EXAM 2 Flashcards
FVD
-loss of extracellular fluid exceeds intake of water
-dehydration
Hypovolemia (FVD) causes
-vomiting, diarrhea, nasogastric suctioning
-excessive skin loss w/o sodium and water replacement
-diuresis (polyuria), kidney disease, adrenal insufficiency
-third spacing burns
-anorexia, nausea, impaired swallowing, confusion, NPO
dehydration (FVD) causes
-hyperventilation
-prolonged fever
-diabetic ketoacidosis
-diabetes insipidus
-osmotic diuresis
-excessive intake of salt, salt tablets, or hypertonic fluids
-hemorrhage or plasma loss
FVD clinical manifestations
-Rapid weight loss
-Tented skin turgor
-oliguria/concentrated urine (late sign)
-postural hypotension (orthostatic hypotension)
-rapid, weak pulse
-hyperthermia
-lack of energy
-thirst
-nausea
-muscle weakness and cramps
-decreased CVP (late sign)
-oliguria
-tachypnea
-hypoxia
-seizures (rapid/severe dehydration)
FVD lab values
-normal: 10:1, FVD: 20:1, >25mg/dl due to hemoconcentration
-increased hematocrit
-sodium >145 meq/L with dehydration
-USG >1.030
-blood osmolarity >295 w/ dehydration/hypernatremia
FVD nursing management
-administer oral/iv fluids
-monitor I/O
-monitor weight every 8 hrs (1 Kg = 1 L fluid loss or gained)
-check skin turgor
-assess for gait stability
-encourage pt to stand up slowly (orthostatic hypotension)
-provide oral care
Hypovolemic shock
-occurs when a significant amount of fluid is lost (cells are no longer able to carry oxygen)
-administer oxygen and monitor oxygen
-check v/s q 15 minutes
-provide IV fluids (crystalloids: LR or 0.9% NS) (colloids: PRBCs or plasma)
-administer vasoconstrictors: norepinephrine, phenylephrine, and dopamine
-perform hemodynamic monitoring
FVE
-Fluid overload: excess of fluid causing hemodilution
-decreases hematocrit
-excess of water and electrolytes
-Risk for CHF and pulmonary EDEMA
Hypervolemia causes
-heart failure
-kidney disease
-cirrhosis
-an overdose of fluids
-fluid shifts following major burns
-corticosteroids
-severe stress
-hyperaldosteronism
Overhydration causes
-water replacement w/o electrolytes, excessive water intake
-SIADH (too much adh)
-excessive administration of IV D5W or hypotonic fluids
FVE clinical manifestations
-tachycardia
-HTN
-Tachypnea
-Edema
-DISTENDED NECK VEINS
-crackles, cough, dyspnea
-bounding pulse
-increased weight and urine output
-increased CVP
-seizures (if severe hyponatremia)
FVE nursing management
-Monitor I/O and weight
-assess lung sounds/edema
-promote adherence to fluid restrictions and sodium
-encourage REST (favors diuresis)
-discuss certain meds (some have Sodium)
-fowler’s or semi-fowler position
-turn and reposition pt.
Pulmonary Edema causes
-FVE
-clinical manifestations: anxiety, PVCs, dyspnea at rest, change in LOC, restlessness, lethargy, ascending crackles, pink tinged sputum
-put into high-fowlers pos.
-administer oxygen, positive airway pressure
-administer nitrates, morphine, diuretics if possible (BP has to be adequate)
hyponatremia
-< 136 mEq/L
-net gain of water or loss of sodium rich foods
-water moves from ECF to ICF
-caused by:
-adrenal insufficiency
-water intoxication
-SIADH
-vomiting, diarrhea, sweating,
diuretics
hyponatremia clinical manifestations
-poor skin turgor (hypovolemic)
-dry mucosa (hypovolemic)
-decreased salivation (hypovolemic)
-decreased BP and increased HR (hypovolemic)
-headache
-nausea
-abdominal cramping
-neurologic changes