Fluid Volume Distrubances Flashcards
It occurs when loss of ECF exceeds fluid intake
HYPOVOLEMIA
Causes of hypovolemia
-Vomiting
-Diarrhea
-GI suctioning
-Diaphoresis
-Decreased intake
-Adrenal insufficiency
-Third-spacing
-Osmotic diuresis
-Diabetes insipidus
-Hemorrhage
How does diabetes insipidus contribute to hypovolemia
One of the manifestations of the diabetes insipidus is the decreased/lack of release of AVP (Arginine-Vasopressin).
AVP helps regulate kidney function.
Decreased AVP = Increased urination
Clinical Assessments/manifestations of hypovolemia
Increased BUN
Increased Serum creatinine
Increased HCT
Increased urine specific gravity
Hypokalemia/Hyper
Hyponatremia/hypo
Delirium
Management of hypovolemia
- Fluid replacement (Isotonic to Hypotonic)
- Monitor I & O
- Daily weights (same day, same clothes, same weighing scale)
- Observe for weak, rapid pulse, orthostatic hypotension, decreased body temp
- Monitor skin and tongue turgor
- Assess oral mucous membrane
- Offer ORS
- Antiemetic
Places to check for skin turgor
- Forehead
- Sternum
-Inner thigh
Isotonic expression of the ECF caused by abnormal retention of water & sodium in body
HYPERVOLEMIA
Example of antiemetic
Metoclopramide (Plasil)
Contributing factors of hypervolemia
- Heart failure
- Renal failure
- Liver cirrhosis
- Excessive salt consumption
- Excessive administration of Na-containing IV fluids
Clinical manifestation of Hypervolemia
- Edema
- Distended neck vein
- Crackles (too much fluid)
Assessment of hypervolemia
- Decreased BUN
- Decreased HCT
- Decreased serum osmolarity
- Decreased serum sodium level
- Azotemia
- Hyperuricemia
- Edema (Asanarca)
Increased nitrogen levels in blood
AZOTEMIA
Increased uric levels in blood
Hyperuricemia
Generalized edema
ANASARCA
Medical management for hypervolemia
- Administration of diuretic
- Loop (Furosemide-Lasix)
- Thiazide (Hydrodiuril)
- K-Sparing Diuretics - Restrict fluid & sodium
- Dialysis
