Fluid and Electrolytes Flashcards
What is hypervolemia?
Excess volume in the vas. space caused by any blood vessel
What are the causes of FVE/ Hypervolemia?
HF - decreased kidney perfusion / c/o / u/o - staying only in vascular space Kidney failure Effervesent medications Canned foods IVF w/ Sodium
What is the mechanism of aldosterone in the body?
Normal Action:Aldo is activated by the adrenal gland (sitting on top of kidney) to retain sodium.
What happens when there is too much aldosterone secretion ?
Blood volume increases caused by:
Cushing syndrome
Crohns disease
What does ADH do?
Retains water activated by the pituitary gland
What happens when there is too much ADH?
Retain too much water Caused by SIADH Urine is concentrated Blood volume is diluted *Too many letters too many problems*
Concentrated numbers go up.
Diluted numbers go down
What happens when there is too little ADH?
Diurese losing water
SHOCK - DI
Urine is diluted
Blood volume is concentrated
Desmopressin
A drug to replace ADH for DI pts.
What happens with FVE
Volume is third spacing, leaking.
Neck veins distended CVP UP bpm UP , bounding Lungs Wet Because there is so much water instead of going forward its going back up. Weight UP.
What are complications of FVE?
SIADH Hyperadolsterone Addison's Crohns Renal Failure / Heart failure
Fluid retention think heart problems first
Treatment for FVE
Daily monitor i/o Low sodium diet Diuretics Furosemide (butamide), hydrochlorothiazide Loop Diuretics Potassium Sparing - Spirnolactone Bed rest - why? ANP
*Caution with elderly. kidney/cardiac pts.
CVP Normal range
2-6 MMHG
Causes of FVD?
Loss of fluid
Third spacing from - Burns, Ascites - watch for hypotension shock
Diabetes - Polyuria - Oliguria - Anuria
S/s of FVD
Decreased skin turgor
Dry Membranes
weight down
Decreased u/o decreased c/o , cvp BPM Up, thready Respiration UP B/p - down Cool extremites due to vasoconstriction
Treatment for FVD
Prevent loss
Mild - Po fluids
Severe IV fluids
*Risk for falls watch for overload
Isotonic fluids?
They go into vas. space and stay there
D5W , D51/4 N/S , L/R
Use for: FLUID loss nausea, vomitting, burns, sweating, trauma
Watch for kidney/ cardiac pts can increase BP!
Hypotonic Solution?
Goes into vas space and goes OUT to replenish cells
Does not cause hypertension
D2.5 /1,2 NS/ 0.33 N/S
Uses for renal and cardiac nausea, vomitting, burns, hemmorhage
* Can lead to FVD and decreased BP.
Hypertonic
Packed with particles* highalert* Draws fluid ENTER vas. space from cells D10W, NS Uses : Hyponatremia Watch for FVE
Hypermagnesium?
Cause: Renal failure , antacids s/s: Muscles first Flushing warmth - vasodilation DTR - Decreased Muscle tone - weak Arrythmia Yes Pulse down Respiration Down Loc Down
Txt:
Ventilation
Calcium gluconate - helps
Hyper- Magnesium and calcium are
Sedatives
Hypercalcemia
Cause: PTH increase, when calcium takes too much Ca from the bone into the blood CA goes up Thiazaides Immobilization S/S Brittle bones Kidney stones Same as MG Txt : Move Phosphate foods (anything with protein) Fluids to prevent kidney stones Calcitonin
Hypomagnesemia
Not enough sedatives
Caused by: Diarrhea lots of MG
Alcoholism - suppresses
S/S Rigid prone to seizure Airway Stridor/ Swallow problem Chovostek Trouseau Arrythmia DTR increase
Tx: Give MG Check Kidney Seizure precaution Eat Mag Stop infusion if pt is flushing/sweating
Hypocal
Not enough PTH - hypoparathyroidism
Radical Neck
Thyroidectomy
Serum Ca down
Same s/s as hpomag
Txt: Give Ca Reduce phosphate Iv Ca slowly , with heart monitor Vit D Phosphate binders Calcium acetate (phoslo)
Hypernatremia
Too much sodium Dehydration Causes: Hyperventilation Heat stroke Diabetes Insipidus 135-145
S/S Dry mouth Thirsty swollen tongue Neuochanges
Txt: Restrict sodium Dilute fluids Daily weight Daily i/o Labwork
