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461 - Exam 4 > ATI - Fluid Imbalances - 57 > Flashcards

ATI - Fluid Imbalances - 57 Flashcards

1
Q

Fluid volume _____ includes the both isotonic FVD and dehydration.

A

deficit (FVD)

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2
Q

______ is the loss of water and electrolytes from the ECF.

A

isotonic FVD

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3
Q

Isotonic FVD is often referred to as ______ because intravascular fluid is also lost.

A

hypovolemia

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4
Q

______ is the loss of water from the body without the loss of electrolytes.

A

dehydration

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5
Q

This hemoconcentration results in increases in Hct, serum electrolytes, and _____.

A

urine specific gravity

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6
Q

Compensatory mechanisms of _______ include sympathetic nervous system responses of increased thirst, ADH release, and aldosterone release.

A

fluid volume deficit (FVD)

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7
Q

FVD can lead to ______ shock.

A

hypovolemic

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8
Q

Older adults have an increased risk for ______ due to multiple physiological factors including a decrease in total body mass, which includes total body water content and a decrease in ability to detect thirst.

A

dehydration

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9
Q

Risk Factors (causes of isotonic FVD) Hypovolemia

A

Excessive GI loss: vomiting, nasogastric suctioning, diarrhea
Excessive skin loss: diaporesis
Excessive renal system losses: diurectic therapy, diabetes insipidus, kidney disease, adrenal insufficiency, osmotic diuresis
Third spacing: peritonitis, intestinal obstruction, ascities, burns
Excessive loss of fluids from a wound
Hemorrhage
Altered intake: anorexia, nausea, impaired swallowing, confusion, nothing by mouth (NPO)

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10
Q

Risk Factors (causes of dehydration) Hypovolemia

A 
hyperventilation
prolonged fever
diabetic ketoacidosis (DKA)
enteral feeding without sufficient water intake
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11
Q

Fluid Volume Deficit (FVD) vital signs

A 
hypothermia
tachycardia
thready pulse
hypotension
orthostatic hypotension
decreased central venous pressure
tachypnea (increased respirations)
hypoxia
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12
Q

Fluid Volume Deficit (FVD) neuromusculoskeletal

A 
dizziness
syncope
confusion
weakness
fatigue
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13
Q

Fluid Volume Deficit (FVD) GI

A 
thirst
dry mucous membranes
dry furrowed tongue
nausea
vomiting
anorexia
acute weight loss
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14
Q

Fluid Volume Deficit (FVD) renal

A

oliguria (decreased production of urine)

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15
Q

Fluid Volume Deficit (FVD) other findings

A 
Diminished capillary refill
Cool clammy skin
Diaphoresis
Sunken eyeballs
Flattened neck veins
Absence of tears
Decreased skin turgor
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16
Q

Assessment of skin turgor in the ________ might not provide reliable findings due to a natural loss of skin elasticity.

A

older adult

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17
Q

Laboratory Tests (4) for FVD

A

Hct
Serum osmolarity
Urine specific gravity
Serum sodium

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18
Q

Hct is _____ in both hypovolemia and dehydration unless the fluid volume deficit is due to hemorrhage.

A

increased

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19
Q

With dehydration how is serum osmolarity effected?

A

Hemoconcentration osmolarity (greater than 295 mOsm/kg); increased protein, BUN, electrolytes, glucose.

20
Q

With dehydration _____ is increased above 1.030.

A

urine specific gravity

21
Q

With dehydration, serum sodium lab tests reveal an increased ________ (greater than 145 mEq/L).

A

hemoconcentration

22
Q

Review pg 344 patient centered care list

A

-

23
Q

_____ includes fluid volume excess (FVE) and overhydration.

A

fluid volume excesses (FVE)

24
Q

______ is the isotonic retention of water and sodium in high proportions.

A

fluid volume excess (FVE)

25
Q

FVE is often referred to as _______ because of the resulting increased blood volume.

A

hypervolemia

26
Q

Overhydration, or _________, is the retention of more water than electrolytes.

A

hypoosmolar fluid imbalance

27
Q

With overhydration, hemodilution results in _____ in Hct, serum electrolytes, and protein.

A

decreases

28
Q

Severe FVE can lead to ______ and heart failure.

A

pulmonary edema

29
Q

With fluid volume excesses (FVE), compensatory mechanisms include an increased release of natriuretic peptides, resulting in increased excretion of sodium and water by the kidneys, and __________.

A

a decreased release of aldosterone

30
Q

Risk Factors of Hypervolemia (FVD)

A

Chronic stimulus to the kidney to conserve sodium and water (heart failure, cirrhosis, increased glucocorticosteroids)
Altered kiney function with reduced excretion of sodium and water (kidney failure)
Interstitial to plasma fluid shifts (hypertonic fluids, burns)
Age-related changes in cardiovascular and kidney function
Excessive sodium intake from IV fluids, diet or medications (sodium bicarbonate antacids, hypertonic enema solutions)

31
Q

Risk Factors of Overhydration (FVD)

A

Water replacement without electrolyte replacement (strenuous exercise with profuse diaphoresis)
Syndrome of inappropriate antidiuretic hormone (SIADH), which is the excess secretion of ADH
Head injuries
Barbiturates
Anesthetics

32
Q

Expected findings for Fluid Volume Excesses (FVE) vital signs

A 
Tachycardia
bounding pulse
hypertension
tachypnea
increased central venous pressure
33
Q

Expected findings for Fluid Volume Excesses (FVE) - neuromusculoskeletal

A

confusion

muscle weakness

34
Q

Expected findings for Fluid Volume Excesses (FVE) - GI

A

weight gain

ascities

35
Q

Expected findings for Fluid Volume Excesses (FVE) - respiratory

A

dyspnea
orthopnea
crackles

36
Q

Expected findings for Fluid Volume Excesses (FVE) - other findings

A

edema

distended neck veins

37
Q

For FVE: Hypervolemia Hct will ______.

A

decrease

38
Q

For FVE: Overhydration Hct will ______ = hemodiution.

A

decrease

39
Q

With overhydration osmolarity will be less than _____ mOsm/kg

A

280

40
Q

With hypervolemia sodium will be _____.

A

within expected ranges

41
Q

Overhydration/hypervolemia results in decreased electrolytes, _____, and _____.

A

BUN

creatinine

42
Q

______ can indicate pulmonary congestion involved with FVE.

A

Chest x-rays

43
Q

With FVE PaCO2 ______(less than 35 mm Hg).

A

decreased

44
Q

With FVE there urine specific gravity will be ______ (if not due to SIADH)

A

less than 1.010

45
Q

The blood pH will be _____with FVE.

A

increased (greater than 7.45)

respiratory alkalosis?

46
Q

p344 nursing care

A

?

461 - Exam 4 (6 decks)

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