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Abstract
To stablish a middle range theory for the understanding of the causal mechanisms and clinical consequentes of the nursing diagnosis Excess Fluid Volume (00026) among pregnant women. The Middle Range Theory was constructed in five stages: defining of construction approach, establishing main concepts, elaborating propositions, developing a pictorial diagram, and establishing the causal relationships and evidence for practice of the Middle Range Theory. We identified 14 clinical indicators and 6 causal factors of Excess Fluid Volume. A pictorial diagram was developed and relationships between Excess Fluid Volume elements were established with 6 propositions for them. The Middle Range Theory included both physiological and pathological conditions to explain Excess Fluid Volume. This Middle Range Theory might help in the better understanding of interactions between causal factors and clinical indicators of Excess Fluid Volume.
Highlights
The nursing diagnosis (ND) Excess fluid volume (EFV) (00026) is defined as the excessive fluid intake and/or fluid retention
The articles selected to provide the information required to the development of the Middle Range Theory, its authors, years of publication and study design are described on Chart 2
The present study identified, through integrative review, the following causal factors for EFV: chronic diseases, extremes of reproductive age, primiparity, excessive sodium intake, hormonal changes, mechanic factor and vascular alterations related to gestational pathologies
Summary
The nursing diagnosis (ND) Excess fluid volume (EFV) (00026) is defined as the excessive fluid intake and/or fluid retention. It was incorporated to NANDA-I taxonomy in 1982 and revised in the years of 1996, 2013 and 2017. It belongs to the domain Nutrition and the class Hydration in the version 2018-2020 of NANDA-I and, in the latest review, this ND has level of evidence of 2.1.(1). EFV might appear both in physiological conditions – pregnancy – as pathological conditions – cirrhosis, congestive heart failure, chronic renal failure. Special mechanisms for ions transport, through cell membranes, keep the difference of ionic concentration between the extracellular and intracellular fluids(2). Effective intravascular volume is equivalent to the arterial system intravascular volume, it is responsible for tissue infusion and aortic arch, carotid sinus and kidney baroreceptors stimulation(2)
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