Fluid & Electrolytes- Hypovolemia/ Fluid Volume Deficit Flashcards
What happens when you don’t have enough ADH?
Lose a lot of water, and you go into a fluid volume deficit
One disease where you don’t make enough ADH?
Diabetes insipidus “D”i …. D= diuresis
T OR F?
Patient with D.I have a low chance of experiencing shock
F!
DI can lead to shock, but they’ll have increased U.O
What is the #1 concern with Diabetes insipidus?
T OR F?
You do a fingerstick test for blood sugar monitoring Q4 hours when patients have D.I
SHOCK
F! (this type of diabetes has nothing to do with your blood sugar at all!!)
In DI,
Urine is____
Blood is___
urine= dilute
blood= concentrate (you’re losing water from the vascular space)
What’s the difference between the urine output of a regular shock patient VERSUS the urine output of a D.I patient experiencing shock?
Shock: this patient is going to have decreased U.O because their kidney is not being perfused. Their urine is going to be very concentrated because the body is going to try to hang on to as much water as possible.
DI: The lack of ADH is making the vascular space lose a lot of water. the kidneys are being perfused, but the lack of ADH is not allowing it to absorb back the extra water, so it is making a lot of dilute urine.
A patient with D.I is going into shock. How is that worst compared to regular shock?
Because the lack of ADH from this patient is going to keep this patient producing large amounts of dilute urine. The body is not able to produce the ADH like a regular shock patient. This can kill them.
Where does ADH live?
where is it?
In the pituitary gland (in your head)
Craniotomy, head injury, sinus surgery, transphenoidal hypophysectomy or anything that can lead to increased cranial pressure (any patient with any head complication)
are all potential causes of_____
Are all potential ADH problem because this may mean damage of the pituitary gland
Another name for ADH IS____.
What is it used as?
Vasopressin (Pitressin or DDAVP)- makes u hold on to your water.
-An ADH replacement in Diabetes Insipidus.
so, ADH is the same thing as Vasopressin
Thoracentesis paracentesis vomiting diarrhea hemorrhage
Anytime you’re pulling fluids
Can all cause___
which can result in____
Fluid volume deficit (Loss of fluid anywhere) can result in shock
Fluid that has gone to anywhere that does you no good___
out of the vascular space & into the surrounding tissues
3rd spacing
EXAMPLE:
When you have a patient with ascites, you must measure their_____ everyday.
Can they lie flat?
why?
abdominal girth
no;
they can’t breathe
If you’re diabetic, you will pee a lot because the vascular space is filled with____ particles.
sugar
Any time you get too many particles in your vascular space/ blood stream, your body will try to balance it out by pulling extra fluid from the interstitial space. So, this will result in P.I.D aka____
How do your kidneys make this happen?
Particle induced diuresis
Your kidneys are always watching your bloodstream to see how they can help it stay in homeostasis.
When they see all of those particles in the blood stream, they wanna help excrete some of the particles
Since particles need fluid in order to come out, you pee sugar plus fluid.
