Fluid And Electrolytes Flashcards
Hypervolemia = FVE
Definition and causes
Define: too much fluid in space
Causes:
1) HF (heart weak, ⬇️ CO, ⬇️ perfusion ⬇️ UO) 2) IVF w/NA , fleet enema, Alia-seltzer 3) Renal Failure 4) alka seltzer ( sodium bicard therapy)
what 3 hormones regulate fluid volume?
Aldosterone
ANP
ADH
how does aldosterone regulate fluid volume?
found in adrenals above kidney.
1) decrease blood volume (vomit, hemmorrhage, etc) =
2) aldoserone secretion increases
3) retain Na and water
4) blood volume incease
what if we have too much aldosterone?
What if we have too little aldosterone?
Cushings disease ( too many steriods, FVE) Conns syndrome
Addisons (FVD)
how does ANP (atrial natriuretic peptide) regualte fluid volume?
found in atria of heart
when fluid pressure builds aroung heart, ANP is released which causes excretion of NA and water
gets rid of fluid
How does ADH regualte fluid volume?
makes you retain WATER ONLY
What happens is we have too much ADH?
SIADH
retain water (FVE)
decreased Urine output because holding onto fluid
concentrated urine because putting out very little urine
diluted blood because of excess fluid in body
what happens if we have too little ADH
DI
lose water (FVD)
watch for SHOCK
increased urine output because losing fluid
diluted urine
concentrated blood
concentrated makes number go?
dilute makes numbers go?
concentrated = up dilute= down
urine specific gravity
sodium
hematocrit
Where is ADH found and why is this important?
ADH found in pituitary (head)
key words for ADH problems
1) craniotomy
2) head injury
3) sinus surgery
4) transphenoidal hypophysectomy
5) any condition that can lead to an increased ICP
what is another name for ADH?
vasopressin (pitressin) desmopressin acetate (DDAVP) -nasal spray
used as ADH replacement in DI
Signs and symptoms of FVE
Cardiovascular
1) increased pulse (bounding)
2)distended neck veins
3)increased CVP
4)increased BP
more volume more pressure
Respiratory
1) increased respirations (shallow)
2) wet moist crackles
3) SOB, dyspna
Integumentary
1) peripheral edema, third spacing (vessels start to leak)
2) skin pale and cool to touch
Polyuria Increased weight (acute gain or lose is not fat, its fluid)
if patient is retaining fluid think what first?
Heart Problems
Treatment for FVE
Low sodium diet
Restrict fluids
I and O and daily weights
Diuretics
Furosemide, bumetanide (loop)
Hydrochlorothiazide
Aldactone (watch K+ levels)
Bed rest (induce diuresis by releasing ANP)
watch for electrolyte imbalances
What causes FVD?
1) Loss of fluid anywhere (suction, vomit, diarhea, paracentesis)
2) Third spacing (Burns, Ascites)
3) Diseases with polyuria (DI)
What are the signs of FVD?
⬇️ weight ⬇️ skin turgor Dry mucous membranes, dry skin, dry mouth ⬇️ UO ⬇️BP (less volume less pressure) ⬆️ pulse weak and thready because heart trying to push around what little fluidis left ⬆️ resp bc body thinks it is hypoxic ⬇️ CVP peripheral veins vasocontrict Cool extremeties ⬆️ USG ( if putting out any urine will be VERY concentrated) decreased weight thirst
what is the treatment of FVD?
Prevent further loss
Replace volume
Mild PO
Severe IV
safety precautions
Higher risk for falls
Monitor for overload
causes of Hypermagnesemia
renal failure
antacids
Signs and Symptoms of Hypermagnesemia
ACTS LIKE A SEDATIVE (SLEEPY)
Flushing and warmth decrease DTR weak flaccid muscles arrythmias (PROLONG PR AND WIDE QRS) decrease LOC decrease pulse decrease respirations
Treatment of Hypermagnnesemia
ventilator
dialysis
give calcium gluconate bc reverse depression and arrythmias
safety precautions
causes of hypercalcemia
hyperparathyroidism (too much PTH)-pulls calcium from bone to blood
thiazides retain Ca
immobilization
signs and symptoms of hypercalcemia
brittle bones
kidney stones
WIDE T
decreased DTR
decrease LOC respirations pulse
weak muscle tone
treatment of hypercalemia
MOVE! BEAR WT! give fluids to prevent kidney stones phospho soda and fleet enema bc have phosporus steroids add phos to diet safety precautions must have vit d to use calcium give calcitonin
phos foods is anything with protein
causes of hypernatremia
hypertension heat stoke DI vomit diarrhea
