Fluid Volume Excess/Hypervolemia - ✔✔ Too much fluid in the vascular space
Causes of FVE: (3) - ✔✔ Heart Failure
Renal
... [Show More] Failure
Sodium
Heart Failure characteristics - ✔✔ Heart is weak; cardiac output decreases
decreased kidney perfusion; urinary output decreases
Volume stays in the vascular space
Three things with a lot of sodium - ✔✔ Effervescent soluble medications (Alka-seltzer)
Canned/processed foods
IVF with sodium
3 Main Hormonal Regulation of Fluid Volume - ✔✔ Aldosterone
Atrial Natriuretic Peptide (ANP)
Anti-diuretic hormone (ADH)
Where is aldosterone found - ✔✔ adrenal glands
Normal action of aldosterone - ✔✔ blood volume gets low (vomiting, hemorrhage) } aldosterone secretion increases } retain Na & water } blood volume goes up
Diseases with too much aldosterone - ✔✔ Cushings
Cons syndrome
LIver Dz
Heart Dz
Disease with too little aldosterone - ✔✔ Addisons disease
Characteristics of Addisons - ✔✔ less aldosterone
decreased sodium/water
FVD
Where is ANP found? - ✔✔ Atria of the heart
How does ANP work? - ✔✔ Opposite of aldosterone
causes excretion of sodium and water
Function of ADH - ✔✔ makes you retain water
Two ADH Problems - ✔✔ SIADH
DI
Too much ADH causes (3) - ✔✔ water retention
FVE
SIADH (too many letters, too much water)
SIADH characteristics - ✔✔ Urine output; decreases, concentrated
blood is dilute
urine specific gravity, Na, and Hmt decreases
Treatment for SIADH - ✔✔ water restriction
3% Na Cl
Not enough ADH causes (3) - ✔✔ Lose (water) diurese
FVD
DI (think diuresis/deficit)
Diabetes Insipidus can be caused by what? (3) - ✔✔ trauma to the head or pituitary gland
sinus sx
increase ICP
DI characteristics - ✔✔ urine output increases & dilute
blood is concentrated
urine specific gravity, Na, Hmc increases
large amount of urine output can lead to what complication? - ✔✔ shock
ADH is found in the ? - ✔✔ Pituitary
Key words to think potential ADH problems (5) - ✔✔ craniotomy
head injury,
sinus surgery,
transsphenoidal hypophysectomy
any condition that leads to increased ICP
Trans = - ✔✔ going all the way through
sphenoid = - ✔✔ sinus
hypophysis = - ✔✔ pituitary
ectomy = - ✔✔ taking something out
Another name for anti-diuretic hormone (ADH) that may be used as an ADH replacement in DI? - ✔✔ vasopressin
desmopressin acetate
Signs & Symptoms FVE:
Veins (2)
Fluid causes (3)
lung sounds
UO
vitals (2)
increased (2) - ✔✔ Distended neck veins/peripheral veins: vessels are full
Peripheral edema/third spacing/vessels can't hold anymore and start to leak
wet lung sounds
Polyuria: kidneys help to diurese
increase pulse & BP
increased: weight, CVP
CVP is measured where? - ✔✔ in the right atrium
More volume = - ✔✔ more pressure
If the fluid goes backwards into the lungs, it can lead to: (2) - ✔✔ Heart failure and pulmonary edema
Treatment FVE:
diet (2)
interventions (2)
med
activity
-
precaution - ✔✔ - low sodium diet/restrict fluids
- I&O and *daily weight* (same time, same clothes, same weight, have pt void first)
- Diuretics
- bed rest
- Physical assessment
- Give IVF slow
Diuretics - ✔✔ - Lasix (worry about HYPOKALEMIA)
- Aldactone (NOT LOSING K+ , HYPERkalemia)
How does bed rest benefit FVE? - ✔✔ when supine --> kidneys perfused more (*UO* goes UP)
it induces diurese by the *release of ANP* and *decrease the production of ADH*
IVF are given slowly to who? (4) - ✔✔ elderly ---> go into fluid overload fast
very young
kidney disease
heart disease
Fluid Volume Deficit: Hypovolemia
Big time deficit = - ✔✔ Shock
3 Causes of FVD - ✔✔ loss of fluids from anywhere
third spacing
diseases with polyuria [Show Less]