Hypovolemia Vs. Hypervolemia

Question 1

Diabetes: cause of (blank)volemia

Answer 1

Hypovolemia

Question 2

Excess dietary sodium: cause of (blank)volemia

Answer 2

Hypovolemia

Question 3

Renal dysfunction: cause (blank)volemia

Answer 3

Hypovolemia and Hypervolemia

Question 4

Serum protein depletion and hyponatremia: cause (blank)volemia

Answer 4

Hypervolemia

Question 5

CHF, Pulmonary Edema: cause of (blank)volemia

Answer 5

Hypervolemia

Question 6

Cirrhosis (with ascites and portal hypertension): cause of (blank)volemia

Answer 6

Hypervolemia

Question 7

overuse of diuretics: cause of (blank)volemia

Answer 7

Hypovolemia

Question 8

Iv fluid excess

Answer 8

Hypervolemia

Question 9

burns

Answer 9

Hypovolemia

Question 10

Signs and Symptoms: Hypovolemia

Answer 10

Restlessness, lethargy, confusion, weakness
Thirst
Decreased BP

Question 11

Signs and Symptoms: Hypervolemia

Answer 11

Headache, confusion, lethargy
Restlessness, anxiety
Distended neck veins (JVD)
Bounding pulse

Question 12

Seizures and Coma

Answer 12

Hypo/Hypervolemia

Question 13

Decreased urine output

Answer 13

Hypovolemia

Question 14

Postural Hypotension

Answer 14

Hypovolemia

Question 15

Dyspnea/Crackles

Answer 15

Hypervolemia

Question 16

3rd heart sound (S3)

Answer 16

Hypervolemia

Question 17

How will I know there is postural hypotension?

Answer 17

Drop in Bp with body position change

Question 18

If there are concerns with pulmonary edema, audible crackles, dyspnea….what would you do?

Answer 18

Apply o2 as neccessary, chest xray, Lasix (you want to diuresis), evaluate work of breathing (auscultate lung sounds, are they using accessory muscles) , inform physician, ABG if LOC changing with work of breathing…

Question 19

Interventions/Nursing Considerations:Monitor Intake/Output

Answer 19

Hypervolemia and Hypovolemia

Question 20

Interventions/Nursing Considerations: Encourage fluids/Oral Intake

Answer 20

Hypovolemia

Question 21

Interventions/Nursing Considerations: Monitor Daily Weight

Answer 21

Hypervolemia (change in weight significant if increase 2 pounds a day–also in hypovolemia)….weight very important in pt’s with fluid overload

Question 22

Interventions/Nursing Considerations: Neurological – LOC, PERLA, voluntary movement of extremities, muscle strength, reflexes

Answer 22

Hypervolemia and Hypovolemia

Question 23

Interventions/Nursing Considerations: Chest xray

Answer 23

Hypervolemia (lungs will appear white on xray when in fluid overload)

Question 24

What is the most accurate measure of determining a pt’s fluid balance

Answer 24

A patient’s weight. Weigh daily in am prior to breakfast. Hard to account for insensible fluid loss on a fluid in/out graphic sheet.

Question 25

Interventions/Nursing Considerations: Promote adherence to fluid restrictions and patient teaching related to sodium and fluid restrictions
include medications

Answer 25

Hypervolemia

Question 26

Interventions/Nursing Considerations:monitor responses to medications such as diuretics

Answer 26

Hypervolemia

Question 27

Interventions/Nursing Considerations: Insert a foley

Answer 27

Hyper/Hypo— Inserting a foley lets you accurately measure the output of urine accurately vs how much an individual is receiving (intake), measure effectiveness of medications such as diuretics, assist in addressing kidney function

… ex. a patient is receiving 250mls in tube feed, iv fluid, oral intake in total an hour for 12 hours and putting out 20mls of urine an hour, what can this information tell you

Question 28

Interventions/Nursing Considerations: Use semi-Fowler’s position for orthopnea

Answer 28

Hypervolemia