Fluid Volume

Question 1

Hypervolemia ^

Answer 1

Excessive intake of fluids, abnormal retention of fluids (CHF), or interstitial-to-plasma fluid shift

Question 2

Hypervolemia ^

Causes

Answer 2

Too much blood
Too much/fast IV fluid
Organ issues (heart failure, kidney dysfunction, cirrhosis)
Increased Na intake 
Hypertonic solution

Question 3

Hypervolemia ^

Manifestations

Answer 3

CNS: lethargic, seizure, coma
CVS: Increased HR (bounding pulse), increased BP, JVD
Resp: Pulmonary edema
GU: Increased U/O (dilute urine)
Skin: Edema

Question 4

Hypervolemia ^

Interventions

Answer 4

Diuretics
Low sodium diet
Daily in and out
Daily weight
Check lab values
BIPAP

Question 5

Hypovolemia

Causes

Answer 5

Decreased blood volume
Vomiting, diarrhea
Severe dehydration
Trauma burn
Diuretics
Third spacing

Question 6

Hypovolemia

Manifestations

Answer 6

CNS: Thirst, confusion, lethargic, seizure, comma
CVS: Increased HR (thready pulse), decreased BP, orthostatic hypotension
Resp: RR increases
GU: Decreased U/O (dark urine)
Skin, decreased skin turgor

Question 7

Hypovolemia

Interventions

Answer 7

PO/IV rehydration
Daily in/out
Daily weight
Check lab values

Question 8

Hypernatremia ^

Causes

Answer 8

Meals
Osmotic Diuretics
Diabetic Insipidus
Excessive water loss
Low water intake

Question 9

Hypernatremia^

Manifestations

Answer 9

Flushed skin
Restlessness
Increased fluid retention
Edema
Neuromuscular excitability
Decreased urine output
Sleepy (lethargy, coma)

Question 10

Hypernatremia^

Interventions

Answer 10

Restrict diet sodium intake
Diuretic to promote sodium loss
Give free water
Daily weight
IV infusion for fluid loss
Monitor CVS, resp, neuro, cerebral, renal, stuts

Question 11

Hyponatremia

Cause

Answer 11

SIADH (Syndrome of ineffective ADH)
Intoxication of water
Adrenal Insufficiency
Diuretic, diarrhea, diaphoresis, drain (NG suction)
Heat exhaustion or high fever

Question 12

Hyponatremia

Manifestations

Answer 12

Stupor (comma)
Anorexia (N/V)
Lethargy
Tendon reflex decrease

Limb weakness
Orthostatic hypotension
Seizure
Stomach cramping

Question 13

Hyponatremia

Intervention

Answer 13

Medication antagonize ADH
Osmotic diuretic
increase oral sodium intake
IV sodium chloride infusion (careful)
Monitor for CVS, resp, neuro, cerebral, renal, status

Question 14

Hyperkalemia^

Cause

Answer 14

Medication (ACE, NSAIDS)
Acidosis
Cellular destruction (burn, traumatic injury)
Hypoaldosteronism
Intake (excessive)
Nephrons (renal failure)
Excretion impaired

Question 15

hypercalcemia^

Cause

Answer 15

hyperparathyroidism
Antacid
Malignancy cancer

Question 16

Hypercalcemia^

Manifestations

Answer 16

Groans constipation
Moans Joint pain
Bones loss of calcium
Stones Kidney stones
Overtones Psychiatric overtones (confusion or depression)

Question 17

Hypercalcemia^

Intervention

Answer 17

Low calcium diet
promote excretion of calcium
use calcium reabsorption inhibitor
dialysis

Question 18

Hypocalcemia

Cause

Answer 18

Alcoholism
Blood transfusion multiple
Calcium and vit D low intake
Diarrhea or chrons disease
Low Parathyroidism
Oral meds (laxatives, diuretics, steriods)
Wound drainage

Question 19

Hypocalcemia

Manifestations

Answer 19

Convulsions
Arrythmia
tetany (numbness or tingly of muscle)
Trousseau's or Chvostek's sign
Spasm and Stridor

Question 20

Hyperkalemia