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Fluid and electrolytes
Terms in this set (54)
What is fluid volume excess?
Too much fluid in the vascular space
What is another term for fluid volume excess?
How can heart failure cause hypervolemia (or fluid volume excess)?
The heart being weak = decreased cardiac output which means the kidneys aren't being perfused well. Decreased perfusion leads to a decreased urinary output. Fluid then stays in the vascular space
How can renal failure cause fluid volume excess?
If the kidneys are not working then the fluid will be retained in the vascular space
How can IV fluids with sodium induce hypervolemia?
Because sodium causes retention of water
Alka-seltzer and fleet enema all contain what?
How can alka-seltzer and fleet enema cause hypervolemia?
Since they both have lots of sodium, causes retention of fluid in the vascular space
What is the normal action of aldosterone?
Aldossterone causes retention of sodium and water in the vascular space
How can aldosterone cause hypervolemia?
Too much aldosterone causes retention of sodium and water in the vascular space
What is the name of the disease a client can have that will induce hypervolemia due to too much aldosterone?
What hormone works opposite of aldosterone?
How does ANP correct FVE?
ANP works opposite of aldosterone, so it causes the excretion of sodium and water
What is the normal action of ADH, and what does ADH stand for?
Anti-diuretic hormone, causes the retention of water in the cascular space
How can ADH cause hypervolemia?
Too much ADH causes retention of too much in the vascular space (SIADH)
Where is ADH stored?
What will the effects be on the body if a client is producing too much ADH? What is the name of this disease?
Too much ADH causes too much retention of too much water... SIADH
What will be the effects be on the body if the client does not have enough ADH? What is the name of the disease?
Diabetes insipidus. Diureses - shock (losing water)
What happens to the veins of the client who is hypervolemic?
They distend (full)
Why does the hypervolemic client develop edema?
The vascular space gets full and cannot hold anymore, and the fluid eventually leaks into the tissue
Define CVP. Where is it measured?
Central venous pressure. Known as right atrial pressure. It reflects the amount of blood returning to the heart and the ability of the heart to pump the blood to the arterial system. Measured at the right atrium of the heart.
What is the normal CVP?
2 - 6 mmhg (if measured by monitor)
If a client is hypervolemic, what will happen to the cvp?
increase (more volume = more pressure)
If a client is hypovolemic, what will happen to the cvp?
Decrease (less volume = less pressure)
If a client is hypervolemic, what are the lung sounds like and why?
Wet. SOB can occur; fluid in the lungs
Why does the client who is hypervolemic develop polyuria?
Kidneys are trying to compensate by getting rid of the fluid
What happens to the blood pressure and pulse with hypervolemia? explain why
Blood pressure increases because there is so much volume, the pulse increases, heart is trying to pump faster and harder to keep the blood moving forward; we would rather the blood go forward instead of backwards into the lungs.
What happens to the weight in hypervolemia? why?
Increases - excess fluid makes weight increase rapidly
What type of diet is prescribed for hypervolemic client? explain why?
Sodium restricted to decrease fluid retention
If a hypervolemic client is placed on a high sodium diet, what would happen?
The client will retain more fluid and the condition would worsen.
Why would you do a daily weight on the hypervolemic client?
Daily weight is the best evaluator of fluid volume status.
Explain why diuretics are given to the hypervolemic client
Because the client has too much volume, and needs to diurese.
What major electrolyte imbalance are you worried about with lasix?
what major electrolyte imbalance to watch for with thiazide diuretics?
What major electrolyte imbalance to watch for with aldactone?
How does bedrest cause diuresis?
When you lie supine, blood pressure moves from the lower extremities to the thorax and to the heart. This increases preload, stretches the atria, and the ANP is released. ANP causes loss of sodium and water. On bedrest ADH release decreases
Why is it so important to give IV fluids very slowly to the elderly?
Kidneys and hearts may be weak. The heart may not be able to pump the excess forward, and the kidneys may have problems excreting the excess.
What is another name for fluid volume deficit?
Define fluid volume deficit
loss of water from vascular space equally
how can GI losses affect your vascular space?
Excessive GI loss can reduce the volume in the vascular space (anytime you lose fluid from year body, no matter where it comes from, the vascular space can eventually be depleted.
What is third spacing?
Fluid leaves the vascular space and goes somewhere where it does you no good (tissue and abdomen)
How can ascites induce hypovolemia?
Fluid leaves vascular space and goes out into the abdomen; therefore vascular volume goes down
How can burns induce hypovolemia
Fluid leaves the vascular space and goes to the tissue (edema occurs) or out of the body completely
Why will the diabetic client develop polyuria?
Because they are trying to get rid of the particles (excess glucose particles) in the vascular space. The glucose has to go out in volume (with fluid). You have never excreted a sugar particle!
The person with polyuria will eventually develop what life threatening complication?
What changes will you see in the urine output that will indicate the body is compensating?
Turns shocky, will produce less urine
Kidneys may retain what fluid is left, decreasing the urine output.
Urine output may switch to oliguria and could possibly go all the way to anuria, if either of these occur we would worry about renal failure
how does hypovolemia affect the weight?
decrease because there is less volume
During hypovolemia, what happens to the blood pressure and pulse and why?
Blood pressure decreases. Less volume , less pressures. The pulse increases, but it is weak and thready. The pulse increases because your heart is trying to pump what little fluid you have around the bod to perfuse vital organs.
During hypovolemia, what happens to the cvp?
decrease - less volume = less pressure
during hypovolemia, what happens to the veins?
They get small because there is not much volume to distend them
Why do the extremeties of a client who is hypovolemic become cool?
Peripheral vasocontriction helps shunt blood to vital organs when you vasoconstrict peripherally, skin gets cool
Whats happens to urine specific gravity if a client is hypovolemic?
Urine specific gravity increases. They kidneys will not be putting too much urine so what little urine is excreted and will be very concentrated
What is the treatment for mild fluid volume deficit?
Increase po fluids
What is the treatment for severe FVD?
What safety precautions are needed for the FVD client and why?
FVD = less volume, less pressure. So safety with position changes and ambulation because of orthstatic hypotension
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