fluid and electrolyte balance Flashcards
(35 cards)
older adult considerations: skin
- decrease elasticity and turgor
- unreliable indicator of fluid status
- catheter might not stay in
- tent over sternum or forehead
older adult considerations: renal
- decrease glomerular filtration
- retain fluid, waste product, medications
- unable to concentrate
- increased water loss
older adult considerations: muscular
- decrease muscle mass
- holds a lot of water
- increased risk for dehydration d/t decreased total body water content
older adult considerations: neurologic
- decreased thirst refelx
- decreased intake, increased risk for dehydration
older adult considerations: endocrine
- adrenal glands begin to atrophy
- poor regulation of na/k
intracellular
within cell
extracellular
plasma- blood
interstitial- space between
normal fluid intake
2300ml
fluid loss routes
urine, feces, emesis, drainage
insensible- perspiration, lungs
fluid loss output
obligatory: 400-600ml a day
prefer 30ml/hr—> 720ml/day
insensible: 500-1000ml/day
hypervolemia
results from too much fluid in body or dilution of electrolytes and rbcs
hypovolemia
not enough fluid in body, especially in the intravascular area
fluid deficit causes: inadequate fluid intake
- poor PO intake
- NPO- nothing by mouth
- dysphagia
- unconsciousness
- inadequate IVF replacement
fluid deficit causes: excessive fluid or sodium losses
- gastrointestinal losses
- excessive diaphoresis
- prolonged hyperventilation
- hemorrhage
- diabetes insipidus
- burns
- open wounds
- excessive use of diuretics
- fluid shifts: ascites, effusions
fluid deficit signs and symptoms
- thirst
- rapid weak pulse
- low bp
- dry skin and mucous membranes
- skin tenting
- increased temp
- decreased urine output: increase concentration/ specific gravity
- increase BUN
- increase HCT
fluid deficit interventions
MONITOR DAILY WEIGHT 1L=2.2LBS
- monitor intake and output
- treat underlying cause
- increase fluid intake: PO IV
- use caution with elderly pt
isotonic
what it does?
type of solutions
same concentration no fluid shift
- equal pressure inside and outside cell
- “stay where I put it”
- expands volume
- dilute meds
- fluid resuscitation
- .9 nacl
- lactated ringers
hypotonic
lower concentration- fluid shift out of vessel into cell
- less salt or more water than normal body fluids
- water leaves blood and into cells
- “goes out of vessel”
1/2 normal saline
D5W dextrose 5% water
could lead to vascular fluid depletion and cardiovascular collapse
hypertonic
- higher concentration- fluid shifts into vessel from cell s
- either more salt or less water than our own fluids
- water is removed pulled from cells and pulled into vascular
- can result in vascular overload and dehydration
- enters the vessel
used for na replacement
- volume replacement
D 1/2 NS
D5LR
fluid excess causes: excessive sodium or water intake
- high sodium diet
- psychogenic polydipsia
- hypertonic fluid admin
- free water
- enteral feedings
fluid excess causes: inadequate sodium or water elimination
inadequate sodium or water elimination
- organ failure:renal liver heart
- endocrine disorders: hyperaldosteronism, cushings syndrome, syndrome of inappropriate antidiuretic
fluid excess s/s
- bounding pulse
- elevated blood pressure
- respiratory changes
- weight gain
- edema
- increased urine output
- diluted/ decrease specific gravity
- decrease BUN decease NA
fluid excess interventions
- monitor dailey weight
- place in fowleys positon
- admin oxygen
- admin diuretics
- monitor I&O
- restrict fluid and sodium
sodium
135-145
