Hydration and fluid balance
Water is involved in every bodily function, for example circulation, digestion and elimination, regulation of body temperature. Effective fluid management relies on accurate assessment of the patient, which includes fluid balance. Fluid and electrolyte homeostasis is maintained by the cardiovascular, renal, respiratory and gastrointestinal systems, the skin and the brain. In illness, where cardiac volume is insufficient, there is renal impairment, and selective reabsorption takes place. Loss or gain of relatively small amounts of fluid and electrolytes can influence a delicate balance in an unstable patient. Through careful monitoring of the patient’s fluid status using the skills of assessment, including an accurate fluid-balance recording, nurses are in a key position to predict, recognise and initiate prompt action in relation to issues of fluid imbalance.