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Adult Nursing PracticeUsing evidence in care$
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Ian Bullock, Jill Macleod Clark, and Joanne Rycroft-Malone

Print publication date: 2012

Print ISBN-13: 9780199697410

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780199697410.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.date: 28 January 2022

Managing Hydration

Managing Hydration

(p.328) 19 Managing Hydration
Adult Nursing Practice

Debra Ugboma

Michelle Cowen

Oxford University Press

This chapter addresses the fundamental nursing role of managing hydration. Water is a basic nutrient and is essential to sustaining human life. In the developed world, we often take for granted the basic commodity of clean and plentiful water, but in other parts of the world water can have a profound effect on human health, in both the reduction and the transmission of disease (World Health Organization, 2011). For health, body water and electrolytes must be maintained within a limited range of tolerances. For nurses working in acute or primary care settings anywhere in the world, it is important to have a clear understanding of fluid and electrolyte homeostasis to assess haemodynamic status, to anticipate and recognize deterioration in status, and to implement appropriate corrective interventions. Developing knowledge and associated skills around this topic will be facilitated by reflecting upon your clinical experiences as a student or as a qualified nurse, and your ability to link theory and practice. Your basic foundation of knowledge should include an understanding of how fluid is gained and lost from the body, the distribution of water between different compartments within the body, the processes by which fluid and electrolytes move between the intracellular and extracellular environments (Pocock and Richards, 2009; Cowen and Ugboma, 2011), and knowledge of the different types of intravenous replacement fluid (Endacott et al., 2009: 249舑73). Equally important is an insight into the use of criteria such as clinical/outcome indicators and benchmarking, what to use on what occasions, and how to use such tools to your best advantage. Armed with this knowledge, you will be well equipped to assess each patient’s needs and to make clinical decisions about the most appropriate evidence-based nursing interventions to be used. The state of water balance within the body is principally maintained by the osmoreceptors in the hypothalamus. These are best described as ‘sensors’ that detect the osmolarity (concentration) of the blood to stimulate or suppress the thirst mechanism, as well as regulate the amount of antidiuretic hormone (ADH) released by the posterior pituitary gland. When a person is becoming dehydrated, the thirst centre will be stimulated and usually he or she will seek fluid to rehydrate him or herself.

Keywords:   action plans, angiotensin-converting enzyme, antidiuretic hormone, cardiac failure, drinking aids, hydration, overhydration, thirst mechanism

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