1750: Fluid & Electrolyte Imbalances

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1750: Fluid & Electrolyte Imbalances
2015-03-11 08:47:41

F&E imbalances
Show Answers:

  1. What is Hypovolemia?

    Will you see a big change in lab values?
    Low volume of blood --> loss of extracellular fluid volume (circulating blood volume)

    No, because it is an equal loss of fluid & electrolytes.
  2. Types of FVD:

    Isotonic FVD

    Hypotonic FVD

    Hypertoniic FVD
    • Iso FVD: loss of F&E in equal proportions from extracellular compartment:
    • Causes: vomiting, diarrhea.

    • Hypo FVD: (hyponatremia dehydration)
    • Na+ loss > water loss
    • Causes: burns, renal disease, prolonged vomiting & diarrhea.

    • Hypertonic FVD: (hypernatremic dehydration)
    • water loss > Na loss
  3. What is Third-spacing?
  4. Risk factors for FVD.

    What are some risks?
    • Age & decreased:
    • thirst response
    • intracellular reserves

    Pregnancy: vomiting - miscarriage - blood loss

    Infant/small child: higher body surface area & more fluid loss via faster RR
  5. S/SX of FVD?
  6. What is the major defining signs of dehydration?

    What must you do to find out their electrolytes?
    Rapid wt loss.

    Lab draw is needed.
  7. Age-related Variations; Collaborative Interventions

    Peds vs Elders.
    Rehydration: volume expansion.

    Need 30 mL/kg body wt-replace deficit over 24h.

    Beverages w/ sugar OK since it helps w/ absorption of Na-no diet beverages.
  8. Age-related Variations; Collaborative Interventions

    What IV solutions are used for severe dehydration?
    LR, 0.9% NaCl-

    *Switch to 0.45% NaCl when BP is normal.
  9. Nursing Process.

    ADPIE for dehydration.
  10. Fluid Volume Excess/Hypervolemia.
    Fl&E retained by body.

    Fluid volume overload.
  11. Causes of FVE.
  12. S/SX of Fluid Volume Excess.

    What is azotemia?
    • Wt gain
    • Full, bounding pulse
    • Distended neck veins (JVD) & peripheral veins.

    Azo: elevated nitrogen in blood DT decreased perfusion by kidneys & decreased exretion of wastes.
  13. Collaborative Interventions for Hypervolemia.
    • Limit Na+ & H2O intake.
    • Administer diuretics and K+ supplements to avoid hypokalemia.

    Labs: serum electrolytes/seerum osmolality, hct, hgb

    • Fluid restriction
    • Na+ restricted diet
    • Dialysis