hypovolemia Flashcards
occurs when loss of ECF volume exceeds the intake of fluid.
HYPOVOLEMIA
occurs when water and electrolytes are lost in the same proportion as they
exist in normal body fluids; thus, the ratio of serum electrolytes to water
remains the same.
HYPOVOLEMIA
refers to loss of water alone, with increased serum sodium levels.
Dehydration
pathophysiology of hypovolemia
Loss of body fluids + decreased fluid intake
Prolonged period of inadequate intake.
Causes of Loss of Water and Electrolytes
Vomiting
- Diarrhea
- Fistulas
- Blood loss
- Gastrointestinal suction
- Third space fluid shifts
causes of Prolonged Period of Inadequate Intake
- Anorexia
- Nausea
- Inability to gain access to fluid
CLINICAL MANIFESTATIONS in hypovolemia
Neurological Mucous membranes Integumentary Urinary Cardiovascular Metabolic processes
Potential complication of hypovolemia
Hypovolaemic shock
blood pressure of hypovolemia
Decreased systolic
Postural hypotension
Heart rate of hypovolemia
Increased
Pulse amplitude of hypovolemia
Decreased
Respirations of hypovolemia
normal
Jugular vein of hypovolemia
flat
edema in hypovolemia
rare
skin turgor of hypovolemia
Loose, poor turgor
Urine output of hypovolemia
Low concentrated
weight in hypovolemia
loss
DIAGNOSTIC FINDINGS OF HYPOVOLEMIA
Increased hematocrit and hemoglobin
Decreased plasma volume
DIAGNOSTIC FINDINGS OF HYPOVOLEMIA
Increased serum and urine osmolality
and specific gravity
due to kidney’s attempt to conserve
water
DIAGNOSTIC FINDINGS OF HYPOVOLEMIA
Decreased urine sodium
due to secretion of aldosterone
DIAGNOSTIC FINDINGS OF HYPOVOLEMIA
Increased BUN and creatinine
a volume-depleted patient has a BUN
elevated out of proportion to the
serum creatinine (ratio greater than
20:1)
Serum Electrolyte changes
hypokalemia
Occurs with GI and renal losses.
Serum Electrolyte changes
hyperkalemia
Occurs with adrenal insufficiency
Serum Electrolyte changes
hyponatremia
Occurs with increased thirst and ADH
release.
Serum Electrolyte changes
hypernatremia
Results from increased insensible
losses and diabetes insipidus.
MEDICAL MANAGEMENT OF HYPOVOLEMIA
HYDRATION
MONITORING
FLUID CHALLENGE
rapid administration of a designated amount of
intravenous fluid when urine output is low and cardiac or renal function is
typical fluid challenge test involves administering 100 to 200 ml of
normal saline solution over 15 minutes.
Fluid Challenge
The goal is to provide fluids rapidly enough to attain adequate tissue
perfusion without compromising the cardiovascular system. The response
by a patient with FVD but normal renal function is increased urine output
and an increase in blood pressure and central venous pressure.
Fluid Challenge
a hemodynamic monitoring method for monitoring method for
evaluating fluid volume status
Central Venous Pressure
Normal CENTRAL VENOUS PRESSURE CVP range
2 to 5mmHg
Low CVP-
inadequate venous return from fluid deficit and hypovolemia or
peripheral vasodilation
High CVP
fluid overload, cardiac problems that decrease cardiac contractility
or pulmonary disorders that Increase pulmonary vascular resistance
TRUE OR FALSE
Monitor I and O every 7 hours. Normal Urine Output is 30m/hour
FALSE, 8 HOURS
TRUE OR FALSE
180 measurements are totaled at the end of the shift (every 8 to 12 hours),
and the totals are recorded in a client’s chart
TRUE
TRUE OR FALSE
Compare the total 12-hour fluid output measurement with the total 24-
hour fluid intake measurement and compare both to previous
measurements
FALSE, 24-HOUR FLUID OUTPUT
TRUE OR FALSE
Clients whose output substantially exceeds intake are at risk for fluid
volume deficit, whereas clients whose intake substantially exceeds output
are at risk for fluid volume excess
TRUE
TRUE OR FALSE
When there is a significant discrepancy between intake and output or
when fluid intake or output is inadequate (for example, a urine output of
less than 30 mL/h in an adult)
TRUE
WHAT ARE THE NURSING DIAGNOSIS FOR HYPOVOLEMIA
Deficient fluid volume
Ineffective tissue perfusion
Risk for injury
