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The next patient is a 67 year old female, Helen Webb, who presents with a chief...

The next patient is a 67 year old female, Helen Webb, who presents with a chief complaint: “I can’t sleep at night---I can’t lie down, I get so out of breath.” She is sitting in high Fowler’s position on the exam table.  She has a history of heart problems.  She is diagnosed with acute exacerbation of congestive heart failure, and you identify a nursing diagnosis of Fluid Volume Excess (FVE).  

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Fluid volume excess in Congestive Heart Failure patients is due to failure in the regulation of sodium balance in the body.When heart starts to fail renal perfusion also fails which makes kidneys respond only to the production of renin which further leads to the production of excessive aldosterone thus results in water and sodium retention.

Fluid volume excess related to congestive heart failure as evidenced by difficulty in breathing.

Fluid volume excess related to sodium retention as evidenced by insomnia.

Fluid retention related to congestive heart failure as evidenced by inability to perform normal activities.

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