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NURS124 > Fluid Balance > Flashcards

Fluid Balance Flashcards

1
Q

what is osmosis

A

movement of FLUID from high to low concentration

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2
Q

what is diffusion

A

movement of SOLUTES from greater to lesser concentration

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3
Q

what is filtration

A

movement of FLUID & SOLUTES from high hydrostatic pressure to low pressure
also known as hydrostatic pressure

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4
Q

what is osmolality

A

concentration of solutes in a solution
high means more more solutes

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5
Q

what are the 4 main causes of edema

A
  1. increased hydrostatic pressure (renal failure, HF)
  2. decreased colloid osmotic pressure (low albumin)
  3. increased capillary permeability (infection, burns)
  4. obstruction of lymphatic system (cancer, infection)
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6
Q

how would fluid volume overload affect the cardiovascular system

A
  • hypertension
  • bounding pulses
  • JVD
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7
Q

how would fluid volume deficit affect the cardiovascular system

A
  • hypotension, orthostatic hypotension
  • weak, thready pulses
  • flat veins
  • tachycardia

cardiac damage
multi-organ failure eventually

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8
Q

how would fluid volume overload affect the skin

A
  • periorbital edema
  • pitting edema
  • pale, cool skin
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9
Q

how would fluid volume deficit affect the skin

A
  • sunken eyes
  • dry skin: poor turgor & tenting
  • dry mucous membranes
  • increased body temp
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10
Q

how would fluid volume overload affect the neuromuscular system

A
  • ALOC
  • headache
  • weakness & paresthesias
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11
Q

how would fluid volume deficit affect the neuromuscular system

A
  • lethargy
  • weakness
  • coma

cerebral edema, seizures
cerebral hypoperfusion -> ischemic stroke

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12
Q

how does fluid volume overload & deficit affect urine specific gravity

A

high - low fluids
low - high fluids

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13
Q

what weight change is scary for fluid gain

A

2-3 lbs in 1 day
5 lbs in 7 days

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14
Q

how does fluid volume overload affect the resp system

A
  • crackles, pulmonary edema
  • rapid, SHALLOW RR
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15
Q

how does fluid volume deficit affect the resp system

A
  • rapid, DEEP RR
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16
Q

how does fluid volume overload affect the GI system

A
  • increased motility: diarrhea
  • hepatomegaly
  • ascites
17
Q

how does fluid volume deficit affect the GI system

A
  • decreased motility: constipation
  • diminished bowel sounds
18
Q

what are the hypotonic solutions

A

think lower osmolarity
1/2 NS, 1/4 NS, D5W (isotonic then hypotonic)

19
Q

what is the use of hypotonic solutions

A

hypernatremia

20
Q

what is hypotonic solns contraindicated for

A

increased ICP

21
Q

why do we give hypotonic solns slow

A

SLOW to avoid cellular edema & cerebral swelling

22
Q

what are the hypertonic solutions

A

think HIGH & DRY
higher osmolarity
3 NS, D10W, D5NS, D5LR, D5 1/2NS

23
Q

what is hypertonic solutions used for

A

hypovolemia
heat exhaustion
peritoneal dialysis

24
Q

why do we give hypertonic solns slow

A

to avoid cellular dehydration & avoid fluid volume overload

25
Q

what is the normal range of osmolality in the body

A

275 - 295 mOsm/kg

26
Q

what is starling’s law

A

hydrostatic and oncotic pressures determine movement across the capillary membrane

27
Q

what counts as orthostatic hypotension

A

decrease in 20mmHg systolic, 10mmHg diastolic within 2-5 minutes

28
Q

what is normal BNP level

A

below 100
above 400 is definitely HF

29
Q

what are signs of hypovolemic shock

A
  • cold, clammy, cyanotic skin
  • pain somewhere: abdomen, chest
  • ALOC
  • increased anaerobic metabolism -> lactic acidosis (lactate >4 not good)
30
Q

how much fluid & sodium restriction should a pt have

A

fluids: 1.5 - 2L /day
sodium: less than 2g / day

31
Q

causes for fluid volume deficit

A

bleed, burns, third spacing

32
Q

causes for fluid volume excess

A

polydipsia i.e. SIADH, diabetes insipidus
excess Na intake

NURS124 (6 decks)

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