Chap 32- Altered Fluid & Electrolytes; Water, F&E Imbalances Flashcards
Older Adult Effects on F & E
-Decreased kidney function/ affects filtration
-Increase use of diuretics
-Increased body fat
-Fluid restriction in evening bc they dont want to go to bathroom @ night
-Decreased thirst response
Examples of whats calculated in FLuid Intake:
Water, Tea, Juices, IV fluids
Examples of whats calculated in FLuid Output:
Vomiting
Diarrhea
Diaphoresis
Diuretics
Stress
Chronic Illness
Liver, Hear, Kidney Failure
a class of drugs that increase urine production and help the body get rid of excess salt and fluid
Diuretic
How does a diuretic work?
it increases the amount of water and salt excreted through urine by the kidneys
Risk of diuretics; what combats it?
Can cause you to lose too much potassium leading to dysarthymia
- Potassium sparing diuretics cause you to lose fluids EXCEPT Potassium
Loss of fluid through difficult-to-measure means such as respiration stool, sweat
insensible fluid loss; accounts for 600 mL daily
Fluid deficit may result in
SHOCK !!!
Vascular and Interstitial compartments are influenced by which fluids?
ECF (deficit in ECF is most critical)
Loss of ECF contains ______
Sodium
Chloride
BiCarb
Water
Terms that describe loss of fluids
interchangeable
Hyopvolemia
Isotonic dehydration
Saline Deficit
An ECF volume balance problem where fluid leaves vascular spaces and inappropriately accumulates in interstitial spaces
third spacing ; can happen due to decreased plasma proteins (they are necessary to keep fluid IN the vessels
Cause of third spacing
R side heart failure
Cirrhosis of liver
Burns
first S&S of third spacing
Decreased urine output (fluid is not where it should be, in order for it to be excreted)
S& S of ECF Deficit
Orthostatic Hypotension
Increased Pulse
Decreased Urine Output (more concentrated, no volume to put out)
Dehydration, tented skin turgor, dry skin/mouth
I
Treatment for ECF Deficit
Forced Fluids orally
IV Replacement
Safety (dehydration syx pose risk for saftey)
S&S of Excess ECF
- Edema
-Rapid weight gain - Increased BP
-Bounding Pulse
-Neck Vein Distention
-Dyspnea
Treatment of of Excess ECF
Low Sodium Diet
Diuretics
-Natremia’s
Water imbalances/ ICF deficit
when there is a decrease in water intake, an increase in water loss, or an excess intake of solute
-Decrease in water intake
-Increase in water loss
-Excess intake of solute
a condition where there is too much sodium blood, relative to the amount of water in the body
hypernatremia; due to excess sodium
As NA increases, water is drawn from _____ resulting in____ leading to ______
ICF; cell shrinkage; aeb changes in cognition
S&S of Hypernatremia
confusion
agitation
seizures
death possibly
oliguria- low urine output
decrease thirst
Treatment of Hypernatremia
Gradually lower Na w/ D5 water as it replaces water, not Na
a condition where the level of sodium in the blood is too low, which can cause water to move into cells and make them swell
Hyponatremia; sodium deficit; can be acute or chronic
Causes of hyponatremia
Dilution- drinking lots of water leading to dilution of solute (Sodium)
or
Dehydration- getting rid of electrolytes through excretion, diarrhea, excess sweat, etc
S&S of hyponatremia
lethargy
irritability
confusion
personality changes
seizures
coma
death
Treatment for hyponatremia
Free water restriction
Sodium Pills/ Sodium Replacement
How to monitor for fluid & electrolyte imbalances?
Compare Daily body weights
Monitor changes in LOC
Which change in LOC presents as imbalance becomes more severe?
Confusion
Manifestations of F&E imbalance
Dehydration
Edema
Skin Tenting
Muscle Spasms
Constipation
Change in Vital Signs
Tingling Sensations
Normal Urine Output …
1500 mL in 24 hrs
*highly dependent on what you take in *
Should wound drainage be calculated in “Output”? Y or N
Yes
