Fluid Excess/Intoxication
Original Editors - Jordan Benock & Riley Benock from Bellarmine University's Pathophysiology of Complex Patient Problems project.
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Definition/Description
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Fluid excess can occur in two main ways in the body, water intoxication and edema. [1]
Water Intoxication - The result of an excess of extracellular water without having an excess of solutes. Due to this imbalance, the extracellular fluid (ECF) becomes diluted causing water to move into cells to equalize solute concentration on each side of the cell. Hyponatremia, a potentially lethal situation, may occur if high volumes of water are comsumed without solute replacement.
Edema - The excess of both solutes and water, which is also termed isotonic volume excess. The additional fluid is retained in the extracellular compartment resulting in fluid accumulation in the interstitial spaces.
Prevalence[edit | edit source]
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Characteristics/Clinical Presentation[edit | edit source]
Water Intoxication Clinical S&S:
- Decreased mental alertness
- Sleepiness
- Anorexia
- Poor motor coordination
- Confusion
In severe imbalances:
- Convulsions
- Sudden weight gain
- Hyperventilation
- Warm, moist skin
- Signs of increased intracerebral pressure
- Slow pulse
- Increased SBP (more than 10 mm Hg)
- Decreased DBP (more than 10 mm Hg)
- Mild peripheral edema
- Low serum sodium
- Low hematocrit
Edema Clinical S&S:
- Weight gain (primary symptom)
- Excess fluid
- Dependent edema (accumulation of fluid in lower parts of the body)
- Pitting edema
- Increased blood pressure
- Neck vein engorgement
- Effusions (pulmonary, pericardial, peritoneal)
- CHF
Associated Co-morbidities[edit | edit source]
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Medications[edit | edit source]
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Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Etiology/Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Case Reports/ Case Studies[edit | edit source]
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Resources
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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- ↑ Goodman CC, Snyder TEK. Differential diagnosis for physical therapists: screening for referral. 5th ed. St. Louis: Elsevier Saunders, 2013.
- ↑ University of Maryland Medical Center. Lower Leg Edema. http://www.umm.edu/graphics/images/en/8857.jpg (accessed 20 March 2013).
