Angelite Nurses: Fluid Volume Deficit

Fluid Volume Deficit

(_)Actual (_) Potential

**Related To:**
*[Check those that apply]*
(_) Excessive urinary output. (_) Inadequate fluid intake. (_) Abnormal drainage. (_) Excessive emesis. (_) Difficulty in swallowing. (_) Medication:________________________ (_) Diarrhea (_) Shock (_) Hemorrhage (_) Fever (_) Burns (_) Other:_____________________________ ____________________________________ ____________________________________

**As evidenced by:**
*[Check those that apply]*
Major: (Must be present)	(_) Output greater than intake. (_) Dry skin/mucous membranes.
Minor: (May be present)	(_) Increased serum sodium. (_) Increased pulse from baseline. (_) Decreased or excessive urine output. (_) Concentrated urine. (_) Urinary frequency. (_) Decreased fluid intake. (_) Poor skin tugor. (_) Thirst/nausea/anorexia.

Date &
Sign.

Plan and Outcome
[Check those that apply]

Target
Date:

Nursing Interventions
[Check those that apply]

Date
Achieved:

The patient will:

(_) Demonstrate adequate fluid balance A.E.B.:

(_) Other:

(_) Asses:

(_) Encourage fluid intake of ____ cc/day; ____.

(_) Assist patient with drinking if necessary.

(_) Explore patient's understanding of etiological factors and provide necessary teaching.

(_) Other:________________
________________________
________________________
________________________

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Patient/Significant other signature

__________________________
RN signature

Angelite Nurses