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Hypervolemia Flashcards

1
Q

What is fluid volume excess?

A

Too much fluid in the vascular space

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2
Q

What is the vascular space?

A

Veins
Capilaries
Artery
CV system

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3
Q

What are some causes to hypervolemia?

A

HF
Renal failure
Lots of sodium

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4
Q

When you have HF, what happens? (4)

A
  • Heart is weak
  • CO decreases
  • Kidney perfusion decreases
  • UO decreases
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5
Q

HF where is fluid?

A

In vascular space

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6
Q

What happens with renal failure?

A

Kidneys aren’t functioning

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7
Q

What are examples of things with lots of Na?

A
  • Effervescent soluble meds
  • Canned/processed foods
  • IV fluids with sodium
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8
Q

What does Na do?

A

Makes you retain H20 and stays in vascular space

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9
Q

What is aldosterone?

A

Steroid…mineralocoticoid

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10
Q

Where is aldosterone found?

A

Adrenal glands (on top of kidneys)

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11
Q

What is the NORMAL action of aldosterone?

A

When blood volume gets low (hemorrhage, vomiting, etc) aldosterone secretion with increase, which helps retain Na and H20 (in vas. space). When Na and H20 increases in vascular space, it increases blood volume

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12
Q

What are diseases with too much aldosterone (retaining too much Na and H20)?

A 
Cushings
Hyperaldosteronism (Conns)
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13
Q

What is a disease with too little aldosterone?

A

Addison

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14
Q

Where is ANP found?

A

Atrium of heart

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15
Q

How does atrium work?

A

Opposite of aldosterone

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16
Q

Since ANP is the opposite of aldosterone, what does ANP do?

A

Excretion of Na and H20

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17
Q

ANP is a mechanism to ____

A

Decrease fluid volume

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18
Q

ANP or aldosterone?

Found in atrium of heart

A

ANP

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19
Q

ANP or aldosterone?

Retains Na and H20

A

Aldosterone

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20
Q

ANP or aldosterone?

Found on top of kidneys

A

Aldosterone

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21
Q

ANP or aldosterone?

Decreases blood volume

A

ANP

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22
Q

ANP or aldosterone?

Increases blood volume

A

Aldosterone

23
Q

ANP or aldosterone?

Found in adrenal glands

A

Aldosterone

24
Q

ANP or aldosterone?

Excretion of Na and H20

25
What does anti-diuretic hormone (ADH) do?
Makes you retain H20 ONLY
26
Too much or too little ADH Fluid volume deficit
Too little ADH (DI)
27
Too much or too little ADH Retain water
Too much ADH (SIADH)
28
Too much or too little ADH Blood is diluted
Too much ADH (SIADH)
29
Too much or too little ADH Urine is diluted
Too little ADH (DI)
30
Too much or too little ADH Blood is concentrated
Too little ADH (DI)
31
Too much or too little ADH Fluid volume excess
Too much ADH (SIADH)
32
Too much or too little ADH Diureses
Too little ADH (DI)
33
Too much or too little ADH Urine is concentrated
Too much ADH (SIADH)
34
Too much or too little ADH Loose water
Too little ADH (DI)
35
Too much or too little ADH SIADH
Too much ADH (SIADH)
36
Too much or too little ADH DI
Too little ADH
37
Where is ADH found?
Pituitary
38
What makes you think and ADH problem?
Head traumas!!! | craniotomy, head injury, sinus surgery, transsphenoidal hypophysectomy, increased ICP conditions
39
What is another name for ADH?
Vasopressin or DDAVP
40
What disease would need ADH: SIADH or DI?
DI (too little ADH)
41
ADH= vasopressin. What does ADH do?
Causes you to retain H20
42
Fluid volume overload SS (9)?
- Distended neck veins/peripheral veins (vessels=full) - Peripheral edema/3rd spacing - CVP increases - Wet lung sounds/crackles - Polyuria - HR Increases - BP increases - Weight increases
43
Why is there peripheral edema/3rd spacing with fluid volume overload?
Vessels can't hold anymore, so start to leak
44
Fluid volume overload Where is CVP measured and why would it increase?
Measured in right atrium Move volume, more pressure
45
Fluid volume overload What is normal CVP?
2-6
46
Fluid volume overload Why would there be polyuria?
Kidneys trying to diurese
47
Fluid volume overload What problems can these lead to due to the fluid not being able to be pushed forward efficiently?
Can lead to HF and pulmonary edema
48
Fluid volume overload Why does BP increase?
More volume, more pressure
49
Acute weight gain: fat or fluid?
FLUID
50
Fluid volume overload Fluid retention, think what problems first?
Heart problems
51
Treatment?
Low Na/restrict fluids I&O and daily weights Diuretics
52
What are the diuretics given?
Loop: Furosemide (40mg) or Bumetanide (1mg) Hydrochlorathiazide Potassium sparing: Spirolanactone
53
Treatment Bedrest induces diuresis by the release of ____ which does what?
Bedrest induces diuresis by the release of ANP (loose Na and H20) and decreases production of ADH (so you don't retain H20 and Na since normal ADH causes you to retain)
54
Who to give IV fluids slowly to? Why are we even giving fluids during hypervolomia?
To elderly and very young Pt. on bedrest= increased risk for complications like constopation, pneumonia, DVT

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