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# Fluid imbalance:- In a patient occurs when there is loss of fluid from the body or reduced intake. # Causes of fluid imbalance: Diarrhea, vomiting,severe blood loss. # Signs and symptoms of fluid imbalance: • General symptoms: • Fatigue • dry mouth • dry mucosa • excessive thirst • Muscle cramps • weakness • nausea, vomiting, headache. # Vitals • Weak thready pulse • Tachycardia • low blood pressure • Loss of skin turgor # CNS symptoms: • confusion • irritability

# Treatment: • Patient should be treated with fluid replacement therapy, the route of replacement of fluid will be based on patients condition for example: if he able to tolerate oral fluids or not if able then oral fluids can be given. #Routes of administration of fluids in patient: • There are four routes of administration in patient with fluid imbalance: 1) Oral 2) subcutaneous 3) intravenous 4) intraperitoneal 5) intramedullary 6) rectal • Fluid replacement is done in two phases 1st phase- Rehydration phase 2nd phase - Maintainance phase

1)Oral administration:- oral administration of fluids is considered in patients who are able to tolerate oral feeds or is done by placing orogastric tube. • Factors that must be considered for oral administration are : Severity of dehydration, Availability of technician for placement of orogastric tube. Contraindicated in patients with vomiting. • Advantages: It is the easy and relatively safe administration of fluids. This route is usually considered in mild dehydration where only small or normal fluid intake is necessary. 2) Subcutaneous route: This route is preferred when patient is suffering from mild dehydration or when IV line is not accessable. • Points to keep in consideration:- when we administer fluids via subcutaneous route isotonic fluids must be used like normal saline and must not be administered more than 10ml / kg at each site. • The fluids must be brought to body temperature before administration. • Fluid absorption via this route will take up to 6 to 8 hours hence not preferred in case of severe fluid imbalance. • Disadvantage:-multiple sites are required inorder to replace adequate volumes. Fluids like dextrose cannot be used via this route so cannot be used to correct hypoglycemia.

3) Intravenous administration:- This route is the most preferred route in patients with moderate to severe dehydration. Peripheral venous sites are the ones which are used to administer. • Points to keep consideration: Aseptic measures should be taken into consideration. IV site must be checked for any swelling or pain. IV site must be changed every three days. • Advantages: All kinds of fluids can be administered via this route hence for used to correct hypovolemia, hypoglycemia and electrolyte imbalance  Causes of Fluid Imbalance Patients Essay Example

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Disadvantage: Thrombophlebitis, in case of severe dehydration peripheral venous sites are not accessible, then other routes are preferred. 4) Intraperitoneal route:- Administration of fluids via this route is easy and quick and are absorbed quickly. Disadvantage: Peritonitis, abdominal abscess, puncturing of abdominal organs. 5) Intramedullary Route:- also known as intra osseous route. • Sites which are suitable for this are greater tubercula of numerus and proximal tibia and anterior aspect of femur. • Here the fluids are directly injected into marrow of the bone. • This route is preferred when intravenous route is not available. • It is used in cases of severe dehydration, cardiac shock. •Contraindications : osteomyelitis •Points to keep into consideration: The intra osseous route must not be used for more than 24 hours and should be removed as soon as IV route is available., As use of intra osseous route for more than 24 hours leads to osteomyelitis. •Complications : osteomyelitis and compartment syndrome. 6) Rectal route : This route of administration is used in cases of fluid resuscitation in hypovolemic shock, it is non invasive easy method for replacement of fluids in cases of shock where Intravenous route is not accessible.

Final answer:- #Routes of administration of fluids in patient: • There are four routes of administration in patient with fluid imbalance: 1) Oral 2) subcutaneous 3) intravenous 4) intraperitoneal 5) intramedullary 6) rectal • Fluid replacement is done in two phases 1st phase- Rehydration phase 2nd phase - Maintenance phase 1)Oral administration:- oral administration of fluids is considered in patients who are able to tolerate oral feeds or is done by placing orogastric tube. 2) Subcutaneous route: This route is preferred when patient is suffering from mild dehydration or when IV line is not accessible. 3) Intravenous administration:- This route is the most preferred route in patients with moderate to severe dehydration. Peripheral venous sites are the ones which are used to administer. 4) Intraperitoneal route:- Administration of fluids via this route is easy and quick and are absorbed quickly. 5) Intramedullary Route:- also known as intra osseous route. • Sites which are suitable for this are greater tubercula of numerus and proximal tibia and anterior aspect of femur. 6) Rectal route : This route of administration is used in cases of fluid resuscitation in hypovolemic shock, it is non invasive easy method for replacement of fluids in cases of shock where Intravenous route is not accessible.  Causes of Fluid Imbalance Patients Essay Example