Fluid & Electrolytes: Fluid Spacing & Hypervolemia vs Overhydration

Third spacing causes (think capillaries)

CHF -increases venous pressure fluid overload liver failure - causing fluid overload & no albumin. obstruction of venous return due to thrombus hypoalbuminemia - lack of protein to pull fluids back into capillaries. Capillary damage inflammation intestinal obstruction abdominal surgery

Overhydration causes

Fluid replacement with water only SAIDH syndrome of inappropriate ADH Excessive irrigation of a body cavity with water.

Fluid overload causes

Increase in Na+ in body (with water following) CHF triggering RAA in kidneys (to save H2O) Renal Failure triggering RAA in kidneys Cirrhosis Cushing's Syndrome Alka-Seltzer - Na+ ingestion in diet or medication

is it overhydration or hypervolemia?

Look at the lab results. If Na+ is low than it is overhydration of water only and solutes are diluted. If Na+ is high than it is hypervolemia and edema - pt is retaining all fluids.

Third spacing

abnormal fluid collection in areas that normally contain minimal or no fluids

Fluid overload

access fluid & SOLUTES causing hypervolemia

Third spacing spaces

ascites pulmonary edema blistering (burns to skin)

Excess fluid s/s

cardiovascular overload generalized edema pulmonary edema impaired skin due to edema polyuria

Overhydration critical complications

cerebral edema

rapid changes in weight

could indicate excess fluid. 1kg = 1L of fluid.

Excess fluid treatments

furosemide - which is a potassium waster so keep an eye on K+

Second spacing

increased fluids in the interstitial compartment: -generalized edema -pitting edema -periorbital an scrotal edema -brawny edema

Overhydration

known as water intoxication where the body gains water only! H2O goes to cells where solute concentration is higher and cells swell.

First spacing

normal distribution of fluid in the body

Excess fluid interventions

urine specific gravity <1.010