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Download Peritoneal Dialysis Fluid Balance Assessment Table:
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Peritoneal Dialysis Fluid Balance Assessment Table: FLUID VOLUME EXCESS Designed to provide prompts for patient assessment FLUID VOLUME DEFICIT SIGNS & SYMPTOMS may be above target weight Shortness of breath SIGNS & SYMPTOMS low blood pressure pulse weakness dizziness fatigue muscle cramps poor skin turgor may be below goal weight thirst blurred vision ASSESSMENT QUESTIONS: Dizziness have you taken your BP meds any nausea and vomiting, diarrhea what is your blood sugar (diabetic) last bag selections over past 24 hours BP : lying / upon standing / sitting / 1st thing in the morning – other conditions at same time: time of day out in heat perspiring food and fluid intake changes pulse Cramps location time of day when ie after certain activity how resolved SIGNS & SYMPTOMS blood pressure within normal range for individual no postural drop related to fluid volume normal nonlabored respirations lung fields clear to auscultation good skin turgor minimal to edema free state mucus membranes moist ASSESSMENT QUESTIONS: higher than usual blood pressure (note: BP may be variable with cardiac patients) shortness of breath crackles and wheezing in lungs c/o headache edema (facial, eye, fingers, sacral region, legs, ankles or feet) do you lie flat when sleeping how many pillows do you use other co-morbid conditions i.e. COPD , smoker, low Hgb, allergies, respiratory infections Edema how long have you had this edema? are you being treated for peritonitis / is your effluent clear? / is fibrin present? has your eating pattern changed? Skin presence of: - weeping tissues - shiny taut with edema Thirst change in fluid /eating intake increased thirst recent intake of salty foods alcohol intake presence of fever query diabetes Constipation when was your last bowel movement? any problems draining? Skin presence of: - dryness - poor skin turgor - dry mucus membranes Other: pattern of bag selection Other: pattern of bag selection Home Dialysis Interest Group (HDIG) – PD Intended as healthcare team material Reviewed – June 2012
