Fluid & Electrolytes 2 Flashcards
Hypertonic solution would be used for….
Increased ICP
Hypertonic is usually given with..
Diuretic so we do not stress out the heart (b/c hypertonic increases intravascular fluid volume)
Hypotonic can cause…
Edema or increased ICP
Straight D5W is…
Hypotonic
Arterial end of capillaries has a _____ hydrostatic pressure
High
Venous end of capillaries has a _____ hydrostatic pressure
Low
Oncotic pressure at arterial end
So much fluid that colloids have less of a pull
Fluid shift from the plasma to the interstitial space is due to…
High venous hydrostatic pressure
Low plasma oncotic pressure
High interstitial oncotic pressure
Fluid shift from the interstitial space to the plasma could be due to…
Low venous hydrostatic pressure (dehydrated)
High plasma oncotic pressure (diabetes, too much salt, urea)
Low interstitial oncotic pressure
Reasons for increased plasma oncotic pressure
Therapeutically administered (Mannitol, albumin, hypertonic solutions), hyperglycemia
Therapeutic reasons for increased interstitial hydrostatic pressure
Elastic stockings, ted hose
Reasons for high venous hydrostatic pressure (plasma –> interstitial space)
Fluid overload CHF Liver failure Obstruction of venous return to the heart Varicose veins
Reasons for decreased plasma oncotic pressure (plasma –> interstitial space)
Insufficient protein intake
Excessive protein loss (nephrotic syndrome)
Deficient protein synthesis (liver disease)
Increased interstitial oncotic pressure could be due to…
Trauma
Burns
?
Local effects of plasma –> interstitial space
Rubor (redness) Tumor (swelling) Calor (heat) Dolor (pain) Functiolaesa (function loss)
Systemic effects of plasma –> interstitial space
Malaise / fatigue
Nausea / vomiting
Tachycardia / tachypnea
Fever
When the nurse if evaluating the fluid balance for a patient admitted for hypovolemia associated with multiple draining wounds, the most accurate assessment to include is
Daily weight
When caring for an alert and oriented elderly patient with a history of dehydration, the home health nurse will teach the patient to increase fluid intake
If the oral mucosa feels dry
The home health nurse notes that an elderly patient has a low serum protein level. The nurse will plan to assess for
Edema
A patient is receiving 3% NaCl solution for correction of hyponatremia. During administration of the solution, the most important assessment for the nurse to monitor is
Lung sounds 9water retention, fluid volume excess)
ADH is released from the..
Posterior pituitary
ADH is triggered by..
Decreased H2O
Increased Na
(also stress, narcotics, anesthetics, heat, nicotine, etc)
ADH causes..
Kidney reabsorption of H2O
Diabetes Insidipus involves..
Too little ADH
Diabetes insipidus would be caused by…
A tumor or damage to the pituitary
Patients with diabetes insidious will be..
Very thirsty because they urinate frequently
SIADH
Too much ADH
Major cause of SIADH
Secretion by an oat-cell or small-cell lung cancer
Symptoms of SIADH
Hypervolemia symptoms and hyponatremia symptoms
Focus of nursing care for diabetes insipidus
Replacing fluids
Monitoring for circulatory collapse
Focus of nursing care for SIADH
Skin care, treat underlying cause
