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Flashcards in Fluid And Electrolytes Deck (44)
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1

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)



2

what 3 hormones regulate fluid volume?

Aldosterone
ANP
ADH

3

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

4

what if we have too much aldosterone?

What if we have too little aldosterone?

Cushings disease ( too many steriods, FVE)
Conns syndrome

Addisons (FVD)

5

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

6

How does ADH regualte fluid volume?

makes you retain WATER ONLY

7

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

8

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

9

concentrated makes number go?
dilute makes numbers go?

concentrated = up
dilute= down

urine specific gravity
sodium
hematocrit

10

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

11

what is another name for ADH?

vasopressin (pitressin)
desmopressin acetate (DDAVP) -nasal spray

used as ADH replacement in DI

12

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)

13

if patient is retaining fluid think what first?

Heart Problems

14

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

15

What causes FVD?

1) Loss of fluid anywhere (suction, vomit, diarhea, paracentesis)

2)Third spacing (Burns, Ascites)

3) Diseases with polyuria (DI)

16

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

17

what is the treatment of FVD?

Prevent further loss

Replace volume
Mild PO
Severe IV

safety precautions
Higher risk for falls
Monitor for overload

18

causes of Hypermagnesemia

renal failure
antacids

19

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

20

Treatment of Hypermagnnesemia

ventilator
dialysis
give calcium gluconate bc reverse depression and arrythmias
safety precautions

21

causes of hypercalcemia

hyperparathyroidism (too much PTH)-pulls calcium from bone to blood

thiazides retain Ca

immobilization

22

signs and symptoms of hypercalcemia

brittle bones
kidney stones
WIDE T

decreased DTR
decrease LOC respirations pulse
weak muscle tone

23

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

24

causes of hypernatremia

hypertension
heat stoke
DI
vomit
diarrhea

25

signs and symtoms of hypernatremia

dry mouth
thirsty
swollen tongue
neuro changes

26

treatment of hypernatremia

restrict Na
dilute client with fluds
fluid problem- daily wts, i and o, lab work

27

causes of hyponatemia

drinking water for fluid replacement (vomitting, sweating)
pyschogenic polydipisia
d5w
SIADH

28

signs and symtoms

headache
seizure
coma

29

treatment of hyponatremia

client needs Na not water
if having neuro probles give hypertonic saline (3% or 5%)
monitor for FVE when giving hypertonic fluids

30

causes of hyperkalemia

kidney trouble ( increases k)
aldactone

31

signs and symptoms of hyperkalemia

PROLONG PR/ life threatening arrhythmias

muscle twitch then
muscle weakeness
and finally flaccid paralysis

32

ECG changes for hyperkalemia

bradycardia
tall adn peaked t waves
prolong PR interval
flat or absent p waves
wide QRS
conduction blocks
v fib

33

treatment for hyperkalemia

dialysis
calcium gluconate
glu and insulin (watch for increase k
kayexalate
push fluids

sodium and k are inverse

34

causes of hypokalemia

vomitting
NG suction
diuretics
not eating

35

signs and symtoms of hypokalemia

muscle cramps
weakness
arrythmias

36

ECG changes for hypokalemaia

U waves
PVCs
V tach

37

treatment of hypokalemia

give k
aldactone makes retain k
eat more k

38

causes of hypomagnesmia

diarrhea
ETOH bc suppress ADH adn make u diureses
ETOH is hypertonic

39

signs and symtoms og hypomagnesmia

ekg

Tall T
depressed ST

tight rigid muscles
seizure precautions
stidor/laryngospasm
+ chov adn trouss
increased DTR
neuro changes
swallowing problems
arrythmias

40

treatment of hypomagnesmia

give mg
check kidney function
seiure precautions
eat mg

41

casues of hypocalcemia

hypoparathyroidism
radical neck
thyroidectomy

42

signs and symtoms of hypocalcemia

same as MG
not enough sedative

43

treatment of hypocalemia

vit d
phosphate binders (sevelamer hydrocholride//renagel) phoslo

iv Ca slowly and on heart monitor
oscal

44

micellanous info on potassium

assess UO before iv K
po K watch for GI upset
IV k on a pump always
mix well
never give IV k push (dilute in somthing)
burns during infusion