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What is FVD aka Hypovolemia?
What compartments are involved?
Decrease in intravas, interstitial, or intracellular fluid in the body either in combo w/ other electrolytes or acid-base balance.
HYPOvolemia: loss of ECF (circulating blood volume)
Types of FVD
What are the CAUSES of:
Iso tonic dehydration
Hypo Na tremic dehydration
Hyper Na tremic dehydreation
Iso: vomiting, diarrhea; lose both water and Na+ equally from ECF.
Hypo: burns, renal disease, PROLONGED vomiting & diarrhea. (cells swell; more ECF dehydration)
Hyper: Water loss > Na+ loss (cells shrink; too much serum Na+; SERIOUS condition before symptoms appear.
What is "third spacing"? aka..due to which compartment?
What happens to this fluid?
What are some examples?
aka: interstitial fluid loss; a type of dehydration.
ECF fluid, especially from intravas fluid is trapped and does not support normal and cardiac functions.
Ex: ascites, burns, peritonitis, bowel obstruction, bleeding into joints.
What are some Risk Factors?
- Third spacing
What are some S/SX?
- *rapid WT loss
- dry mucus membranes
- Decreased: output, skin turgor
- Increased: HCT, BUN, urine osmol.
- Altered LOC (elderly)
What are some Tx for:
What if BP returns to normal?
- Oral rehydrate; need 30 mL/kg over 24h gradually
- IV: isotonic solution
BP normal then change to HYPOtonic solution.
What are some causes?
- Renal failure
- Increased Na+ intake (=HTN)
FVE causes edema from which compartment?
In order to have edema or pitting edema, how much liters of fluid must be obtained?
Edema of interstitial fluid.
Edema: at least 2.5 L.
Pitting Edema: at least 7 L.
What are some s/sx?
What increases and decreases?
- Wt. gain
- Dyspnea; SOB d/t fluid in peritoneum.
- Wheezing/crackles causing Pulm. edema.
- Increased: output, nitrogen serum.
- Decreased: HCT, BUN, kidney perfusion causing decreased excretion of wastes.
What are some Tx?
- Fluid restriction (H2O)
- Na+ restriction (Na+)
- Diuretics: HCTZ, furosemide
- K+ supplements to avoid hypokalemia
What kind of pulse would a Pt w/ FVD have compared to a Pt w/ FVE?
FVD: weak, rapid pulse.
FVE: bounding pulse, JVD.
Which electrolytes are in the:
What does the Na+/K+ pump do?
- ECF: Na+, Cl-, Ca+, HCO3-.
- ICF: K+, phosphate-, Mg+.
To maintain normal electrolyte balance, Na+ exits cell and K+ enters cell.