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Med Surg I > Wk 3 Fluid Volume Imbalances > Flashcards

Wk 3 Fluid Volume Imbalances Flashcards

1
Q

Albumin has __ power

A

pulling

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2
Q

Albumin is related to…

A

Colloid osmotic pressure

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3
Q

What does it mean that albumin has pulling power?

A

If there is adequate albumin in the intravascular space, then you will have fluid in the intravascular space

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4
Q

If you are low in albumin, fliud will

A

leak into the interstitum and create third spacing

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5
Q

Back up of hydrostatic pressure will cause fliud to move from…

A

the intravascular space into the interstitial space

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6
Q

Hydrostatic pressure has __ power

A

Pushing

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7
Q

Who is at risk for getting volume excess from excess isotonic/hypotonic IV fluids?

A

Elderly and those with heart failure

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8
Q

What is third spacing?

A

Too much fluid in a space where it doesn’t belong, like in a place such as the peritoneum

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9
Q

Someone with renal failure is at risk for fluid volume excess because…

A

Their kidneys aren’t secreting enough urine

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10
Q

Why is primary polydipsia a risk factor for fluid volume excess?

A

Their psychological status may cause them to drink more water than they can excrete

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11
Q

3 other conditions that puts a patient at risk for fluid volume excess

A

SIADH
Cushing syndrome
Long-term use of corticosteroids

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12
Q

What does SIADH stand for?

A

Sydrome of Inappropriate anti-diuretic hormone secretion

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13
Q

What is SIADH?

A

condition in which the body makes too much antidiuretic hormone (ADH). This hormone helps the kidneys control the amount of water your body loses through the urine. SIADH causes the body to retain too much water.

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14
Q

What is cushing’s syndrome?

A

occurs when your body makes too much of the hormone cortisol over a long period of time

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15
Q

What is an example of insensible (can’t be measured) water loss?

A

High fever
Perspirations
Heatstroke

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16
Q

3 examples of conditions that lead to fluid volume deficit

A

Diabetes insipidus
Osmotic diuresis
Hemorrhage

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17
Q

What is diabetes inspidus?

A

causes an imbalance of fluids in the body. This imbalance leads you to produce large amounts of urine. It also makes you very thirsty even if you have something to drink.
A disorder of salt and water metabolism marked by intense thirst and heavy urination.
Diabetes insipidus occurs when the body can’t regulate how it handles fluids. The condition is caused by a hormonal abnormality and isn’t related to diabetes.

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18
Q

What is osmotic diuresis?

A

increased urination due to the presence of certain substances in the fluid filtered by the kidneys.

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19
Q

What are two examples of an osmotic diuretic?

A

mannitol and isossorbide

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20
Q

Who else is at risk for fluid volume deficit?

A

Someone who is not taking in enough fluid

21
Q

How are GI losses related to fluid volume deficit?

A

Vomiting
NG suction
Diarrhea
Fistula drainage

22
Q

Overuse of diuretics can lead to…

A

fluid volume deficit

23
Q

What are examples of third spacing fluid shifts that lead to fluid volume deficit?

A

Burns

24
Q

If your skin is burned you have problems with…

A

Capillary permability

25
Q

What is another example of third spacing?

A

Pleural effusion

26
Q

What are the manifestations of fluid volume excess?

A 
Headache, confusion, lethargy
Peripheral edema
Jugular vein distention
S3 sound
Bounding pulse
Hypertension
Central venous pressure
Polyuria
Dyspnea
Crackles
Pulmonary edema
Muscle spasms
Weight gain
Seizures 
Coma
27
Q

What are the manifestations of fluid volume deficit?

A 
Resetlessness
Drowsiness
Lethargy
Confusion
Thirst
Dry mucous membranes
Cold clammy skin
Decreased skin turgor
Decreased capillary refill
Postural hypotension
Tachycardia
Decreased CVP
Decreased urine output
Tachypnea
28
Q

What is a S3 heart sound called?

A

A Gallop

29
Q

What is CVP?

A

Central venous pressure

30
Q

What does fluid volume excess lead to seizures and coma?

A

Due to the hyponatremia

31
Q

Who has a decreased thirst mechanism?

A

The elderly

32
Q

To measure a daily weight it needs to be what three things?

A

Same scale
Same clothes
Same time of day

33
Q

What are nursing management of FV imbalances

A

Daily weights
I&Os
Lab findings

34
Q

What are three labs to pay attention to for a patient with FV imbalances?

A

BUN
Na+
Hct

35
Q

When a patient has a FV balance, their labs might be…

A

False high or low

36
Q

What else can we measure that related to FV?

A

Urine and serum osmolality

37
Q

What does a urine and serum osmolality measure?

A

How concentrated the urine and serum is

38
Q

If a patient has mild fluid volume deficit…

A

may encourage oral rehydration

39
Q

If a patient has severe fluid volume deficit…

A

May replace volume with blood products or balance IV solutions

40
Q

If a patient has fluid volume excess, what might we do?

A

Restrict fluids

41
Q

With fluid volume excess, what will the heart rate sound like?

A

Bounding

42
Q

With fluid volume deficit the pulse will sound…

A

Faint, weak, thready

43
Q

With fluid volume deficit, why does the pulse become tachycardic?

A

Trying to keep up with drop in blood pressure

44
Q

What is a way you can measure if someone has fluid volume deficit concerning blood pressure?

A

See if they have orthostatic hypotension

45
Q

What brings a patient into the hospital when they have fluid volume overload?

A

Pulmonary edema, they can’t breathe

46
Q

What are patient safety concerns?

A

Change in LOC

Orthostatic hypotension

47
Q

Why would a patient with FVE or FVD have a change in LOC?

A

Due to the very high or very low levels of sodium in the blood

48
Q

What can be delegated to a UAP when it comes to FV imbalances?

A 
Obtain daily weights and vital signs
Offer frequent oral care
Record accurate intake and output
Perform skin care and frequent position changes
Elevated extremities
Encourage oral fluids

Med Surg I (41 decks)

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