Fluid Volume Deficit

Fluid Volume Deficit

Instructions: Fill out this form, print it, and hand it in with your assessment to your instructor. If you save the page with new name, you can use it again for future clients with minor changes as needed.

AOL users: Read this instruction.

Definition: state in which an individual experiences decreased intravascular, interstitial, and/or intracellular fluid.

1. Client's initials (required):

2. Defining Characteristics- check those that apply to your client:

None- high risk diagnosis thirst change in mental state
decreased BP orthostatic hypotension weak pulses decreased urine output decreased skin turgor dry mouth elevated hematocrit elevated urine specific gravity elevated BUN elevated sodium

3. Related Factors- check those that apply to your client:

decreased fluid intake increased fluid output fluid shifts (burns for example) failure of regulatory mechanisms (diabetes insipidus for example)
fever medications

4. Goal (ultimate, long term)

5. Outcome Criteria (short term)

6. Evaluation: Was the outcome criteria met?

Yes- Give Evidence:

No- Explain how you would change the plan:

7A. Interventions

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7B. Rationale for each intervention

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