Hypervolemia or fluid overload is a condition in which there is too much fluid in the blood. This can throw off the body's chemical balance, increasing sodium levels. Hypervolemia often resolves on its own, but it is usually a sign of an underlying health issue. Some of the most common symptoms of hypervolemia include unexplained or rapid weight gain, shortness of breath, or swelling in the abdomen, arms, hands, ankles, and legs. A person with hypervolemia may have an irritated cough, distended jugular vein, or rapid pulse. There are many causes of hypervolemia.
Congestive heart failure occurs when the heart muscles lose their full pumping power. In this state, the heart cannot pump enough blood to make the body function at its best. Ultimately, the other organs may begin to malfunction. For example, the kidneys stop working as they should and create excess fluid. Hypervolemia is common in people who have chronic heart failure. It also never goes away completely, even if doctors are treating it.
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People who have kidney problems are at serious risk for hypervolemia. Their kidneys stop regulating the amount of sodium and fluid and those who have been hospitalized must be carefully monitored because these abnormal levels lead to bowel problems and poor wound healing, as well as congestive heart failure. One study suggests people who have hypervolemia caused by heart failure or end-stage kidney disease may also develop sleep apnea.
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Cirrhosis is a late-stage scarring condition of the liver triggered by diseases like hepatitis and chronic alcoholism. A liver with cirrhosis cannot properly detoxify the body or clean the blood. When the liver can no longer store and process nutrients or filter out toxins, this often leads to fluid retention in the abdominal area, hands, and feet. Hypervolemia is often inevitable.
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When patients receive intravenous fluids, it is often to prevent or reverse the effects of dehydration. This is especially true following surgery when patients are too weak or incapacitated to drink. Most IV fluids contain sodium and water to re-hydrate the body and balance sodium levels. In many cases, this is a life-saving therapy, although too much IV fluid can cause hypervolemia. The risk is much higher if there are other health conditions.
Women who go through premenstrual syndrome (PMS) and pregnancy sometimes retain more sodium and water. This creates some of the bloating, swelling, and discomfort many describe while they are expecting a child or menstruating. In pregnant women, this may be a sign of high blood pressure, but it can also lead to hypervolemia.
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Preeclampsia is a serious condition. Often, a women experiencing this condition has high blood pressure and some damage to the kidneys or liver. Many women, even those with normal blood pressure otherwise, begin to see signs of preeclampsia in the 20th week of pregnancy. If untreated, preeclampsia can be fatal for both mother and child. Women experience severe headaches, changes in vision, excess protein in the urine, upper abdominal pain, nausea and vomiting, and decreased urine frequency. Often, the best way to treat it is to deliver the baby, even if the mother has not carried the baby to term. This condition develops without any warning symptoms and can become hypervolemia as it progresses.
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Medications can change the chemical balance in the body, and this is a prime opportunity for excess fluid or high sodium in the blood. Hormonal medicines are especially problematic, but antidepressants, anti-inflammatory drugs, birth control pills, and blood pressure medications also trigger these issues.
According to the American Heart Association, the average American takes in 3,400 mg of sodium per day. The recommended amount is only 2,300 mg. This means that most people retain too much water based solely on their sodium intake. This causes bloating and mild hypervolemia. People who have congestive heart failure, liver problems, or kidney diseases are often on low-salt diets to curb the risk of hypervolemia.
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The first 24 hours after a blood transfusion are critical. This period can determine the success of a procedure and the need for additional measures. This is also the time when doctors monitor for acute transfusion reactions. Patients can show signs of fever, chills, severe itching, or skin welts. In many cases, these symptoms resolve on their own without additional treatment. However, any of these signs could indicate excessive fluid levels. In extreme cases, patients experience severe shortness of breath, high fevers, loss of consciousness or blood in their urine.
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In postoperative environments, healthcare practitioners have to constantly monitor both the patient's changing status and the medical environment following surgery. Not only are the amounts of fluids important, but the type of fluids and the timing of administering them is also crucial. The main goal is to make sure there are enough fluids to resuscitate tissues without hurting the patient. Any inaccurate dosage or failure to monitor changes in the patient's condition may result in hypervolemia.
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