Topic 10 : Fluid and Electrolytes Imbalances Collaboration Care and Nursing Management Using The Nursing Process

1. Water (Fluid) Retention: Causes, Symptoms, Treatment for Edema

What causes excessive fluid in the body?

Fluid overload is also called hypervolemia. It's when you have too much fluid in your body. It can be caused by several different conditions including heart failure, kidney failure, cirrhosis, or pregnant

Water retention, called “edema”, refers to excess fluid that is improperly stored in the muscles and other organs of the body. The main causes of water retention are a sodium-heavy diet and lifestyles in which sitting and standing for many hours. The main symptom of water retention is the swelling of extremities and puffiness in the abdomen and face. Treatment for water retention is lifestyle changes, like increasing movement and altering diet.

Edema is caused by nutrient deficiencies and imbalances, with vitamin A, vitamin C, vitamin B-6, magnesium, and zinc being common vitamins and minerals that have an effect on symptoms. , edema is affected by behavioural habits; the way a person physically moves and exercises and how they massage their muscles has a significant impact on the presence or severity of the disease

1.1. Symptoms of Water Retention

Generalized edema-Swelling.
Particularly in the fingers, , ankles, feet, toes and lower legs that is due to fluid retention.

Bloating.
Particularly in the stomach and abdomen.

Puffiness.
The cheeks, eyes, or entire face may be puffy in appearance and to the touch because of water retention.

Stiffness and muscle pain.
Water retention often makes the affected body parts feel stiffer, and it may become painful to move the affected areas.

Fatigue and lethargy.
The excess water from edema may cause significant fatigue and lethargy, as the muscles become heavier and more sensitive.

Crackles in the lungs upon auscultation Dyspnea

Orthopnea Cough

Weight gain

Headache

1.2. Causes of Water Retention

The causes of water retention include numerous diseases plus some lifestyle issues.

Too much salt in my diet.
Excess salt in the body disrupts the body’s water balance and can result in fluid storage in the muscles.

Certain medications.
Hormonal medications, diabetic medications, and many other types of prescription medications may affect fluid retention and cause edema.

Kidney disease.
Improper functioning of the liver can cause fluid build-up, including from diseases like glomerulonephritis and nephrotic syndrome.

Lack of movement.
Sitting too long can make it harder for the blood to circulate from the legs back up to the heart.

Cancer.
Malignant tumours on the muscles and lymph nodes can cause edema.

Heart failure.
If the heart is not able to pump blood as normal it will try to make up for the poor circulation by increasing the amount of blood it is circulating through the body. This causes the liver, body cavities, and legs among other locations to swell.

Chronic lung disease.
When fluid builds up in the lungs, it is called pulmonary edema. There is a circular effect from emphysema (damaged air sacs in the lungs) causing shortness of breath that causes the heart to pump harder, which then creates pressure from blood vessels that pushes fluid into the lungs and makes breathing even more difficult.

Liver disease.
Liver disease such as cirrhosis makes it more difficult for the organ to function, slowing blood flow. This causes increased pressure in the veins which can lead to fluid build-up in the legs.

Malignant lymphoedema.
If cancer cells cause blockages in the lymphatic system, lymph fluid can back up in the body.

Hormonal changes.
Hormones are responsible for maintaining balance in the body, and so if there are disruptions to one’s hormones or a condition in the thyroid (the gland that produces many hormones), hydration levels may be affected and water retention is more likely to occur.

Thyroid disease.
Severe cases of hypothyroidism are called myxedema and can have numerous serious symptoms including major fluid retention and swelling, particularly in the legs and face. Premenstrual syndrome (PMS). Hormonal changes surrounding PMS impact how fluid is stored in the body and can cause swelling.

Arthritis.
The affected joints from arthritis will often swell with water, which often makes moving the affected joints even more difficult and painful.

Allergic reaction.
An allergic reaction is an underlying reason behind some people’s edema. A major allergic reaction often causes immediate inflammation and bloating, but smaller allergies may cause milder but still noticeable swelling and edema.

Autoimmune diseases such as lupus.
Lupus prevents the kidneys from functioning properly, leading to fluid build-up that can cause water retention and swelling.

Substantial changes in air pressure.
Air pressure affects how the body stores water, so plane rides may be one reason for water retention.