Etiology:

• Physiological causes, eg decreased fluid losses d/t kidney, liver, or cardiac failure; diminished water and sodium losses d/t changes in exercise or climate; SIADH
• Food and nutrition related knowledge deficit
• Psychological causes, eg depression or disordered eating

S/S:

• Lowered plasma osmolality (270-289 mOsm/kg), only if positive fluid balance is in excess of positive salt balance
• Decreased serum sodium in SIADH
• Weight gain
• Edema in the skin of the legs, sacral area, or diffusely; weeping of fluids from lower legs
• Ascites
• Pulmonary edema as evidenced by shortness of breath; orthopnea; crackles or rales
• Reports or observations of:
• Fluid intake in excess of recommended intake
• Excessive salt intake
• Conditions associated with diagnosis or treatment, eg end stage renal disease, nephritic syndrome, heart failure, or liver disease
• N/V, anorexia, headache, muscle spasms, convulsions, coma (SIADH)
• Shortness of breath or dyspnea with exertion or at rest
• Providing medications in large amounts of fluid
• Use of drugs that impair fluid excretion