fluid volume excess also another word for ? - ✔✔ - HYPERvolemia
definition of fluid volume excess - ✔✔ - too much fluid in the vascular
... [Show More] space ( any vessel in our body ex: vein , artery)
what are 2 causes of fluid volume excess? - ✔✔ - heart failure
- renal failure
heart failure ( HF) means what? - ✔✔ - the heart is weak
- the cardiac output is DOWN
- kidney perfusion is DOWN
- urinary output is DOWN
- the volume stays in the vascular space
renal failure( RF) means what? - ✔✔ - kidneys arent working
what are three things that contain A LOT of sodium? - ✔✔ - canned process foods
- IVF with sodium
- fleet enemas
Aldosterone ( steroid, mineralocorticoid) is found where? - ✔✔ - adrenal glands ( on top of the kidneys)
what is the normal action of aldosterone ? - ✔✔ When your blood volume gets low through for example vomiting or hemorrhage, the aldosterone secretion increases and makes your body retain sodium and water and therefore increases the blood volume
aldosterone makes us retain what? - ✔✔ SODIUM AND WATER
when aldosterone secretion increases ----> retain sodium/water---> blood volume goes ________ ----> retain in ______________________ - ✔✔ - up
- vascular space
what two diseases have too much aldosterone? - ✔✔ - cushings ( too much steroids)
- hyperaldosterosteronism ( aka: CONNS)
what disease has too little aldosterone? - ✔✔ - Addisons disease ( not enough aldosterone means you lose NA & water directly from the vascular space)
when taking a Anti-diuretic hormone ( ADH) do you retain or diurese? - ✔✔ - retain
when taking a anti-diuretic what do you retain ? - ✔✔ - water
when you have too much ADH what happens in the body ? - ✔✔ - RETAIN water
- fluid volume EXCESS
- Syndrome of inappropriate ADH ( TOO MANY LETTERS TOO MUCH WATER )
- urine is CONCENTRATED ( too much ADH and NA )
- blood is DILUTED
when you have not enough ADH what happens in the body ? - ✔✔ - DIURESE water
- fluid volume DEFICIT
- DI ( diabetes insipidus) DIurese
- urine is DILUTED
- blood is CONCENTRATED
when checking the urine specific gravity, sodium, and hematocrit on lets say a urine test strip if the urine is concentrated will it make the numbers go up or down? - ✔✔ - UP
when checking the urine specific gravity, sodium, and hematocrit on lets say a urine test strip if the urine is diluted will it make the numbers go up or down? - ✔✔ - down
where is ADH found ? - ✔✔ - pituitary gland
what should you think about first when you think your patient has a ADH problem? - ✔✔ head injuries ( craniotomy, increase ICP )
transsphenoidhypophysisectomy - ✔✔ all the way through ( across) sinus pituitary removal
what are some drugs that are anti diuretic hormones ( ADH) - ✔✔ - vasoPRESSIN
*ends in PRESSINS)
what are some S?S of fluid volume excess? - ✔✔ - distended neck veins/ peripheral veins ( VESSELS ARE FULL)
- third spacing
- lungs are CRACKLED
- polyuria
- pulse INCREASED ( palpate the artery)
- Blood pressure INCREASES ( more volume = more pressure )
- weight INCREASES
what is the treatment for fluid volume excess? - ✔✔ - low NA diet
- restrict fluids
- daily I& Os and weights
what are some diuretics you can give to help FVE? - ✔✔ - FurosemIDE ( lasix ) ( DECREASES K+)
- drugs that end in IDE !!!!!
what is an example of a potassium spraing drug ? - ✔✔ - spironolactone ( retain K+)
when thinking of fluid retention you should think what first? - ✔✔ - HEART PROBLEMS
bed rest induces _________ by the release of ___________- and lowers the production of ____________- - ✔✔ - diurese
- ANP
- ADH
what is another word for fluid volume deficit? - ✔✔ - HYPOvolemia
when you have a big time deficit you should think what first ? - ✔✔ - SHOCK
what are the three causes of Fluid volume deficit? - ✔✔ - loss of fluid from annywhere
- third spacing
- diseases with polyuria
what is third spacing? - ✔✔ - when fluid is in a place that does you no good
ex: burns, ascites ( measure abdominal girth daily/ worry about HYPOtension)
what is an example of a disease that deals with polyuria? - ✔✔ - diabetes mellitus
when you see the word POLYURIA what should you think of first? - ✔✔ - SHOCK
what are some S/S of fluid volume deficit ? - ✔✔ - weight DOWN
- decreased skin turgor
- dry mucous membranes
- urine output DECREASED ( kidneys arent being profused or they are trying to hold on to fluid ( compensate))
- blood pressure is DOWN ( less volume, less pressure )
- pulse is INCREASED ( heart is trying to pump what little fluid is left ) ( weak and thready in FVD)
respirations are INCREASED ( hypoxia)
- veins are CONSTRICTED
- urine specific gravity is INCREASED and CONCENTRATED
what is the treatment for FVD ? - ✔✔ - prevent further losses
- replace volume
ex: mild deficit- PO fluids
severe deficit- IV fluids
what are patients are higher risk for when they are dealing with FVD? - ✔✔ - falls b/c of changes in V/S & mental status
what happens in the body when you are given isotonic solutions? - ✔✔ - goes into the vascular space and stays there
what are some examples of isotonic solutions? - ✔✔ - normal saline
- lactated ringers
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