1750: Fluid/Elec. Imbalances EXAM II

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xiongav
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300400
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1750: Fluid/Elec. Imbalances EXAM II
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2015-04-11 12:57:00
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FE Imbalances EXAM II
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F&E Imbalances
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  1. 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)
  2. 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.
  3. 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.
  4. FVD.

    What are some Risk Factors?
    • age
    • infants
    • Pregnancy
    • Diuretics
    • Sweating
    • Third spacing
  5. FVD.

    What are some S/SX?
    • *rapid WT loss
    • Thirst
    • lethargy
    • dry mucus membranes
    • Decreased: output, skin turgor
    • Increased: HCT, BUN, urine osmol.
    • HYPOtn
    • Tachycardia
    • Altered LOC (elderly)
  6. FVD.

    What are some Tx for:

    Moderate FVD?

    Severe FVD?

    What if BP returns to normal?
    • Moderate:
    • Oral rehydrate; need 30 mL/kg over 24h gradually

    • Severe:
    • IV: isotonic solution

    BP normal then change to HYPOtonic solution.
  7. FVE.

    What are some causes?

    (chronic illnesses)
    • CHF
    • Renal failure
    • CirrhosisĀ 
    • Increased Na+ intake (=HTN)
  8. FVE.

    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.
  9. FVE.

    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.
  10. FVE.

    What are some Tx?
    • Fluid restriction (H2O)
    • Na+ restriction (Na+)
    • Diuretics: HCTZ, furosemide
    • K+ supplements to avoid hypokalemia
    • Dialysis
  11. What kind of pulse would a Pt w/ FVD have compared to a Pt w/ FVE?
    FVD: weak, rapid pulse.

    FVE: bounding pulse, JVD.
  12. Which electrolytes are in the:

    ECF (4)
    ICF (3)

    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.

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