Question

what is a priority intervention for a patient diagnosed with excess fluid volume related to increase preload?

im assuming maybe limit fluids and administer a dierutic ?

Answer 1

The priority intervention for a patient diagnosed with excess fluid volume related to increasing preload are:

1. Restrict fluid intake to less than 1 litre per day.
2. Maintain strict input and output chart. ( Urinary catheter insertion if required).
3. Give the patient a propped up position. This allows fluid to gravitate into the lower limbs and reduces the preload and reduce the fluid in the lungs. This makes it easy for the patient to breath.
4. The patient may require supplemental oxygen or non invasive ventilatory support. This will help to reduce the respiratory effort. The patient may have pulmonary edema. Non invasive ventilatory support helps to thin out the edema fluid present in the alveoli. This improves oxygenation.
5. The patient should be started on diuretics. This will reduce the preload. This reduces the pressure on the heart and lung.
6. The patient's jugular venous pressure should be monitored. If a central line is present insitu, then central venous pressure should be monitored.
7. The patient's blood pressure should be monitored as diuretics can lead to hypotension.
8. The patient's weight, abdominal circumference and level of edema should be monitored daily. This gives an idea about the level of water retention.
9. Provide the patient with anti-embolic stock to prevent thormbosis in the deep veins of the lower limbs. If the thrombosis develops in the deep veins of the lower limbs, it can embolize into the lung and give rise to pumonary thromboembolism. This can be life-threatening.
10. Mobilize the patient as early as possible.