into nonfunctional spaces. T; e._____, Heart failure (HF) is one of the most common reasons for admission to hospital. It is associated with long in-patient stays, and has a high in-hospital and post-discharge morbidity and mortality, whether left ventricular ejection fraction (LVEF) is reduced (HFREF) or normal (HeFNEF).[1,2] Congestion, or fluid overload, is a classic clinical feature of patients presenting with HF., 5 likes • 552 views. V4Veeru25. common sign symptoms , causes, management & nursing management of fluid & eletrolyte imbalance. Healthcare. 1 of 47. Fluid and Eletrolyte imbalance and nursing care. - Download as a PDF or view online for free., Study with Quizlet and memorize flashcards containing terms like A patient is prescribed an electrolyte replacement. How should the nurse explain the purpose of an electrolyte to the patient? a. Any substance that enhances a chemical reaction b. A chemical that can conduct electricity when dissolved in water c. A substance that uses electrical current to attach to receptor sites d. A substance ..., During the postoperative care of a 76-year-old patient, the nurse monitors the patient's intake and output carefully, knowing that the patient is at risk for fluid and electrolyte imbalances primarily because a. older adults have an impaired thirst mechanism and need reminding to drink fluids., This presentation provides information about fluid balance in the body, various types of fluid and electrolyte imbalances and their management. 1. Seminar On Fluid and Electrolyte Imbalance Raksha Yadav 1st Year M.Sc. Nursing AIIMS Rishikesh. 2. INTRODUCTION. 3. HOMEOSTASIS. 4. Water content of the body., Testing or stool examinations will distinguish infectious or parasitic organisms, bacterial toxins, blood, fat, electrolytes, white blood cells, and potential etiological organisms for diarrhea. 4. Determine tolerance to milk and other dairy products. Diarrhea is a typical indication of lactose intolerance., Neonatal providers' approach to fluid management changes and adapts based on the newborn's age, maintenance needs, deficits, and ongoing losses. Understanding the total body water content of the fetus and newborn is foundational to management of electrolyte disturbances. This article reviews common imbalances of sodium and chloride, identifies ..., Daily random urine electrolytes and urinary volume measurement can be utilized to monitor C e H 2 O and adjust daily fluid administration in this manner, while following plasma Na + concentration. Physicians often calculate the free water deficit to guide therapy of hypernatremia, providing half the deficit in the first 24 h., D) Keep client on complete bed rest. A) Monitor fluid intake and output. A 25-year-old client is admitted to a healthcare facility with complaints of fever, vomiting, and watery diarrhea for 2 days. On examination, the client has dry skin, delayed skin turgor, and hypotension., Dehydration is one of the ten most frequent diagnoses for hospital admission in older adults , and has been reported to be the most common fluid and electrolyte imbalance in older adults . A study showed that 6.7% of inpatients aged ≥65 years were diagnosed with dehydration, with it being the principal diagnosis in 1.4% ., Rationale: Fluid overload may lead to pulmonary edema and HF evidenced by development of adventitious breath sounds, extra heart sounds. Assess level of consciousness. Investigate changes in mentation, presence of restlessness. Rationale: May reflect fluid shifts, accumulation of toxins, acidosis, electrolyte imbalances, or developing hypoxia., Diabetic Ketoacidosis DKA Nursing Care Plan 4. Nursing Diagnosis: Imbalanced Nutrition: Less than Body Requirements related to insulin deficiency, as evidenced by ... Advice the patient to take an adequate number of fluids and closely monitor that patient's fluid and electrolyte balance. To avoid dehydration and complications such as low ..., Several fluid and electrolyte mechanisms function to keep the body in balance. The proper maintenance of fluids and electrolytes helps the body with muscle action, blood chemistry, and other processes. Interstitial fluid accounts for 75% of the extracellular fluid (ECF). This is the fluid that surrounds the cells., Realizing that your vehicle is dripping some sort of mystery liquid is very unsettling. Maybe it’s nothing, or maybe you’re about to face a costly visit to the mechanic. The good n..., There are five potential factors for the occurrence of electrolyte imbalance as; the causative disease process, endorgan injury, fluid and electrolyte interventions, use of medications with the ..., The combination of reduced blood flow and tubular injury leads to a decline in Glomerular Filtration Rate (GFR), impairing the kidney's ability to filter and excrete waste products and maintain fluid and electrolyte balance. Fluid and Electrolyte Imbalance: As AKI progresses, the kidneys struggle to regulate fluid and electrolyte balance., 3. Monitor electrolytes, ABGs, and cardiac biomarkers. Cardiac dysrhythmia occurs secondary to hypokalemia and/or acidosis in DKA and often resolves after proper treatment. The nurse should initially assess these lab results and redraw them as directed until resolution. Interventions: 1. Correct electrolyte imbalances., Testing or stool examinations will distinguish infectious or parasitic organisms, bacterial toxins, blood, fat, electrolytes, white blood cells, and potential etiological organisms for diarrhea. 4. Determine tolerance to milk and other dairy products. Diarrhea is a typical indication of lactose intolerance., When fluids or electrolytes become imbalanced, individuals are at risk for organ system dysfunction. If an imbalance goes undetected and is left untreated, organ systems cannot function properly and ultimately death will occur. ... Based on the assessment information that has been gathered, the nurse creates the following nursing care plan for ..., The development of a plan for managing fluid and electrolyte abnormalities should start with correcting the underlying condition. In most cases, this is followed by an assessment of fluid balance with the goal of achieving euvolemia. After fluid status is understood and/or corrected, electrolyte imbalances are simplified., Impaired Memory NCLEX Review and Nursing Care Plans. Memory loss (amnesia) is defined as one’s inability to recall and retrieve information. Patients are unable to recall recent events, one or more past recollections, or both. The memory loss could be temporary and eventually disappear (transient). It may not go away, or it may worsen …, Study with Quizlet and memorize flashcards containing terms like A nurse is planning care of a client who has hypernatremia. Which of the following actions should the nurse anticipate including in the plan of care? A. Infuse hypotonic IV fluids B. Implement a fluid restriction C. Increase sodium intake D. Administer sodium polystyrene sulfonate, A nurse is reviewing the medical record of a ..., Acute kidney injury (AKI), formerly known as acute renal failure (ARF), denotes a sudden and often reversible reduction in kidney function, as measured by glomerular filtration rate (GFR).[1][2][3] There is no clear definition of AKI. Several different criteria have been used in research studies, such as RIFLE, AKIN (Acute Kidney Injury Network), or KDIGO (Kidney Disease: Improving Global ..., Which situation puts runners at a higher risk for fluid and electrolyte imbalances? A. The use of electrolyte replacement fluids during a race B. ... Skin turgor, blood pressure, and intake and output are assessments that would be included in the care of a client with fluid imbalances, but daily weight is the best indicator of changes in fluid ..., Plan of care. Teaching plan. Response to interventions, teaching, and actions performed. Attainment or progress toward desired outcomes. Modifications to plan of care. Long term needs. Practice Quiz: Appendicitis. Here’s a 5-item quiz about the study guide. Please visit our nursing test bank for more NCLEX practice questions. 1., Learn about fluid and electrolyte balance. Water is made up of 2 hydrogen atoms and 1 oxygen atom (Figure 8.3.1 8.3. 1 ). A human body is made up of mostly water. An adult consists of about 37 to 42 liters of water, or about eighty pounds. Fortunately, humans have compartmentalized tissues; otherwise we might just look like a water balloon!, Study with Quizlet and memorize flashcards containing terms like A nurse is planning care of a client who has hypernatremia. Which of the following actions should the nurse anticipate including in the plan of care? A. Infuse hypotonic IV fluids B. Implement a fluid restriction C. Increase sodium intake D. Administer sodium polystyrene sulfonate, A nurse is reviewing the medical record of a ..., 4 days ago · This can occur if too much fluid is removed during the dialysis process, leading to dehydration and electrolyte imbalances. Measure and record intake and output, including all body fluids, such as wound drainage, nasogastric output, and diarrhea. Provides information about the status of the patient’s loss or gain at the end of each exchange. , Hospital patients needing IV fluids are very variable in terms of their fluid and electrolyte status and their likely responses to IV fluid therapy. Therefore, a full assessment is required by a competent clinician regarding the best content, volume and rate of IV fluids to be administered in order to minimize risks associated with fluid and ...