The Role of Nurses in Monitoring and Managing Fluid Balance in Hospitalized Patients
DOI:
https://doi.org/10.22399/ijcesen.4603Keywords:
Nurses, fluid balance, hospitalized patients, monitoring, managing, vital signsAbstract
Nurses play a crucial role in monitoring and managing fluid balance in hospitalized patients, ensuring that each individual's needs are met while preventing complications that can arise from fluid overload or deficits. By conducting thorough assessments, including regular checks of vital signs, intake and output measurements, and laboratory tests, nurses can gauge a patient's fluid status effectively. They are trained to recognize the signs of fluid imbalance, such as edema, dehydration, and electrolyte disturbances, enabling them to initiate appropriate interventions promptly. The continuous observation and documenting of a patient's fluid intake and output provide vital information for the healthcare team, serving as a foundation for ongoing treatment decisions. In addition to monitoring, nurses actively manage fluid balance through the administration of intravenous fluids and medications, as well as guiding oral intake based on each patient’s specific needs. They must collaborate closely with physicians, dietitians, and other healthcare professionals to create and implement care plans tailored to individual patients, accounting for conditions such as heart failure, kidney disease, or postoperative recovery. Education is another integral aspect of a nurse's role—informing patients and families about the importance of fluid balance and adhering to prescribed fluid management plans. Ultimately, the diligence and expertise of nurses in both monitoring and managing fluid balance are essential for improving patient outcomes and ensuring safety during hospitalization.
References
1. El-Sharkawy AM, Sahota O, Lobo DN. Acute and chronic effects of hydration status on health. Nutr Rev 2015;73:97–109. DOI: 10.1093/nutrit/nuv038.
2. Sakr Y, Rubatto Birri PN, Kotfis K, et al. Higher fluid balance increases the risk of death from sepsis: results from a large International audit. Crit Care Med 2017;45:386–94. DOI: 10.1097/CCM.0000000000002189.
3. Perren A, Markmann M, Merlani G, et al. Fluid balance in critically ill patients. should we really rely on it? Minerva Anestesiol 2011;77:802–11.
4. Yang S-H, Mu P-F, Wu H-L, et al. Fluid balance monitoring in congestive heart failure patients in hospital: a best practice implementation project. JBI Database System Rev Implement Rep 2019;17:2202–11. DOI: 10.11124/JBISRIR-2017-004021.
5. Brandstrup B, Tønnesen H, Beier-Holgersen R, et al. Effects of intravenous fluid restriction on postoperative complications: comparison of two perioperative fluid regimens: a randomized assessor-blinded multicenter trial. Ann Surg 2003;238:641–8. DOI: 10.1097/01.sla.0000094387.50865.23.
6. Holroyd S. Frequency volume charts and fluid balance monitoring: getting it right. J Commun Nurs 2020;34:4.
7. Michelsen CF, Svendsen MBS, Bagger ML, et al. A study on accuracy and precision of fluid volume measurements by nurses, patients and healthy persons in a clinical setting. Nurs Open 2022;9:1303–10. DOI: 10.1002/nop2.1173.
8. Wakeling J. Improving the hydration of hospital patients. Nurs Times 2011;107:21–3.
9. Albert NM. Fluid management strategies in heart failure. Crit Care Nurse 2012;32:20–32. DOI: 10.4037/ccn2012877.
10. Scales K, Pilsworth J. The importance of fluid balance in clinical practice. Nursing Standard 2008;22:50–7. DOI: 10.7748/ns2008.07.22.47.50.c6634.
11. Eastwood GM, Peck L, Young H, et al. Intravenous fluid administration and monitoring for adult ward patients in a teaching hospital. Nurs Health Sci 2012;14:265–71. DOI: 10.1111/j.1442-2018.2012.00689.x.
12. Georgiades D. A balancing act: maintaining accurate fluid balance charting. Clinical Update 2016:5.
13. Troy DM, Attwood AS, Maynard OM, et al. Effect of glass shape on the pouring accuracy of liquid volume. PLoS One 2018;13:e0204562. DOI: 10.1371/journal.pone.0204562.
14. Hamrick I, Norton D, Birstler J, et al. Association between dehydration and falls. Mayo Clin Proc Innov Qual Outcomes 2020;4:259–65. DOI: 10.1016/j.mayocpiqo.2020.01.003.
15. Wilson DL. Hydration and Older People in the UK Addressing the Problem, Understanding the Solutions. Parliamentary Hydration Forum, 2014.
16. Herrod PJJ, Awad S, Redfern A, et al. Hypo- and Hypernatraemia in surgical patients: is there room for improvement World J Surg 2010;34:495–9. DOI: 10.1007/s00268-009-0374-y.
17. Møller MH, Larsson HJ, Rosenstock S, et al. Quality-of-care initiative in patients treated surgically for perforated peptic ulcer. Br J Surg 2013;100:543–52. DOI: 10.1002/bjs.9028.
18. Tura AK, Aboul-Ela Y, Fage SG, et al. Introduction of criterion-based audit of postpartum hemorrhage in a University hospital in Eastern Ethiopia: implementation and considerations. Int J Environ Res Public Health 2020;17:9281. DOI: 10.3390/ijerph17249281.
19. Joslin J, Wilson H, Zubli D, et al. Recognition and management of acute kidney injury in hospitalised patients can be partially improved with the use of a care bundle. Clin Med 2015;15:431–6. DOI: 10.7861/clinmedicine.15-5-431.
20. Tattersall C. Nursing staff’s ability to gauge fluid intake. Nurs Times 2016;112:19–22. DOI: 10.1007/s41193-016-0199-7.
21. Walker GE, Stewart-Parker E, Chinthapalli S, et al. Intravenous fluid use in the acutely unwell adult medical inpatient: improving practice through a clinical audit process. J R Coll Physicians Edinb 2012;42:211–5. DOI: 10.4997/JRCPE.2012.304.
22. Trejnowska E, Skoczyński S, Armatowicz P, et al. The importance of fluid balance in critically ill patients: a retrospective observational study. Kardiol Pol 2019;77:1147–54. DOI: 10.33963/KP.14991.
23. Tang VCY, Lee EWY. Fluid balance chart: do we understand it Clinical Risk 2010;16:10–3. DOI: 10.1258/cr.2009.090005.
24. Benenson I, Waldron FA, Jadotte YT, et al. Risk factors for hypertensive crisis in adult patients: a systematic review. JBI Evid Synth 2021;19:1292–327. DOI: 10.11124/JBIES-20-00243.
25. Shepherd A. Measuring and managing fluid balance. Nurs Times 2011;107:12–6.
26. Vincent M, Mahendiran T. Improvement of fluid balance monitoring through education and rationalisation. BMJ Qual Improv Rep 2015;4:u209885.w4087. DOI: 10.1136/bmjquality.u209885.w4087.
27. Davies A, Srivastava S, Seligman W, et al. Prevention of acute kidney injury through accurate fluid balance monitoring. BMJ Open Qual 2017;6:e000006. DOI: 10.1136/bmjoq-2017-000006.
28. Polit DF, Beck CT. Nursing Research. Generating and Assessing Evidence for Nursing Practice (10th edn). Wolters Kluwer, 2017.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 International Journal of Computational and Experimental Science and Engineering
This work is licensed under a Creative Commons Attribution 4.0 International License.
