F&E Flashcards
What are ways you can lose water?
urine
stool
insensible -lungs, skin
Fluid Volume Deficit is also known as?
hypovolemia, isotonic dehydration
What are causes of FVD?
Hemorrhage
Vomiting
Diarrhea
Burns
Diuretic therapy
Fever
Impaired thirst
This is an equal loss of sodium and water and results in hypovolemia.
isotonic dehydration hypovolemia or FVD
Weight loss
Thirst
Orthostatic changes in pulse rate and bp
Weak, rapid pulse
Decreased urine output
Dry mucous membranes
Poor skin turgor
dry tongue
Signs/Symptoms of isotonic dehydration
Signs/Symptoms of isotonic dehydration
Weight loss
Thirst
Orthostatic changes in pulse rate and bp
Weak, rapid pulse
Decreased urine output
Dry mucous membranes
Poor skin turgor
dry tongue
Blood pressure drop over 20 mm Hg systolic or 10 mg Hg diastolic or both
Orthostatic Hypotension
Orthostatic Hypotension is defined as?
Blood pressure drop over 20 mm Hg systolic or 10 mg Hg diastolic or both
for dehydration, Labs show ?
Increased hgb and hct (is artificial, not true elevation, a constant amount of solute diluted in less solvent)
Increased urine specific gravity
Increased BUN and creatinine
Increased hgb and hct (is artificial, not true elevation, a constant amount of solute diluted in less solvent)
Increased urine specific gravity
Increased BUN and creatinine
lab results with dehydration
normal Hemoglobin Men ?
Men 13.5 to 17.5 grams per deciliter
normal hemoglobin for women?
12.0 to 15.5 grams per deciliter
What is the normal hematocrit for men?
Men 45% to 52%
What is the normal hematocrit for women?
Women 37% to 48%
: a red protein responsible for transporting oxygen in the blood of vertebrates.
HGB
–carries oxygen through the bloodstream
hemoglobin
what labs are falsely elevated when someone is dehydrated?
hemoglobin and hematocrit
is a measure of the RBCs with plasma separated out.
hematocrit
What are treatments/interventions for isotonic dehydration
for FVD:
Fluid Management
Diet therapy – Mild to moderate dehydration. Correct with oral fluid replacement.
Oral rehydration therapy – Solutions containing glucose and electrolytes. E.g., Pedialyte
IV therapy – Type of fluid ordered depends on the type of dehydration and the client’s cardiovascular status.
if the patient doesnt have low sodium, low potassium, or high potassium, what type of solution will they receive for their dehydration?
NS or LR, an isotonic fluid
What are assessments for isotonic dehydration?
Daily weights should be ______ thing in the am. If they are weighed on a bed scale, you need to make sure the same things are on the bed each time (such as 1 pillow 1 blanket). Patients who end up with multiple blankets and pillows on the bed can weigh significantly different from day to day. Also should make sure that the patient is weighed on the same ____ if at all possible.
first, scale
t/f: you cant measure sweat or fluid loss from breath
true
make sure that they’re getting good _______ : prevents nasty fissures and blisters
oral care
Monitor postural heart rate and bp when getting patients out of bed
nursing implications for isotonic dehydration
What are common causes of fluid volume excess?
CHF
early renal failure
IV therapy
excessive sodium ingestion
corticosteroids
all pumps should have a safety mechanism when you pull tubing out it locks it: anytime you pull pump off IV pump it is ______.
locked
t/f: Techs should not be taking IV off pump to run it through a shirt or anything
true
CHF
early renal failure
IV therapy
excessive sodium ingestion
corticosteroids
common causes of fluid volume excess
Increased BP
Edema
Weight gain
Bounding pulse
Venous distention
Pulmonary edema
Dyspnea
Orthopnea (diff. breathing when supine)
crackles
Signs/Symptoms of fluid volume excess
what are signs/symptoms of fluid volume excess?
Increased BP
Edema
Weight gain
Bounding pulse
Venous distention
Pulmonary edema
Dyspnea
Orthopnea (diff. breathing when supine)
crackles
What happens to the HGB and HCT when someone has FVE?
decreased HGB and HCT
What happens to urine specific gravity with FVE?
decreased urine specific gravity
What is the urine specific gravity normal range?
Normal range 1.002 and 1.030
A high specific gravity (over 1.030) is seen in ____________________
dehydration (fluid volume deficit)
A low specific gravity (over 1.002) is suggestive of _______________________________
the kidneys inability to concentrate urine/fluid volume excess
What are treatments/interventions for fluid volume excess?
Drug therapy
Diuretics may be ordered if renal failure is not the cause.
Restriction of sodium and saline intake
I/O
Weight
So this patient will not have IV fluids and will be on a low sodium (often 2 gm sodium diet)
they wont have IV fluids, they’ll have a saline lock
generally going to have restricted sodium (normal is 2 grams per day)
patient with FVE
What are s/s of fluid volume excess?
Which systems are predominately affected by the FVE?
not so much neurologic, mostly resp cardio and gi
can affect neruo though