How to Evaluate Fluid Status

Question 1

How to evaluate fluid status

Answer 1

• Serum osmolality
• Urine specific gravity
• CMP (Complete metabolic Panel) aka BUN, Creatinine
• Hematocrit
• I&O
• weight (changes)
• Skin Turgor (subjective in older adults)
• BP changes

Question 2

Osmolality
(range, definition, example, numbers mean)

Answer 2

• Measures solutes (particles) in body fluids
• E.g. DI → expect high bc getting rid of too much water
• E.g. Diabetes, HHS→ high solutes
• E.g. SIADH → low bc holds too much water, diluting

Question 3

Urine Specific Gravity (range, definition, example, numbers mean)

Answer 3

• Measures density of urine compared to water
• Is the measure of concentration of solutes in urine
• 1.005 is very dilute or high in water content
• 1.030 is very concentrated or low in water content
• Well-hydrated person (low specific gravity); dehydrated person (high specific gravity)

Question 4

CMP
(range, definition, example, numbers mean)

Answer 4

• BUN (10-20 mg/dL)
• Several variables (ESKD,GIB, eating high protein diet → higher BUN (too much rubbish in the blood)
• Is a lab value that measures amount of urea in bloodstream
• Increased BUN→urine output decreases (seen in renal dysfunction), water content decrease (dehydration), high protein diet (increased amino acid in bloodstream, increasing nitrogen content of blood, thus increasing BUN)
• Creatinine (0.7-1.4 mg/dL)
• Too much creatinine (higher number) → kidney not doing good job in getting rid
• Age, muscle can affect
• Muscle makes rubbish in body (creatinine)

Question 5

Hematocrit (range, meaning)

Answer 5

(42-52% for men; 35-47% for women)
If higher side, hemoconcentration (dehydrated)