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What is ADH?
What does it do?
- Anti Diuretic Hormone
- Holds onto water
What is RAA?
What does it do?
- Renin Angiotensin Aldosterone System
- Vasoconstrictor, Holds onto Sodium
What are Natriuretic Peptides (ANP/BNP)?
Opposes the RAA
What regulates water balance?
- Adrenal Gland
- Insensible Losses
What is diffusion?
molecular movement of solute
What is osmotic movement?
- movement of water - solvent
- - isotonic, hypertonic, hypotonic
What is filtration?
movement of lolute and solvent w/ H2O pressure
What is active transport?
movement of solvent and solute w/ energy expended
What is dehydration?
Fluid volume deficit
What are the types of dehydration?
- Isotonic- losses equal
- hypotonic- cells swell, electrolyte loss is > water loss
- hypertonic- cell shrink, water loss is > electrolyte loss
What is hypovolemia?
water and electrolyte are lost equally
Causes of hypertonic
- excessive sweating, diarrhea, vomiting, hyperventilation
- water moves from ICF to ECF to dilute - increases osmolarity of plasma so cells shrink
Causes of hypotonic
- malnutrition, excessive ingestion of hypotonic fluids - water
- excessive NA++ and K+ losses form ECF = decreased osmolarity of ECF so water moves into ICF to dilute - increases osmolarity of cells so cells swell
What is hypervolemia
- excessive ECF
- no shift of fluids, circulatory overload, edema
- renal failure, heart failure, too much IV therapy, steroids
- water intoxication
- osmolarity of ECF decreases = increase hydrostatic pressure -> fluid moves from ECF to ICF - cells swell
What are nursing assessments of fluid deficit?
- turgor & fluid mobility
- - sternum/abdomen/forehead/forearm
- - pinch/count in seconds/abnormal = > 3 sec
- skin/mucous membranes
- - tongue/membranes - furrows, dry
- - wrinkled/dry skin
- hand veins
- - flat
What are nursing assessments for fluid excess?
- fluid accumulation - 3rd spacing/interstitial
- - edema assessment: 1+, 2+, 3+, 4+, brawny, weeping
- - cool skin, pale, feels firm to touch over tibia, fibula, sacrum - pitting
- - hand veins full and bulging