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Nursing 232 Post Midterm > Fluid Imbalance > Flashcards

Fluid Imbalance Flashcards

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1
Q

Why is fluid balance important?

A

To maintain homeostasis (small window for normal balance of electrolytes and fluid

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2
Q

What organs of the body regulate fluids?

A

Kidneys, Heart, Lungs, Pituitary Gland, Adrenal Gland

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3
Q

What hormone does the pituitary gland secrete that affects fluid balance?

A

Antiduretic hormone, which causes the body to retain water

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4
Q

What hormone does the adrenal gland secrete that affects fluid balance?

A

Aldosterone hormone: causes sodium retention, thus water retention

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5
Q

What follows Na+?

A

H20, Cl-

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6
Q

Body fluids are intracellular and extraceullar. How many thirds is intracellular?

A

2/3

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7
Q

What 3 fluid compartments are considered to be extracellular?

A
  1. interstitial spaces
  2. intravascular
  3. fluid body spaces
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8
Q

What are the process that fluid can move? (5)

A
  1. Diffusion
  2. Osmosis
  3. Osmotic Pressure
  4. Colloid osmotic pressure
  5. Hydrostatic pressure
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9
Q

What does tonicity mean?

A

Measure of the osmotic pressure gradient (hypotonic vs. isotonic v.s hypertonic)

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10
Q

What is osmolarity of the following:

  1. Isotonic
  2. Hypotonic
  3. Hypertonic
A
  1. 250-375

2. 375

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11
Q

Fluid imbalance can be hypervolemia or hypovolemima. In both of these cases, are the electrolytes inbalance with the fluid?

A

Yes, Na+ and H20 in same concentration

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12
Q

Define hypervolemia

A

excess fluid volume

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13
Q

Define hypovolemia

A

fluid volume defecit

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14
Q

Is hypovolemia the same as being dehydrated? Why or why not?

A

No. Hypovolemia the fluid and electrolytes are both lost, where as dehydration there is an increase of electrolytes but a decrease of fluid

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15
Q

Define 3rd space shift:

A

Fluid moves into the transcellular spaces, difficult for the fluid to get in and even more difficult for the fluid to et out

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16
Q

What would be 3 symptoms of 3rd space shifting?

A
  1. Decrease urine output (d/t fluid accumulating in the transcelluar space)
  2. Decreasing BP
  3. Swelling in the area where the shift is
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17
Q

What are some of the transceullar spaces where fluid can get trapped in a 3rd space shift?

A

Pleural cavity, peritoneal cavity, pericardial sac, joint spaces

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18
Q

What is 3rd space shift to the peritoneal cavity called?

A

Ascites

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19
Q

Define effusions:

What can they contain?

A

transduction of fluid into serious cavities.

Effusions can contain pus, blood, plasma, proteins and or ECF

20
Q

Who is at risk for developing fluid imbalance?

A

ALL AGES ACROSS THE LIFESPAN!

21
Q

What factors can cause a fluid imbalance? (4)

A
  1. Vomitting
  2. Diahhrea
  3. Burns
  4. Diuretics
22
Q

What Lab work would you assess for monitoring fluid balance? (6)

A
  1. Serum electrolytes: Na+, K+, Cl-
  2. BUN / Creatinine (kidney function tests)
  3. Serum Albumin
  4. Urine AND serum osmolality
  5. Hct
  6. Urine specific gravity
23
Q

Why is serum albumin an important diagnostic testing? What condition would cause this to be lowered?

A

Albumin = most abundant protein in the blood, produced by the liver.
It plays a role in colloid osmotic pressure.
Person w/ liver failure is @ risk for not making enough albumin, therefore decreased colloid osmotic pressure, can lead to fluid shift.

24
Q

What is the normal range for Hct? When would Hct elevate? When would it decrease?

A

0.4-5.2, elevate = fluid loss, decrease = fluid overload

25
Q

Define Hypervolemia:

A

Fluid volume in excess

26
Q

What would cause hypervolemia to occur? 3

A
  1. Increase fluid injestion (iatrogenic.. ex. IV bag)
  2. Increased fluid retention (cardiac arrest)
  3. Decrease fluid excretion (liver/renal failure)
27
Q

What are the S/S of hypervolemia? (4)

number 4 is a diagnostic lab tests.. what would you expect to see?

A
  1. Acute weight gain (ascites)
  2. CVS symptoms = increased BP, HR, JVD, peripheral edema
  3. RS Symptoms= pulmonary edema
  4. Lab findings: Low hct, pulm edema or CxR
28
Q

Treatment for hypervolemia. (4)

A
  1. Identify & Treat the cause
  2. Restrict Na+ and fluid in the diet
  3. Diueretics (Thiazide, Loop diuretics)
  4. Hemodialysis
29
Q

Why restrict the Na+ fluid intake?

A

Water follows Na+

30
Q

Nursing Interventions for Hypervolemia include:

A
  • Detecting is the primary importance!
  • Accurate Measuring / recording
  • Assess for edema
  • Rest
  • Monitor and teach Na+ restrictions
  • Admin. Diuretics
  • Frequent chest assessment (looking for pulmonary edema)
  • Vital sings q 4-6 hr
  • elevate legs when sitting
  • position for optimal comfort, circulation, respiration
  • May require IV Albumin (seems super weird to me… that would cause an increase in osmotic pressure which would then increase the pull of more fluids in)
31
Q

Define Hypovolemia:

A

Fluid voluma deficit

32
Q

What would cause hypovolemia? (2)

A
  1. reduced Intake

2. Increased losses

33
Q

What could the losses of fluid be through? (4)

A
  1. Skin
  2. Resp
  3. Urine
  4. Bowels
34
Q

What are the S/S of hypoveolmia? (7)

A
  1. Acute weight loss
  2. CVS symptoms (low or postural BP, increase HR To compensate for low BP)
  3. Thirst
  4. Constipation
  5. Thready pulse
  6. Dehydration (poor turgor, dry mucousa)
  7. Lab findings: Increase Hct, Increase serum and urine osmolality
35
Q

What is the treatment for hypovolemia?

A
  1. Identify and treat the cause
  2. Consider usual maintenance requirements
  3. fluid replacement: isotonic solutions
  4. Replace fluid quickly to prevent renal damage
  5. Encourage oral fluid intake
36
Q

What are examples of isotonic solutions that could be given to a patient IV with hypovolemia? (2)

A
  1. NS

2. RL

37
Q

Nursing Interventions for hypovolemia:

A
  • monitor I/O accurately
  • Daily weight
  • Bowel care PRN
  • Skin care
  • Vital signs q 4-6 hr
  • Parenteral Admin (monitor for fluid overload when replacing fluids)
  • Mouth care
  • NV/S to monitor LOC
38
Q

What are the gerontological considerations for hypovolemia?

A

Gotta look it up

39
Q

What is the minimum urine output per hour?

A

30 mls/hr

40
Q

Define hypernatremia:

What causes it?

A

excessive Na+

-Increased water loss, reduced water intake, sodium gain

41
Q

What is the importance of Na+?

A

Plays a large role in water distrubution throughout the body

42
Q

What are S/S of hypernatremia?

A
  • Lab findings: Na> 145 mmol/L
  • CNS: confusion, change in LOC, change in muscle tone
  • Thirst
  • Dehydration
43
Q

Define hyponatremia:

A

low levels of sodium

44
Q

What causes hyponatremia?

A
  • Increase water intake
  • Reduced water loss
  • Sodium loss
45
Q

What are S/S of hyponatremia?

A

Lab: Na+

46
Q

What is hemodilution?

A

Decreased concentration (as after hemorrhage) of cells and solids in the blood resulting from gain of fluid—compare hemoconcentration.

47
Q

What is hemodialysis?

A

Hemodialysis is a therapy that filters waste, removes extra fluid and balances electrolytes (sodium, potassium, bicarbonate, chloride, calcium, magnesium and phosphate).

Nursing 232 Post Midterm (10 decks)

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