Nursing assessment of fluid balance requires close monitoring and recording of a patient’s fluid intake and output.

Nursing assessment of fluid balance is vital in determining fluid status and electrolyte balance. Measures can be taken to intervene to correct an imbalance either through fluid therapy, if there is a deficit, or diuretics in the case of fluid overload.

It is a nurse’s responsibility to ensure that patients are assessed on a continual basis to ensure that their hydration needs are met. Fluid imbalance can arise from a number of causes and can have detrimental effects on body function. Nurses, therefore, need to have a sound understanding of pathophysiological principles of hypovolaemia, normovolemia, hypervolaemia and fluid shifting.

A working knowledge of the different fluid types is also essential to avoid potential complications and adverse reactions. It is also important to note that all patients receiving IV therapy, through a peripheral IV site, are at risk of developing associated complications. This highlights the need for nurses to regularly assess IV sites to ensure early detection and management of problems.

Fluid Balance in the Emergency Department

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External Websites

A Balancing Act: Maintaining accurate fluid balance charting
Fluid balance charting is not a new practice based issue in nursing. Evidence reveals that fluid balance charts have been poorly and inaccurately maintained since 1985 (Chung et al, 2002; Scales & Pilsworth, 2008).
https://healthtimes.com.au/hub/nutrition-and-hydration/42/practice/nc1/a-balancing-act-maintaining-accurate-fluid-balance-charting/2167/

Fluid Balance
Daily fluid balance is the daily sum of all intakes and outputs, and the cumulative fluid balance is the sum total of fluid accumulation over a set period of time
https://lifeinthefastlane.com/ccc/fluid-balance/

Fluids Management – Theory and Practice
Deciding on the correct IV fluid management for hospital patients is something that junior doctors are faced with on a daily basis.
http://fluidstutorial.com/index.html

Everything you need to know about electrolytes
An electrolyte is a substance that conducts electricity when dissolved in water. They are essential for a number of bodily functions.
https://www.medicalnewstoday.com/articles/153188.php

Electrolyte Imbalance + Normal Ranges and Disturbances for Common Electrolytes
Electrolyte imbalances can occur due to hundreds of factors, none of which line up in neat, tidy queues.
https://www.ausmed.com/articles/normal-electrolyte-levels/

Research Articles

Bontant, T., Matrot, B., Abdoul, H., Aizenfisz, S., Naudin, J., Jones, P., & Dauger, S. (2015). Assessing fluid balance in critically ill paediatric patients. European Journal of Paediatrics, 174(1), 133-137. doi:10.1007/s00431-014-2372-9

Crawford, D. (2018). Understanding fluid homeostasis in infants and children: part 1. Nursing Children & Young People, 30(1), 39-46. doi:10.7748/ncyp.2018.e947

Georgiades, D. (2016). A balancing act: maintaining accurate fluid balance charting. Australian Nursing & Midwifery Journal, 24(6), 28-31.

Gooch, M. D. (2015). Identifying acid-base and electroylyte imbalances. Nurse Practitioner, 40(8), 37-42. doi:10.1097/01.NPR.0000469255.98119.82

Gross, W., Samarin, M., & Kimmons, L. A. (2017). Choice of Fluids for Resuscitation of the Critically Ill: What Nurses Need to Know. Critical Care Nursing Quarterly, 40(4), 309-322. doi:10.1097/CNQ.0000000000000170

Kear, T. M. (2017). Fluid and electrolyte management across the age continuum. Nephrology Nursing Journal, 44(6), 491-497.

McGloin, S. (2015). The ins and outs of fluid balance in the acutely ill patient. British Journal of Nursing, 24(1), 14-18. doi:10.12968/bjon.2015.24.1.14

Nazli, A., Brigham-Chan, F., Fernandes, M., & Anjum, A. (2016). Adequacy of fluid balance chart documentation on wards. Clinical Medicine, 16, s21-s21. doi:10.7861/clinmedicine.16-3-s21