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define
hypervolemia
list the
causes of
hypervolemia
List the 3
hormones
that help
regulate fluid
volume
1. aldosterone
2. atrial naturetic peptide (ANP)
3. anti-diuretic hormone (ADH)
What is
aldosterone?
and where is
it found in
the body?
What is the
NL action of
the body
when fluid
volume gets
low?
What does
aldosterone
cause the
body to do?
List 2
diseases that
result from
too much
aldosterone
List one
disease that
results from
too little
aldosterone.
What is ANP
and where in
the body is it
found?
What is the
affect of ANP
on the body?
What is ADH
and where is
it in the
body?
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Retain water
What is SIADH
and what
causes it?
Concentrated
makes the #'s go
_______.
Up
Lab values such as HCT, urine SG, and
serum Na+.
Dilute makes
#'s go
________.
Down
Lab values such as HCT, urine SG, and
serum Na+.
What is DI and
what causes it?
1. vasopressin (pitressin)
2. Desmopressin Acetate (DDAVP)
Distened neck
vein/peripheral
veins mean the
vessels are:
What does
peripheral
edema and
third spacing
mean (in
relation to fluid
volume status)?
What are NL
CVP values?
And where is
CVP measured?
More
_________,
means more
___________.
Volume, pressure
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backwards, lungs
Increases b/c of
increased fluid r/i
increased pressure
(resistance-afterload).
WT increased d/t
increased fluid
(acute gain/loss is
fluid, >+-2lbs)
1. distended
neck/peripheral
veins
2. peripheral
edema & third
spacing
3. CVP increased
4. Lungs are wet
5. polyuria
(kidneys
diuresising to dec
fluid)
6. increased pulse
(full & bounding)
7. BP increases
8. WT increases
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diuresis to
decrease fluid
Describe the 6
treatments/interventions used for
FVE.
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What is
hypovolemia?
What is third
spacing, and what
causes it?
What 2 main
assessments are done
with ascities?
1. WT decreases
2. descreased skin turgor
3. dry mucous membranes
4. decreased UO (kidneys either
aren't being perfused, or they are
trying to hold onto fluid)
5. decreased BP (less volume, less
pressure)
6. Pulse increases, and quality is
weak & thready (heart trying to
pump what little fluid is left)
7. Respirations increase (body
perceives decreased blood volume as
hypoxia)
8. decreased CVP
9. peripheral veins/neck veins
vasoconstrict (very tiny)
10. cool extremities (d/t
vasoconstriction to shunt blood to
core organs)
11. concentrated urine (if pt has
UO)
Because of peripheral
vasoconstriction to shunt blood to
the core/vital organs
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What is the
treatment for
hypovolemia
(FVD)? (3)
What sequence
would you use
to assess the
client with
orthostatic
hypotension:
1. assess the VS
with pt sitting
2. assess VS
with pt lying
3. assess VS
with pt
standing
4. record BP &
Pulse with the
position noted
5. have pt lie
down for at
least 3 min
5, 2, 1, 3, 4
What do
isotonic IVF do
to the body?
And when are
they used?
List 4 examples
of isotonic IV
solutions.
1. Normal Saline
2. Lactated ringers (best shock solution)
3. D5W
4. D5 1/4 NS
What types of
pt's should not
receive isotonic
IV solutions?
What do
hypotonic
solutions do to
the body? And
when are they
used?
List 3 examples
of hypotonic
solutions.
1. 1/2 NS
2. 0.33% NS
3. D2.5W
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What do hypertonic
solutions do to the
body? And when are
they sued?
List 8 examples of
hypertonic solutions
1. D10W
2. 3%NS
3. 5% NS
4. D5LR
5. D5.5 NS
6. D5 NS
7. TPN
8. Albumin
What 2 electrolytes
(when in excess) have
sedative effects?
Magnesium is excreted
by the __________
and can be lost through
the GI tract too.
kidneys
1. Renal Failure
2. antacids (they have lots of Mg)
Muscles
1. flushing
2. warmth
3. sedated/change in LOC
4. DTRs decreased, muscle tone
decreased
5. arrhythmias
6. decreased LOC
7. decreased pulse
8. decreased respirations
9. decreased BP (d/t mag makes
you vasodilate)
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If calcium is low,
phosphorous is
_______.
high
If Phosphorous is low,
calcium is _______.
high
1.2-2.1
9.0-10.5
1. hyperparathyroidism (too
much PTH)
2. Thiazides/HCTZ (retain
Ca++)
3. Immobilization (must bear wt
to keep bone)
How does
hyperparathyroidism
cause hypercalcemia?
1. brittle bones
2. kidney stones
3. decreased DTRs & muscle
tone
4. arrhythmias
5. decreased LOC, sedative
effects
6. decreased Pulse
7. decreased RR
What is the
treatment/interventions
for hypercalcemia?
What type of
relationship do calcium
& phosphorous have?
1. Move, ambulation
2. fluids (to prevent kidney
stones)
3. Phospho Soda & fleet enemas
4. steroids
5. add foods rich in
phosphorous (anything with
protein)
6. safety precautions (d/t
sedative effects)
7. must have vitamin d to use
calcium
8. Calcitonin (tx for
osteoporosis) decreases serum
calcium
inverse
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1. diarrhea (lots of Mg in
intenstines)
2. alcoholism (alcohol
suppresses ADH & causes
diuresis)
List the
treatments/interventions
for hypomagnesemia. (4)
1. give Mg
2. check kidney function (before
& during IV Mg)
3. seizure precautions
4. eat Mg
What is the
treatment/interventions
for hypocalcemia?
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Pt should be on a heart
monitor
Water
135-145
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1. dry mouth
2. thirsty
3. swollen tongue
4. neuro changes
1. restrict Na+
2. IVFs (hemodilute)
3. daily weights
4. I&Os
5. labs
dehydrated
DILUTION, RESULTS
FROM TOO MUCH
WATER (NOT ENOUGH
nA+)
1. drinking water for fluid
replacement (only replaces
water, and dilutes the
blood)
2. psychogenic polydipsia
(loves to drink water)
3. D5W (sugar water)
4. SIADH (retaining H2O)
Hyponatremia =
__________
84.
Hemodilution
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93.
1. HA
2. Seizure
3. Coma
4. Neuro changes
**brain doesn't like it when Na+ is
messed up
What is the
treatment for
hyponatremia? (2)
Potassium is
excreted by the
_________.
Kidneys
Potassium
1. Kidney probs
2. aldactone (K+ sparing diureticmakes body retain K+)
1. bradycardia
2. tall, peaked T waves
3. prolonged PR intervals
4. Flat or absent P waves
5. widened QRS complex
6. v-fib
1. dialysis
2. calcium gluconate (decreases
arrhythmias)
3. glucose & insulin (insulin carries
K+ & glucose into cell--worry about
hypoglycemia & hypokalemia)
4. Kayexalate (exchanges K+ for
Na+ - watch for hypernatremia &
dehydration)
inverse
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1. vomiting
2. NG suctioning (lots of K+ in stomach)
3. Diuretics
4. not eating
1. muscle cramps
2. weakness
3. life-threatening arrhythmias
1. Give K+
2. aldactone (makes body retain K+)
3. Eat more potassium
bananas, squash, white beans, prune juice, cantaloupe, pears, halibut, tuna, raisins,
mango, broccoli, potatoes, cabbage, cauliflower, oranges, spinach
urine output
burning