Fluid Imbalances (Deficit & Excess) Flashcards
What is diffusion?
the movement of molecules from an area of high concentration to low concentration
What is osmosis?
the movement of water “down” a concentration gradient, that is, from a region of low solute concentration to one of high solute concentration, across a semipermeable membrane.
Another name for Colloidal Osmotic Pressure
Oncotic Pressure
Albumin is the _______ power.
Pulling
What is the result of low Albumin?
Fluid will leak into the interstitium and third space because there is no pulling power in the intravascular space
What is Colloidal Osmotic Pressure?
the osmotic pressure caused by plasma colloids (large molecules) in solution
What is Albumin?
Protein that is a major colloids in the vascular system contributing to osmotic pressure.
What is hydrostatic pressure?
the force of fluid in a compartment pushing against a cell membrane or vessel wall.
Hydrostatic pressure is the ______ power.
Pushing
An increase in hydrostatic pressure causes a shift of fluids from the __________ space into the _______ space.
(From the Heart failure example– if you have fluid backed up because the heart cannot pump it out as it should)
Intravascular, Interstitium
If you have adequate albumin levels, fluid should remain where?
Intravascular space
Two types of Fluid Volume Imbalance (FVI)
Fluid Volume Excess (FVE)
Fluid Volume Deficit (FVD)
Why would someone have FVE? (Excess) -Causes
- Excess isotonic or hypotonic IV fluids
- Heart failure (inadequate CO-backed up fluid into interstitium and lungs)
- Renal failure (inability to void/urinate)
- Primary polydipsia (drinking excess amounts of water-rare)
- SIADH (endocrine issue)
- Cushing syndrome (endocrine issue)
- Long-term use of corticosteroids (cause fluid retention)
- TACO (blood transfusion administered too quickly)
Why would someone have FVD (deficit)- Causes
- Increase in insensible water loss or perspiration (high fever, heatstroke)
- Diabetes insipidus (endocrine)
- Osmotic diuresis (diuretics that pull excess water out by osmosis–ex: Mannitol(
- Hemorrhage (internal bleeding)
- GI losses: vomiting, NG suction, diarrhea, fistula drainage
- Overuse of diuretics (example: Heart failure Pt)
- Inadequate fluid intake
- Third-space fluid shifts: burns, pancreatitis
Too much fluid in the lungs is ________ _________.
Pulmonary edema
Too much fluid in the ankles is ______ _______.
Peripheral edema
Fluid that collects in an area that serves no purpose and does not belong is called:
a) 2nd Spacing
b) Mitral Spacing
c) 3rd spacing
d) 8th spacing
c) 3rd Spacing
examples: Pleural effusion [PE], peritoneum, pericardium
Two most common Med-Surg co-morbidities in adults for FVE (excess)?
Heart Failure
Renal Failure
Who has a greater risk for FVE, especially due to heart failure?
Elderly/Older adults
Manifestations of Fluid Volume Excess
- Headache, confusion, lethargy
- Peripheral edema
- Jugular venous distention
- S3 heart sound
- Bounding pulse, ↑ BP, ↑ CVP
- Polyuria (with normal renal function)
- Dyspnea, crackles, pulmonary edema
- Muscle spasms
- Weight gain
- Seizures, coma
What part of the body does peripheral edema usually occur? Why?
Ankles, because the ankles are a “dependent” part of the body. It is harder for the blood to pump back up to the heart, especially when standing all day.
Dependent position is…
any area of the body below the level of the heart
S3 heart sound is considered what type of sound?
a) clicking
b) gallop
c) no sound
d) skipping
b) gallop
d/t overload on the heart
With regards to FVE and FVD, is the weight gain/loss due to water or nutrition?
Water weight
