READINESS FOR ENHANCED
A pattern of equilibrium between ﬂuid volume and chemical compo-
sition of body ﬂuids that is sufﬁcient for meeting physical needs and
can be strengthened
• Verbalization of willingness to enhance ﬂuid balance
• Stable weight
• Moist mucous membranes
• Food and ﬂuid intake adequate for daily needs
• Straw-colored urine with speciﬁc gravity within normal limits
• Good tissue turgor
• No excessive thirst
• Urine output appropriate for intake
• No evidence of edema or dehydration
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Fluid and electrolytes
• Cardiac function
• Respiratory function
The patient will
• Have stable vital signs within normal ranges; electrocardiograph
shows no abnormality in rhythm.
• Have normal skin temperature, moistness, turgor, and color.
• Have moist and noncracked mucous membranes.
• Have stable weight.
• Have adequate ﬂuid volume intake and thirst satiety.
• Produce adequate urine volume (approximately equal to ﬂuid
intake) of light to straw-colored urine.
• Maintain a urine speciﬁc gravity between 1.015 and 1.025.
• Have normal values for plasma and serum for electrolytes, osmo-
larity, glucose, blood urea nitrogen, hematocrit (HCT), and hemo-
• Be alert and respond to demands of living; react appropriately to
reﬂex needs (i.e., thirst); have normal muscle reﬂexes, strength,
• Express understanding of factors that contribute to normal ﬂuid
and electrolyte balance.
• Adhere to prescribed therapies to manage such coexisting disease
SUGGESTED NOC OUTCOMES
Fluid Balance; Hydration; Nutritional Status: Food & Fluid Intake;
Tissue Integrity: Skin & Mucous Membranes; Vital Signs
INTERVENTIONS AND RATIONALES
Determine: Assess usual ﬂuid intake and desire to improve ﬂuid sta-
tus to establish a baseline.
Inform: Teach patient to read and interpret labels on beverage and
food containers. For example, humans require 0.5 g (500 mg) of
sodium per day; typical intake is 5–6 g daily. Reducing the amount
of sodium reduces the amount of ﬂuid volume in the vascular
Encourage adequate water intake (1,200–2,000 ml) during
exercise or high environmental temperatures; unmeasured ﬂuid losses
through diaphoresis and lung evaporation can be signiﬁcant.
Teach signs and symptoms of dehydration (dry mouth and
mucous membranes), light-headedness (blood pressure and vital sign
changes), scant urine output (glycosuria and polyuria), and over-
hydration (cough, increased weight gain, dependent edema, and
jugular vein distention). Teaching prevents severe complications.
Attend: Encourage patient to select healthy beverages such as water
and limit beverages such as soda or sports drinks that have high
sugar content (which increase the osmolar content of the body, caus-
ing greater thirst and increased load on the renal system and diuresis)
and caffeine (which causes diuresis and may cause an increased ﬂuid
loss), alcoholic beverages during hot weather because these can
cause ﬂuid and electrolyte disturbances through excess diuresis.
SUGGESTED NIC INTERVENTIONS
Electrolyte Management; Fluid/Electrolyte Management; Fluid Man-
agement; Fluid Monitoring
Mentes, J. (2006, June). Oral hydration in older adults: Greater awareness is
needed in preventing, recognizing, and treating dehydration. American Journal
of Nursing, 106(6), 40–49.