Term
| During studying, be sure to thing of how you would... |
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Definition
| assess, monitor, and teach |
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Term
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Definition
Balance.
Movement of water in the body is continuous in order to achieve homeostasis |
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Definition
The Patient
(Amount of Body water)
Varies with age, body mass and gender |
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Lean (More body water)
The muscle has more water contained in it |
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Definition
Male has more water.
More lean muscle. |
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Term
| Who is most at risk for fluid\electrolyte imbalances. |
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Definition
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Term
| Balance depends on other factors |
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Definition
I's and O's-intake-ingested (liquid, food), Parenteral (IV Fluids)
Output (Sensible and Insensible) |
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Definition
| Can sometimes be measured and we can see it. |
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Definition
| Cannot see our body losing fluid-not visible respiration respiration vapors. |
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Definition
| Breaking down the food you eat |
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| Will output and intake always be equal? |
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Definition
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| Balance is also affected by |
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Definition
| regulatory glands and hormones |
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Definition
Aldosterone (mineral corticoid)
Glucocorticoids |
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Definition
| Causes body to reabsorb water and sodium\excretion of potassium. |
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| What happens when you give someone a steroid? |
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Definition
| They retain fluids\may result in Edema |
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Term
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Definition
| Antidiurectic Hormone (ADH) |
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Definition
| prevents diuresis, retains fluid |
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Term
| Reasons to retain fluid (the body) |
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Definition
Low sodium
Surgery
Trauma
Burns
People in Pain
NPO
Blood Loss |
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Definition
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| Thyroxine (what does it do to hb, blood flow, output) |
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Definition
| affects the metabolic rate. Increases HB, blood flow, and output |
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Term
| Look at stress signals chart (page 4 in first section of notes!) |
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Definition
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Term
| Two special problems of ADH (Diseases of the pituitary gland) |
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Definition
Diabetes insipidus (ADH deficiency)
Syndrome of inappropriate antidiuretic hormone (SIADH) |
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Term
| Not holding onto enough fluids |
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Definition
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Term
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Definition
ADH deficiency
Polyuria (excessive urination)
Dehydration |
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Term
| Syndrome of inappropriate antidiuretic hormone (SIADH) |
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Definition
ADH excess
Water retained-dilution: Holding onto too much fluid dilutes everything (especially sodium) |
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Term
| Balance depends on plasma proteins |
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Definition
| Plasma Proteins\albumin, Glucose, Atrial Natriuretic Peptide (ANP) |
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Definition
| Provides oncotic pressure in the vascular space (Helps hold fluid in vasular space) |
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Definition
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Definition
| Fluid leaks out and patient develops edema |
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| Pt. at risk for low albumin |
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Definition
| -Esp. Post Op, blood loss, liver disease, anemia, malnutrition |
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Term
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Definition
| High particle to water ration results in diuresis. |
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Term
| Atrial natriutretic peptide (ANP) |
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Definition
Compensatory to ADH and Aldosterone
Response to increase intravascular volume
Causes diuresis
It's released when the vessels in the heart become gorged |
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Term
| Intracellular Fluid (ICF) |
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Definition
| 40% of body weight or 70% of body fluid. We can't measure what's in our cell, but we can measure vascular |
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Definition
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Term
| Extracellular fluid (ECF) |
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Definition
20% of body weight or 30% of body fluid
Intravascular fluids or plasma
Interstitial fluid (surrounds tissue cells, Third Space*) |
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Term
Plasma
Interstitial
Intracellular (%) |
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Definition
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Definition
| Whats in the bag (Fluids) |
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Definition
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| shrinks (solutes more than plasma) |
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| Swells (Solutes less than plasma) |
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Definition
(275-295 mOsm\L)
Concentration is similar to plasma
Helps expand circular volume.
Prevents dehydration, supports BP, used in surgery, maintenance of fluids
Indication-hypovolemia |
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Definition
(> or = to 295)
Fluid shifts from ICF to interstitial space to intravascular space. (Prevents from going into the cell)
Indications-intravascular dehydration
Reduce post op edema |
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Term
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Definition
Closely monitor
(< or = 275)
Fluid shifts from intravascular space to ICF
Indications-Cellular dehydration (Not because of dehydration, but because they're diabetic)
This is not common
Closely Monitor |
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Definition
Stay in vascular space and increase osmotic pressure
Packed RBCs, Albumin, Plasma |
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Term
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Definition
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Term
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Definition
14-18 g\dL males
12-16 g\dL female |
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Definition
41-53% males, 36%-46% females,
Fluid balance increase if dehydrated |
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Definition
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| Blood urea Nitrogen (BUN) |
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Definition
Shows concentration (fluid balance)
7-18mg\dL
Increased in older adults
Shows liver and kidney function |
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Term
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Definition
0.6-1.2 mg\dL
Decreases with age |
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Definition
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Term
Fluid Volume Deficit (FVD)
Related to |
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Definition
| N\V\D, actual fluid loss, some parts of the body may not be function properly |
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Term
Dehydration (Hypovolemia)
Common risk factors (Causes) |
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Definition
| Burns, Trauma, malnutrition, overuse of diuretics and laxatives, diabetes insipidous, heat stroke, NPO, Hemorrhage, NG Suctioning, Wounds, Alcohol (acts as a diuretic) |
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Term
Dehydration (hypovolemia)
Clinical Manifestations |
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Definition
increase HR, Respiratory, Urine grav.
Decrease in BP, urine output, skin turgor, cap refill
Dry membrans, skin looks pale cool and clammy, flat veins, possible fever, weight loss, confusion, lethargic |
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Term
Dehydration (Hypovolemia)
Outcomes |
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Definition
Monitor output\cardiac labs
adequate I's and O's
Increased strength
Reverse of cray vitals
Daily weights |
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Term
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Definition
| Same scale, same time of day, have them consistently void before |
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Term
| Third space shift (third spacing) |
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Definition
| Shift from vascular to spaces where fluid cannot be used |
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Term
| third spacing (What places can fluids not be used?) |
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Definition
| Interstitial, pericardium, bowel, plueral, peritoneal, joint |
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Term
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Definition
| Hypoalbuminemia, tissue trauma, ascites, acute bowel obstruction, peritonitis, pleural effusion (lungs), Pancreatitis |
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Term
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Definition
Edema, Pitting (Non-pitting)
Wheezing, crackles, Vascular dehydration (You still have fluid but it isn't in the vascular) |
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Term
| third space interventions |
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Definition
| I&O's, weights, abdominal girth, lung sounds, edema |
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Term
Fluid Volume excess (overhydration)
Risk Factors (Causes) |
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Definition
Poorly controlled IV therapy
renal failure
long term steriod treatment
SIADH
Water intoxication
Congestive HF
Postop |
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Term
Fluid Volume excess (overhydration)
Clinical Manifestations |
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Definition
| Pulse bounding, increase in BP, HR, weight gain, urine output, there is wheezing, crackles, distension, headache, diluted urine, Polyuria, full veins, shortness of breath (dyspnea) |
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Term
Fluid Volume excess (overhydration)
LABS |
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Definition
| Decrease in NA, USG, Serum osmolality, HCT, BUN |
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Term
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Definition
| Increase in Na, USG, Serum osmolality, Hct, BUN |
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Term
Fluid Volume excess (overhydration)
Outcomes |
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Definition
Monitor I's and O's, daily weights, watch IV fluids, diet (sodium), Check labs, listen to lungs, monitor effects of diuretic then watch\monitor loss of potassium, stable output, clear lung sounds,
**slow infusion for elderly and infants
Careful monitoring IV fluids with cardiac and renal patients |
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