Fluid Balance Flashcards
40% of body weight is…
Intracellular
20% of body weight is…
Extracellular
Two types of Extracellular fluid compartments
Interstitial, Intravascular
Interstitial means…
Between
Intravascular means…
Inside
Full-Term Baby is ______ fluid.
80%
Lean adult male is _____ fluid
60%
Aged client is ______ fluid.
40%
3 Parts of Passive Transport Systems
- Diffusion
- Filtration
- Osmosis
Active Transport System…
- Pumping
- Requires energy expenditure
3 Types of Membranes
Permeable, Semipermeable, Impermeable
Molecules move from high concentration to low concentration
Diffusion
Molecules move from low concentration to high concentration
Osmosis
Movement of solutes or solvent across membrane caused by hydrostatic pressure
Filtration
Filtration occurs at the _____ level.
Capillary
Filtration results in __________.
Third Spacing
Solutes can be moved against concentration gradient, also called “pumping”.
Active Transport System
Active Transport System requires the presence of _______.
ATP
3 Types of Fluids
Isotonic, Hypotonic, Hypertonic
No shift because solutions are equally concentrated
Isotonic
Lower solute concentration; cells swell.
Hypotonic
Higher solute concentration; cells shrink.
Hypertonic
Respond to fall in Arterial Blood Pressure; located in atrial walls, vena cava, aoritc arch and carotid sinus; results in retention of fluid due to kidney constriction.
Baroreceptor Reflex
Respond to fluid excess in atria and great vessels; creates strong renal response that increases urine output
Volume Receptors
When we have FVE, ADH is…
decreased.
When we have FVD, ADH is…
increased
4 Fluid Imbalances
Dehydration, Hypovolemia, Hypervolemia, Water Intoxication
Dehydration results from…
loss of body fluids
Loss of body fluids leads to…
increased concentration of solutes in blood, rise in serum Na+ levels.
During Dehydration, fluid shifts out of the ______ and into the ______ to try to restore balance.
out of cells, into blood.
During dehydration, cells _______ and cannot function properly.
shrink
Clients at risk of dehydration
- Confused
- Comatose
- Bedridden
- Infants
- Elderly
- Enterally fed
What do you see in clients with dehydration?
- Irritability
- Confusion
- Dizziness
- Weakness
- Extreme thirst
- Decreased urine output
- Fever
- Dry skin/mucous membranes
- Sunken Eyes
- Poor skin Turgor
- Tachycardia
What do we do for dehydrated patients?
- Oral or IV fludi replacement over 48 hrs
- Monitor symptoms and vitals
- Maintain Intake and Output
- Maintain IV access
- Daily Weights
- Skin and Mouth Care
Hypovolemia is…
Isotonic fluid loss from extracellular space
Hypovolemia can progress to…
Hypovolemic Shock
Hypovolemia is caused by…
- Excessive fluid loss (hemmorhage)
- Decreased fluid intake
- Third Space fluid shifting
What do you see in patients with Hypovolemia?
- Mental Status deterioration
- Thirst
- Tachycardia
- Delayed Cap Refill
- Orthostatic Hypotension
- Urine output of less than 30 ml/hr
- Cool, pale extremities
- Weight loss
What do we do for Hypovolemic clients?
- Fluid replacement
- Albumin replacement
- MAST Trousers for severe shock
- Asses for fluid overload with treatment
Hypervolemia is…
Excess fluid in the extracellular compartment as a result of fluid or sodium retention, excessive intake or renal failure
Hypervolemia occurs when…
-Compensatory mechanisms fail to restore fluid balance
Hypervolemia results in…
CHF and Pulmonary Edema
What do we see in patients who are Hypervolemic?
- Tachypnea
- Dyspnea
- Crackles
- Rapid, bounding pulse
- Hypertension
- S3 Gallop
- Increased central veinous pressure
- JVD
- Acute weight gain
- Edema
Hypervolemia results in edema when…
fluid is forced into the tissues by hydrostatic pressure.
What do we do for a client who is hypervolemic?
-Fluid and sodium restriction
-Diuretics
-Monitor vitals
Hourly intake and output
-Breath sounds
-Monitor ABG’s and labs
-Elevate Head of bed and give o2 as ordered.
-Skin and mouth care
-Daily weights
Water intoxication is caused when…
Hypotonic extracellular fluid shifts into cells in an attempt to restore balance causes cells to swell
Early s/s of increased intracranial pressure with water intoxication
- Changes in LOC
- Nausea and vomiting
- Muscle Weakness
- Twitching
- Cramping
Late s/s of increased intracranial pressure with water intoxication
- Bradycardia
- widened pulse pressure
- seizures
- coma
What do we do for patients with Water Intoxication?
- Prevention is the best protection
- Assess neuro status
- Monitor I&O and vitals
- Fluid Restrictions
- IV access
- Daily Weights
- Monitor Serum Sodium
- Seizure precautions
