Third-space fluid shift in elderly patients undergoing gastrointestinal surgery Part II: Nursing assessment

Abstract

Third-space fluid shift is the mobilisation of body fluid to a non-contributory space rendering it unavailable to the circulatory system. It is a recurrent clinical phenomenon requiring swift identification to minimise deleterious effects. Nurses experience difficulties however in its early identification, diagnosis and subsequent treatment because of the lack of consensual and consistent information regarding third-spacing. This article, part II, building on the previous article, explores the clinical validly and reliability of signs and symptoms of both phases of third-space fluid shift. In addition it reinforces the use multiple patient assessment cues if nurses are to differentiate between, and accurately respond to, the various causes of both hypovolaemia and hypervolaemia. It assists nurses to increase their knowledge and understanding of third-space fluid shift in patients undergoing gastrointestinal surgery.

Key Words:

• third-space fluid shift
• elderly patients
• gastrointestinal surgery
• clinical reasoning
• proactive care