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Study > Hypovolemia > Flashcards

Hypovolemia Flashcards

1
Q

Why does this happen?

A
  1. Loss of fluids from anywhere!!
    (thorcentesis, paracentesis, vomiting, diarrhea, hemorrhage)
  2. Third spacing
  3. Diseases with polyuria
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2
Q

What is third spacing?

A

When fluid is in a place that does you no good–like interstitial space

  • burns (fluids go to tissue)
  • ascites (fluid in abdomen)
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3
Q

Why do diseases with polyuria cause loss of fluid?

A

Polyuria (loose fluid and can cause shock)

Oliguria (trying to save as much fluid as possible)

Anuria (no urine!!–can lead to kidney problems)

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4
Q

S/S?

A
  • Weight decreases
  • Decreased skin turgor
  • Dry MM
  • Decreased UO
  • BP decreases
  • HR and RR increases
  • CVP decreases
  • Tiny veins (hard to start IVs)
  • Cool extremities
  • Urine specific gravity increase
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5
Q

Why is there decreased UO?

A

Kidneys aren’t being perfused or they are trying to hold on to the fluid to compensate

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6
Q

Why is there decreased BP?

A

Less volume, less pressure

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7
Q

What is pulse like?

A

Increased–heart is trying to pump what little fluid is left

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8
Q

Hypovolemia or hypervolemia

Increased HR

A

Both

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9
Q

Hypovolemia or hypervolemia

HR weak and thready

A

Hypo

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10
Q

HR full and bounding

A

Hyper

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11
Q

Why is RR increasing?

A

Body thinks decrease BV is from hypoxia so trying to get more O2 in

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12
Q

Urine specific gravity increased (concentrated)…If UO is happening at all, how will it be?

A

Very concentrated

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13
Q

Treatment?

A
  • Prevent further losses
  • Replace volume
  • Safety
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14
Q

How to replace if mild deficit?

A

Po fluid

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15
Q

How to replace if severe deficit?

A

IV fluids

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16
Q

Why is there a higher risk for falls?

A

Decreased BP—risk for orthostatic hypotension

17
Q

Why would there be high risk for overload with tx for deficit?

A

Giving too much fluid too quick

18
Q

How to take VS for someone with orthostatic hypotension and 3 checks?

A
  • Lie down 3 min
  • Take VS while lying
  • Take VS with sitting
  • Take VS while standing
  • Record
19
Q

What do isotonic fluids do?

A

Go into vascular space and STAYS

20
Q

Examples of isotonic fluids?

A

NS (0.9)
LR
D5W
D51/4NS

21
Q

Who would get isotonic fluids?

A

Those who lots fluids from burns, NV, sweating, and trauma

22
Q

What is the basic solution when administering blood?

A

Normal saline

23
Q

Who does NOT get normal saline?

A

HTN
Cardiac disease
Renal disease

24
Q

Isotonic fluids can cause what 3 things?

A

FV excess
HTN
Hypernatremia (for those that contain sodium)

25
Q

What do hypotonic solutions do?

A

Go into vascular space, then shifts to cells to replace cell fluid

26
Q

Do hypotonic solutions rehydrate?

A

Yes

27
Q

Do hypotonic solutions cause HTN?

A

NO

28
Q

Examples of hypotonic fluids?

A

D2.5W

  1. 45 NS
  2. 33 NS
29
Q

Who gets hypotonic fluids?

A

Those with HTN, renal or cardiac disease

Those who need fluids because of NV, burns, hemorrhage

*also used for client with hypernatremia and for cell dehydration

30
Q

What is the alert with hypotonic fluids?

A

Watch for cell edema bc this fluid is moving to cells which can lead to FV deficit and decreased BP

31
Q

What are hypertonic solutions?

A

Volume expanders that will draw fluid into vascular space from cells

32
Q

Examples of hypertonic solutions?

A 
D10W
3%NS
5% NS
D5LR
D51/2NS
DF NS
TPN
ALbumin
33
Q

Who gets hypertonic solutions?

A

Pt. with HYPOnatremia

Client who has shifted large amounts of vasc. volume to 3rd space

Burns, edema, ascites

34
Q

What solution returns fluid volume to vascular space?

A

HYPERtonic

35
Q

What is alert for hypertonic fluids?

A

Fluid volume excess and pulm. edema

*do frequent monitoring of BP, HR, and CVP!!

36
Q

What solution:

Stay where I put it

A

Isotonic

37
Q

What solution:

Enter vessel

A

Hypertonic

38
Q

What solution:

Go out of vessel

A

Hypotonic

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