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44 Cards in this Set
- Front
- Back
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How many mL of water is released by the metabolism of each 100 calories of fat, carbohydrates, or proteins ?
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About 10 mL
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In regards to body fluid output, what is meant by 'insensible loss' ?
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water lost through the skin and lungs
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What is the average amount of water lost by perspiration?
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100 mL / day
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Which organ plays a major role in regulating fluid and electrolyte balance?
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the kidneys
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Homeostasis
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term that indicates the relative stability of the internal environment
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How do the adrenal glands assist in maintaining fluid balance?
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The adrenal glands secrete aldosterone, which aids in controlling extracellular fluid volume by regulating the amount of sodium reabsorbed by the kidneys.
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How does the pituitary gland contribute to fluid balance?
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Antidiuretic hormone from the pituitary gland regulates the osmotic pressure of extracellular fluid by regulating the amount of water reabsorbed by the kidneys.
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What are the cardiovascular assessment findings of a patient with fluid volume deficit?
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Thready, increased pulse rate
Decreased BP and orthostatic hypotension Flat neck and hand veins in dependent positions Diminished peripheral pulses Decreased central venous pressure Dysrhythmias |
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Respiratory assessment findings of patient with fluid volume deficit
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Increased rate and depth of respirations Dyspnea |
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Neuromuscular assessment findings of patient with fluid volume deficit
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Decreased CNS activity, from lethargy to coma Fever, depending on the amount of fluid loss Skeletal muscle weakness |
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What would a FVD patients urine output be?
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A patient with fluid volume deficit would have decreased urine output
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Integumentary assessment findings of a patient with fluid volume deficit
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Dry skin
Poor turgor, tenting Dry mouth |
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Gastrointestinal assessment findings of a patient with fluid volume deficit
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Decreased motility and diminished bowel sounds Constipation Thirst Decreased body weight |
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Laboratory findings of a patient with fluid volume deficit
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Increased serum osmolality
Increased hematocrit Increased blood urea nitrogen Increased serum sodium level Increased urinary specific gravity |
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Goal of treatment for fluid volume deficit
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Restore fluid volume, replace electrolytes as needed, and eliminate the cause of the FVD.
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Cardiovascular assessment findings of patient with fluid volume excess
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Bounding, increased pulse rate Elevated BP Distended neck and hand veins Elevated central venous pressure Dysrhythmias |
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Respiratory assessment findings of patient with fluid volume excess
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Increased respiratory rate (shallow respirations)
Dyspnea Moist crackles on auscultation |
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Neuromuscular assessment findings of patient with fluid volume excess
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Altered level of consciousness Headache Visual disturbances Skeletal muscle weakness Paresthesias |
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Renal assessment findings of patient with fluid volume excess
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Increased urine output if kidneys can compensate; decreased urine output if kidney damage is the cause
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Integumentary assessment findings for patient with fluid volume excess
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Pitting edema in dependent areas Pale, cool skin |
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Gastrointestinal findings in patient with fluid volume excess
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Increased motility in the gastrointestinal tract Diarrhea Increased body weight Liver enlargement Ascites |
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Laboratory findings in patient with fluid volume excess
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Decreased serum osmolality
Decreased hematocrit Decreased BUN level Decreased serum sodium level Decreased urine specific gravity |
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Goal of treatment for fluid volume excess
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Restore fluid balance, correct electrolyte imbalances if present, and eliminate or control the underlying cause of the overload.
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Isotonic Dehydration
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AKA hypovolemia Most common type of dehydration Water and dissolved electrolytes are lost in equal proportions |
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Causes of isotonic dehydration
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Inadequate intake of fluids and solutes Fluid shifts between compartments Excessive losses of isotonic body fluids |
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Results of isotonic dehydration
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Isotonic dehydration results in decreased circulating blood volume, and inadequate tissue perfusion.
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Hypertonic Dehydration
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Water loss exceeds electrolyte loss The clinical problems that occur result from alterations in the concentrations of specific plasma electrolytes. |
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Causes of hypertonic dehydration
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Conditions that increase fluid loss, such as excessive perspiration, hyperventilation, ketoacidosis, prolonged fevers, diarrhea, early-stage kidney disease, and diabetes insipidus
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Results of hypertonic dehydration
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Fluid moves from the intracellular compartment into the plasma and interstitial fluid spaces, causing cellular dehydration and shrinkage.
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Hypotonic Dehydration
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Electrolyte loss exceeds water loss. The clinical problems that occur result from fluid shifts between compartments, causing a decrease in plasma volume.
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Causes of hypotonic dehydration
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Chronic illness Excessive fluid replacement (hypotonic) Kidney disease Chronic malnutrition |
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Results of hypotonic dehydration
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Fluid moves from the plasma and interstitial fluid spaces into the cells, causing a plasma volume deficit and causing the cells to swell.
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What type of fluid is hypotonic dehydration treated with?
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hypotonic dehydration is typically treated with hypertonic fluid solution
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What type of fluid is isotonic dehydration treated with?
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isotonic dehydration is treated with hypotonic solutions.
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What type of fluid is hypertonic dehydration treated with?
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Hypertonic dehydration is typically treated with hypotonic solutions.
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Isotonic overhydration
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AKA hypervolemia The extracellular fluid compartment is expanded, and fluid does not shift between the extracellular and intracellular compartments |
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Causes of isotonic overhydration
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Causes of hypervolemia include: Inadequately controlled IV therapy Kidney disease Long-term corticosteroid therapy |
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Result of isotonic overhydration
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A serious result of hypervolemia is circulatory overload and interstitial edema; when severe or when it occurs in a patient with poor cardiac function, heart failure and pulmonary edema can result.
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Hypertonic Overhydration
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Occurrence is rare.
Fluid is drawn from the intracellular fluid compartment; the extracellular fluid volume expands, and the intracellular fluid volume contracts. |
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Causes of hypertonic overhydration
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Excessive sodium intake Rapid infusion of hypertonic saline Excessive sodium bicarbonate therapy |
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Hypotonic Overhydration
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AKA water intoxication The excessive fluid moves into the intracellular space, and all body fluid compartments expand. |
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Causes of hypotonic overhydration
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Early kidney disease Heart failure Syndrome of inappropriate antidiuretic hormone secretion Inadequately controlled IV therapy Replacement of isotonic fluid loss with hypotonic fluids Irrigation of wounds and body cavities with hypotonic fluids |
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What is an important intervention to treat a patient with fluid volume excess?
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Administer diuretics; osmotic diuretics typically are prescribed first to prevent severe electrolyte imbalances.
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A patient with acute kidney injury or chronic kidney disease is at high risk for which fluid volume imbalance?
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Fluid Volume Excess
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