Wk 3 Fluid Volume Imbalances Flashcards
Albumin has __ power
pulling
Albumin is related to…
Colloid osmotic pressure
What does it mean that albumin has pulling power?
If there is adequate albumin in the intravascular space, then you will have fluid in the intravascular space
If you are low in albumin, fliud will
leak into the interstitum and create third spacing
Back up of hydrostatic pressure will cause fliud to move from…
the intravascular space into the interstitial space
Hydrostatic pressure has __ power
Pushing
Who is at risk for getting volume excess from excess isotonic/hypotonic IV fluids?
Elderly and those with heart failure
What is third spacing?
Too much fluid in a space where it doesn’t belong, like in a place such as the peritoneum
Someone with renal failure is at risk for fluid volume excess because…
Their kidneys aren’t secreting enough urine
Why is primary polydipsia a risk factor for fluid volume excess?
Their psychological status may cause them to drink more water than they can excrete
3 other conditions that puts a patient at risk for fluid volume excess
SIADH
Cushing syndrome
Long-term use of corticosteroids
What does SIADH stand for?
Sydrome of Inappropriate anti-diuretic hormone secretion
What is SIADH?
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.
What is cushing’s syndrome?
occurs when your body makes too much of the hormone cortisol over a long period of time
What is an example of insensible (can’t be measured) water loss?
High fever
Perspirations
Heatstroke
3 examples of conditions that lead to fluid volume deficit
Diabetes insipidus
Osmotic diuresis
Hemorrhage
What is diabetes inspidus?
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.
What is osmotic diuresis?
increased urination due to the presence of certain substances in the fluid filtered by the kidneys.
What are two examples of an osmotic diuretic?
mannitol and isossorbide
Who else is at risk for fluid volume deficit?
Someone who is not taking in enough fluid
How are GI losses related to fluid volume deficit?
Vomiting
NG suction
Diarrhea
Fistula drainage
Overuse of diuretics can lead to…
fluid volume deficit
What are examples of third spacing fluid shifts that lead to fluid volume deficit?
Burns
If your skin is burned you have problems with…
Capillary permability
What is another example of third spacing?
Pleural effusion
What are the manifestations of fluid volume excess?
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
What are the manifestations of fluid volume deficit?
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
What is a S3 heart sound called?
A Gallop
What is CVP?
Central venous pressure
What does fluid volume excess lead to seizures and coma?
Due to the hyponatremia
Who has a decreased thirst mechanism?
The elderly
To measure a daily weight it needs to be what three things?
Same scale
Same clothes
Same time of day
What are nursing management of FV imbalances
Daily weights
I&Os
Lab findings
What are three labs to pay attention to for a patient with FV imbalances?
BUN
Na+
Hct
When a patient has a FV balance, their labs might be…
False high or low
What else can we measure that related to FV?
Urine and serum osmolality
What does a urine and serum osmolality measure?
How concentrated the urine and serum is
If a patient has mild fluid volume deficit…
may encourage oral rehydration
If a patient has severe fluid volume deficit…
May replace volume with blood products or balance IV solutions
If a patient has fluid volume excess, what might we do?
Restrict fluids
With fluid volume excess, what will the heart rate sound like?
Bounding
With fluid volume deficit the pulse will sound…
Faint, weak, thready
With fluid volume deficit, why does the pulse become tachycardic?
Trying to keep up with drop in blood pressure
What is a way you can measure if someone has fluid volume deficit concerning blood pressure?
See if they have orthostatic hypotension
What brings a patient into the hospital when they have fluid volume overload?
Pulmonary edema, they can’t breathe
What are patient safety concerns?
Change in LOC
Orthostatic hypotension
Why would a patient with FVE or FVD have a change in LOC?
Due to the very high or very low levels of sodium in the blood
What can be delegated to a UAP when it comes to FV imbalances?
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
