Fluid & Electrolytes- Hypervolemia/ Fluid Volume Excess Flashcards
What is hypervolemia?
Fluid volume excess
too much fluid in the vascular space
What is a vascular space?
Any vessel in your body (artery, veins, capillary)
as well as the chambers of the heart (since it is the “cardio-vascular system”)
Because when the vessels/vascular space is filling up with fluid getting bigger and bigger, so are the chambers of the heart.
When their’s too much fluid in the vascular space, where does it start leaking into?
the interstitial space (the tissues)
one cause of fluid volume excess is congestive heart failure (C.H.F)… what happens?
-what happens with
.cardiac output
.kidney perfusion
.urine output
Where does the volume stay?
Your heart is too weak to pump out the blood, so it backs up in the chambers.
as a result, your organs will not be perfused properly.
so, you get decreased C.O
Decreased kidney perfusion which results in deceased urine output.
How does a decreased cardiac output impact the kidneys and fluid volume?
less blood being pumped to the kidney= less perfusion= less cardiac output= increased fluid in the vascular space.
-the extra fluid is not going anywhere. it just stays in the vascular space because you’re not peeing it out.
Another cause of fluid volume excess is kidney failure… how does it cause you to go into fluid overload?
No urinary output= water stays in the vascular space.
Alkaseltzer
Fleet enemas
&
I.V Fluids with sodium
- All have what in common?
- Why can they potentially be bad?
- Sodium
- Makes you retain fluid; which can make you hypervolemic
What is aldosterone?
Where does it come from?
A natural mineralocorticoid in the body
from the adrenal glands which live on top of the kidneys
What is the normal action of aldosterone?
When blood volume gets too low, aldosterone secretion increases to help you retain SODIUM & WATER, so your blood volume is increase.
Increases your blood volume by making you retain sodium & water
Name 2 diseases that are products of making too much aldosterone:
- Hyperaldosteronism (Conn’s disease)
- Cushings
Cushings is when you’re making too____ of all of your steroids. including aldosterone.
Too many
What is a disease where we’re not making enough aldosterone?
Addisson’s disease (You need to “add” steroids)
ADH makes you retain what?
Water only…. ADH aka H2O
Disease where too much ADH is being produced:
SIADH (too many letters, too much water)
T OR F?
Normally, blood and urine like to do the same thing.
ex) dilute urine= dilute blood
T
In SIADH,
The blood is____
the urine is______
blood= dilute (because with ADH, you retain water in the vascular space)
urine= concentrated (the ADH is making you retain the extra water in your kidneys, so all of that water removal= urine concentration)
Your urine output will decrease, and the little bit of urine you will have will be very concentrated
Specific gravity, sodium, & hematocrit
when:
concentrated will make these numbers go___
dilute will make these numbers go___
up
down
Signs & Symptoms of fluid volume excess
____ Veins
_____ Edema caused by____.
Bulging veins (distended neck veins & peripheral veins)
peripheral edema caused by 3rd spacing (because the vascular space in the vessels are so full, the vessels start to leak to the interstitial space)
When a patient has been on bed rest for a while, where do you start seeing edema?
What are they at risk for?
Sacrum…. NOT peripheral
Skin breakdown will occur
Where is CVP measured?
In fluid volume excess, CVP number will___ because?
Right atrium
-increase because of the increased pressure in the vascular space.
More volume in the vascular space= more____
more pressure in the vessel/ vascular space
What are the lungs gonna sound like?
will they experience shortness of breath?
When people start to have fluid in their lungs, where will you hear it first?
Wet
yes
in the bases
if the kidneys are working properly, what’s gonna happen when a patient experiences hypervolemia?
- patient will pee alot / diurese
In fluid volume excess, the pulses will____.
How will they feel?
Increase
- Bounding (how hard your heart is beating trying to push the fluid forward)
& full (big artery/ full of fluid)
