How is heart failure a cause of hypervolemia? - ✔✔ heart is weak, CO drops, kidney perfusion decreases, UOP decreases. toxins and fluid build up in
... [Show More] blood.
Effervescent drugs such as alkaseltzer have a high concentration of what electrolyte? - ✔✔ Sodium, Na+
Where is aldosterone found? - ✔✔ Adrenal glands above the kidneys.
Action of aldosterone?
Action of ADH? - ✔✔ retains Na+ and water
retains water
What is SIADH? - ✔✔ syndrome of inappropriate antidiuretic hormone
body releases too much ADH and causes excess fluid volume
What is DI? - ✔✔ diabetes insipidus
body doesn't release enough ADH-- CAN LEAD TO SHOCK DUE TO HYPOVOLEMIA.
Where is ADH released from? - ✔✔ posterior pituitary
What are key words to make you think of a potential ADH problem? - ✔✔ craniotomy, head injury, sinus surgery, transphenoidal hypophysectomy, increased ICP
What is synthetic ADH? - ✔✔ vasopressin or desmopressin
What are some S&S of FVE? - ✔✔ distended neck veins, peripheral edema, increased CVP, wet lung sounds, SOB, polyuria, tachycardia, bounding pulse, increased BP, increased weight
With fluid retention, think ________ problems first! - ✔✔ heart!
for bed bound patients, sacral edema may start before dependent edema, and causes what? - ✔✔ skin breakdown
Normal CVP? - ✔✔ 2 - 6 mmHg
5 - 10cm H₂O
What are some ways to treat FVE? - ✔✔ low Na+ diet
restrict fluids
daily weights and I&Os
diuretics
bed rest
What is an example of a loop diuretic (K+ losing)? - ✔✔ Furosemide
bumetanide
Which diuretic is potassium sparing? - ✔✔ Spironolactone
(Watch for hyperkalemia)
Is hydrochlorothiazide potassium sparing or losing? - ✔✔ potassium losing
how does bed rest induce diuresis? - ✔✔ bed rest causes diuresis by release of ANP, and decreases production of ADH. While on bedrest, blood shifts from dependent position to the thorax. This increases blood returning to the right atria. This causes atrial stretching and increases ANP.
ANP works opposite of ADH.
hypovolemia can occur from what? - ✔✔ fluid loss from anywhere!
thoracentesis, paracentesis, vomiting, diarrhea, hemorrhage, surgery, trauma, NG suction, third spacing
how can third spacing cause hypovolemia? - ✔✔ for burn, ascites, or liver patients
What are some S&S of FVD? - ✔✔ decreased weight, decreased skin turgor, dry mucous membranes, decreased UOP, decreased BP, tachycardia, tachypnea, decreased CVP, cool extremities
hypovolemic patients are a _____ risk. - ✔✔ fall
list the isotonic iv fluids - ✔✔ NS 0.9%, LR, D5W, and D5 1/4 NS
when are isotonic iv fluids used? - ✔✔ for a pt that has lost fluids through N/V, burns, swelling, trauma
what patients cannot have isotonic solutions? - ✔✔ pts with HTN, cardiac disease, or renal disease.
they can cause FVE, HTN, or hypernatremia
how do hypotonic IV solutions work? - ✔✔ they take fluid into the cells themselves
do not cause HTN
what are examples of hypotonic iv solutions? - ✔✔ D 2.5 W, 1/2 NS, 0.33% NS
when are hypotonic IV solutions used - ✔✔ HTN, renal or cardiac disease and needs fluids replacement due to N/V, burns, hemorrhage, etc.
how do hypertonic iv solutions work - ✔✔ they work by pulling fluid into the vascular space. monitor for FVE
what are examples of hypertonic iv solutions - ✔✔ D10W, 3% NS, 5% NS, D5LR, D5 1/2 NS, D5NS, TPN, Albumin
when are hypertonic iv solutions used - ✔✔ pts with hyponatremia, severe third spacing, severe edema, burns, or ascites
How is magnesium excreted from the body? - ✔✔ through the kidneys.
so if renal failure, there is a buildup of magnesium
What are the normal lab values for Mg and Ca? - ✔✔ Mg: 1.3-2.1 mEq/L
Ca: 9.0-10.5 mg/dL
What things can cause hypermagnesemia? - ✔✔ renal failure, antacids
When answering questions about magnesium and calcium, think _________ first! - ✔✔ muscles [Show Less]