Nursing - Fluid Balance.db

Front 1

intracellular fluid

Back 1

40% of total body weight

Front 2

extracellular fluid

Back 2

20% of total body weight

Front 3

formula for plasma osmolarity

Back 3

2(Na) + BUN/5 + glucose/20

normal range is 275-295 milliosmoles/L

Front 4

antidiuretic hormone - ADH

Back 4

Secreted by posterior pituitary in response to increased serum osmolarity

Front 5

Parathyroid hormone

Back 5

Secreted by parathyroid gland in response to low serum calcium

Front 6

Atrial natriuretic factor

Back 6

Released from cardiac muscle cells in response to atrial distention from fluid overload

Front 7

Aldosterone

Back 7

Secreted by the adrenal cortex in response to decreased blood volume, decreased renal perfusion, angiotensin

Front 8

renin

Back 8

secreted by kidneys in response to aldosterone

Front 9

angiotensinogen

Back 9

produced in liver, normally found in blood, acted upon by renin to form angiotensin

Front 10

angiotensin

Back 10

stimulates adrenal gland to produce aldosterone

Front 11

causes of hypovolemia

Back 11

excess urine output, diabetes insipidus, burns, fever, wound drainage, NG suction, diarrhea, vomiting, diuretics

Front 12

s/s of hypovolemia

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orthostatic changes, neg. I&O, fever, increased heart rate, weak thready pulses, weight loss

Front 13

isotonic fluid volume deficit

Back 13

fluid and electrolyte losses are equal

Front 14

In isotonic hypovolemia, what happens to EC and IC fluids?

Back 14

Volume & solute are lost from EC space; IC fluid unchanged

Front 15

Causes of isotonic hypovolemia

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Hemorrhage, diarrhea, decreased po intake, third spacing (trauma, burns, sepsis, cirrhosis)

Front 16

compensatory mechanisms for isotonic hypovolemia

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renin-angiotensin-aldosterone mechanism, SNS shunts blood to vital organs

Front 17

assessment of isotonic hypovolemia

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Increased Hgb and Hct
Na+ normal
Urine SG >1.010 slightly conc.
BUN increased

Front 18

treatment for isotonic hypovolemia

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NS or LR, blood, albumin, antidiarrheals, increased PO intake and nutrition, ABX

Front 19

hypotonic hypovolemia

Back 19

solute loss is greater than fluid loss

Front 20

In hypotonic hypovolemia, what happens to EC and IC fluids?

Back 20

EC fluid hypotonic; EC fluid shifts to IC space, cells swell & lyse

Front 21

causes of hypotonic hypovolemia

Back 21

CRF, malnutrition, rehydration with hypotonic fluids

Front 22

compensatory mechanisms for hypotonic hypovolemia

Back 22

Renin-angiotensin-aldosterone mechasism, stim. by decr. arterial pressure

Front 23

assessment of hypotonic hypovolemia

Back 23

Increased Hgb & Hct
Na+ decreased
Urine SG<1.010, slightly dilute

Front 24

treatment for hypotonic hypovolemia

Back 24

NS or 3% saline w/ Lasix
K+, nutrition

Front 25

Hypertonic fluid volume deficit

Back 25

Fluid loss greater than solute loss

Front 26

In hypertonic hypovolemia, what happens to EC and IC fluids?

Back 26

EC fluid hypertonic, IC fluid shifts to EC space, cell dehydrate

Front 27

Causes of hypertonic hypovolemia

Back 27

excess sweat, hyperventilation, fever, ketoacidosis, high osmolarity tube feeds

Front 28

compensatory mechanisms for hypertonic hypovolemia

Back 28

increased ADH (posterior pituitary stim by hyperosmolar ECF), increased thirst (hypothalamus)

Front 29

assessment of hypertonic hypovolemia

Back 29

Hgb & Hct normal or increased
Na+ increased
Urine SG>1.030 more conc.

Front 30

treatment for hypertonic hypovolemia

Back 30

1/2 NS, treat the cause (w/ insulin, antibiotics, tylenol...)

Front 31

causes of hypervolemia

Back 31

kidney probs, heart probs, corticosteroids, excess Na+ or fluid intake, hypotonic fluids, SIADH, low protein, venous return probs, immobility

Front 32

s/s of hypervolemia

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incr. HR, bounding pulses, incr. BP & CVP, JVD, dysrhthmias, incr. RR, dyspnea, moist crackles, skin cool & pale, edema, muscle weakness, diarrhea, ascites

Front 33

isotonic hypervolemia

Back 33

serum osmolarity is normal

Front 34

what happens to EC and IC fluids in isotonic hypervolemia?

Back 34

EC space is expanded

Front 35

causes of isotonic hypervolemia

Back 35

excess isotonic fluids infused, ingested, retained

Front 36

compensatory mechanisms for isotonic hypervolemia

Back 36

decr. ADH & aldosterone, incr. urine output
incr. natriuretic factor r/t atrial distension, incr. urine output

Front 37

hypotonic hypervolemia

Back 37

AKA water intoxication, serum electrolytes decreased

Front 38

what happens to EC and IC fluids in hypotonic hypervolemia?

Back 38

hypotonic EC fluid moves into IC space, all compartments expand

Front 39

causes of hypotonic hypervolemia

Back 39

SIADH, excess water consumption

Front 40

hypertonic hypervolemia

Back 40

rare occurence, incr. serum osmolarity

Front 41

what happens to EC and IC fluids in hypertonic hypervolemia?

Back 41

IC fluid shifts to EC space; EC space expands, IC space contracts, cell shrivel

Front 42

causes of hypertonic hypervolemia

Back 42

excessive sodium intake

Front 43

treatments for hypervolemia

Back 43

caution with IV fluids, electrolyte solutions only, no free water, Lasix (furosemide)/Bumex (bumetanide), fluid restrictions

Front 44

What condition can result from too rapid IV infusions or blood transfusions?

Back 44

result - isotonic hypervolemia

Front 45

what is anasarca?

Back 45

generalized body edema from isotonic hypervolemia

Front 46

what are symptoms of anasarca?

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respiratory distress, weight gain, venous distension, incr. blood pressure

Front 47

what condition can results from intake of hypertonic fluids or extreme Na+ ingestion or retention (as from steroids or liver/rental failure)?

Back 47

result - hypertonic hypervolemia

Front 48

You see pitting edema and circulatory overload - what is the condition?

Back 48

dx - hypertonic hypovolemia