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Hypervolemia Flashcards

1
Q

What is fluid volume excess?

A

Too much fluid in the vascular space

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2
Q

What is the vascular space?

A

Veins
Capilaries
Artery
CV system

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3
Q

What are some causes to hypervolemia?

A

HF
Renal failure
Lots of sodium

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4
Q

When you have HF, what happens? (4)

A
  • Heart is weak
  • CO decreases
  • Kidney perfusion decreases
  • UO decreases
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5
Q

HF where is fluid?

A

In vascular space

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6
Q

What happens with renal failure?

A

Kidneys aren’t functioning

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7
Q

What are examples of things with lots of Na?

A
  • Effervescent soluble meds
  • Canned/processed foods
  • IV fluids with sodium
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8
Q

What does Na do?

A

Makes you retain H20 and stays in vascular space

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9
Q

What is aldosterone?

A

Steroid…mineralocoticoid

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10
Q

Where is aldosterone found?

A

Adrenal glands (on top of kidneys)

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11
Q

What is the NORMAL action of aldosterone?

A

When blood volume gets low (hemorrhage, vomiting, etc) aldosterone secretion with increase, which helps retain Na and H20 (in vas. space). When Na and H20 increases in vascular space, it increases blood volume

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12
Q

What are diseases with too much aldosterone (retaining too much Na and H20)?

A 
Cushings
Hyperaldosteronism (Conns)
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13
Q

What is a disease with too little aldosterone?

A

Addison

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14
Q

Where is ANP found?

A

Atrium of heart

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15
Q

How does atrium work?

A

Opposite of aldosterone

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16
Q

Since ANP is the opposite of aldosterone, what does ANP do?

A

Excretion of Na and H20

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17
Q

ANP is a mechanism to ____

A

Decrease fluid volume

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18
Q

ANP or aldosterone?

Found in atrium of heart

A

ANP

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19
Q

ANP or aldosterone?

Retains Na and H20

A

Aldosterone

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20
Q

ANP or aldosterone?

Found on top of kidneys

A

Aldosterone

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21
Q

ANP or aldosterone?

Decreases blood volume

A

ANP

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22
Q

ANP or aldosterone?

Increases blood volume

A

Aldosterone

23
Q

ANP or aldosterone?

Found in adrenal glands

A

Aldosterone

24
Q

ANP or aldosterone?

Excretion of Na and H20

A

ANP

25
Q

What does anti-diuretic hormone (ADH) do?

A

Makes you retain H20 ONLY

26
Q

Too much or too little ADH

Fluid volume deficit

A

Too little ADH (DI)

27
Q

Too much or too little ADH

Retain water

A

Too much ADH (SIADH)

28
Q

Too much or too little ADH

Blood is diluted

A

Too much ADH (SIADH)

29
Q

Too much or too little ADH

Urine is diluted

A

Too little ADH (DI)

30
Q

Too much or too little ADH

Blood is concentrated

A

Too little ADH (DI)

31
Q

Too much or too little ADH

Fluid volume excess

A

Too much ADH (SIADH)

32
Q

Too much or too little ADH

Diureses

A

Too little ADH (DI)

33
Q

Too much or too little ADH

Urine is concentrated

A

Too much ADH (SIADH)

34
Q

Too much or too little ADH

Loose water

A

Too little ADH (DI)

35
Q

Too much or too little ADH

SIADH

A

Too much ADH (SIADH)

36
Q

Too much or too little ADH

DI

A

Too little ADH

37
Q

Where is ADH found?

A

Pituitary

38
Q

What makes you think and ADH problem?

A

Head traumas!!!

craniotomy, head injury, sinus surgery, transsphenoidal hypophysectomy, increased ICP conditions

39
Q

What is another name for ADH?

A

Vasopressin or DDAVP

40
Q

What disease would need ADH: SIADH or DI?

A

DI (too little ADH)

41
Q

ADH= vasopressin. What does ADH do?

A

Causes you to retain H20

42
Q

Fluid volume overload SS (9)?

A
  • Distended neck veins/peripheral veins (vessels=full)
  • Peripheral edema/3rd spacing
  • CVP increases
  • Wet lung sounds/crackles
  • Polyuria
  • HR Increases
  • BP increases
  • Weight increases
43
Q

Why is there peripheral edema/3rd spacing with fluid volume overload?

A

Vessels can’t hold anymore, so start to leak

44
Q

Fluid volume overload

Where is CVP measured and why would it increase?

A

Measured in right atrium

Move volume, more pressure

45
Q

Fluid volume overload

What is normal CVP?

A

2-6

46
Q

Fluid volume overload

Why would there be polyuria?

A

Kidneys trying to diurese

47
Q

Fluid volume overload

What problems can these lead to due to the fluid not being able to be pushed forward efficiently?

A

Can lead to HF and pulmonary edema

48
Q

Fluid volume overload

Why does BP increase?

A

More volume, more pressure

49
Q

Acute weight gain: fat or fluid?

A

FLUID

50
Q

Fluid volume overload

Fluid retention, think what problems first?

A

Heart problems

51
Q

Treatment?

A

Low Na/restrict fluids
I&O and daily weights
Diuretics

52
Q

What are the diuretics given?

A

Loop: Furosemide (40mg) or Bumetanide (1mg)

Hydrochlorathiazide

Potassium sparing: Spirolanactone

53
Q

Treatment

Bedrest induces diuresis by the release of ____ which does what?

A

Bedrest induces diuresis by the release of ANP (loose Na and H20) and decreases production of ADH (so you don’t retain H20 and Na since normal ADH causes you to retain)

54
Q

Who to give IV fluids slowly to? Why are we even giving fluids during hypervolomia?

A

To elderly and very young

Pt. on bedrest= increased risk for complications like constopation, pneumonia, DVT

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