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22 Cards in this Set
- Front
- Back
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fluid volume excess: hypervolemia |
too much fluid in the vascular space |
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causes of hypervolemia |
Heart failure-weak, low CO, low kidney perfusion, low UO. Volume stays in the vascular space |
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causes of hypervolemia |
Renal failure-kidneys not working |
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Aldosterone is a mineralocorticoid found in adrenal gland above kidneys normal action? |
when blood volume gets low like vomiting and hemorrhage aldosterone increases retaining sodium and water making blood volume go back up |
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too much aldosterone |
Cushing's hyperaldosteronism (Conn's syndrome) |
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too little aldosterone |
Addison's disease fluid volume deficit |
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Atrial Natriuretic Peptide ANP is found in the atria of the heart, how does it work? |
It causes excretion of sodium and water the vascular space fills up with too much fluid and body is trying to get volume down. |
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ADH Antidiuretic hormone is found in the pituitary gland in the head how does it work? |
Makes the body retain water. |
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Too much ADH is called? Retain water, fluid volume excess, urine is concentrated blood is diluted |
SIADH: too many letters=too much water |
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Not enough ADH is called? Diurese water, fluid volume deficit, urine is diluted blood is concentrated |
DI: Diabetes Insipidus *Look for shock!! |
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concentrated makes #'s go up urine in SIADH and blood in DI (serum =blood) |
dilute makes #'s go down urine in DI and blood in SIADH (serum=blood) |
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ADH problems secondary to something else Potential ADH problem: |
craniotomy, head injury, surgery through nose to pituitary, sinus surgery, any increased ICP |
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what drug may be utilized as an ADH replacement in DI? If client output too high? |
vasopressin, DDAVP per nasal spray |
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what is a focus PA of fluid volume excess S/S |
distended neck veins/peripheral veins peripheral edema, third spacing, vessels cant hold so they start to leak, increased CVP (normal 2-6), posterior low base lung sounds crackles, wet, polyuria (kidneys try to compensate) artery increased bounding pulse, acute wt gain, increased B/P |
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more volume |
more pressure |
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fluid retention think |
heart problems first |
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tx for fluid vol excess |
low Na diet restrict fluids diuretics-loop Furosmide Bumex thiazide (loose K give foods) spiralactone K sparing retain K (restrict K food) |
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bed rest clients care (induces diuresis) |
always push fluids, because bed rest causes increased blood vol to heart triggers release of ANP loose Na and water and decreased production ADH, Increased urine out decreased blood vol lead to dehydration and fluid vol deficit prone to kidney stone and constipation |
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What is a focus PA of fluid volume deficit S/S |
wt loss, decreased skin turgor, dry MM, decreased UO and very concentrated urine specfic gravity, decreased B/P, increased pulse, increased RR, decreased CVP, very tiny peripheral veins, cool extremities |
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less volume |
less pressure |
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tx for fluid volume deficit |
prevent further loss replace volume for mild PO for severe IV fluids higher risk for falls monitor for overload |
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assess for orthostatic hypotension in fluid vol deficit (hypovolemia) |
have client lie down 3 min assess V/S lying sitting standing Record/document |
