Hypervolemia vs Hypovolemia
Why do you do hourly outputs on someone who is hypovolemic?
An increase in the urine output indicates that perfusion is improving.
What is the normal action of ADH and what does ADH stand for?
Anti-diuretic hormone, tell kidneys how much water to conserve and regulate the amount of water in the vascular space
How can IV fluids with sodium induce hypervolemia?
Because sodium causes retention of water
What is the name of the disease a patient can have that will induce hypervolemia due to too much aldosterone?
Benign adrenal tumor (hyperaldosteronism) holds on to sodium and water
If your are hypovolemic, what happened to your BP and pulse? Tell why.
Blood pressure decreases, less volume equals less pressure. Pulse increase but is weak/thready because it's trying to pump the little fluid you have around the body to perfume vital organs.
What happens to your CVP? Explain why.
CVP decrease due to decrease blood volume from hypovolemia
What will happen to your weight with hypovolemia and why?
Decrease because there is less fluid volume
Why do the extremities of a client who is hypovolemic become cool?
Decreased blood flow to extremity
What will the effects be on the body if a client does not have enough ADH and what is the name of the disease?
Diabetes insipidus which causes the kidney to excrete too much water
How can GI losses affect your vascular space?
Excessive GI loss can reduce the volume in the vascular space (anytime you lose fluid from year body, no matter where it comes from, the vascular space can eventually be depleted.
How can fever and sweating induce hypovolemia?
Fever and sweating cause further volume loss leading further into hypovolemia
How can burns induce hypovolemia?
Fluid leaves the vascular space and goes to the tissue (edema occurs) or out of the body completely
How can ascites induce hypovolemia?
Fluid leaves vascular space and goes out into the abdomen; therefore vascular volume goes down
If a patient is severely hypovolemic, what might be done to replace fluids?
Fluid resuscitation
How can renal failure cause fluid volume excess?
If the kidneys are not working (eliminating enough sodium/H2O) then the fluid will be retained in the vascular space
What class of IV solution would be good for someone who is hypovolemic? Explain why and give examples.
Isotonic crystalloids: normal saline and lactated ringers
If you are hypovolemic, why will your urine output eventually decrease?
Kidneys retain remainder fluid, decrease urine output. Renal failure is now a possibility.
When a patient has polyuria, will they stay in a polyuric state for a long, long period of time?
No, they will eventually become dehydrated and lead to kidney problems or diabetic ketoacidosis or hyperosmolar coma
Fleet enemas contain a lot of what?
Sodium
Alka-Seltzer contains a lot of what?
Sodium bicarbonate
What is the normal action of aldosterone?
Steroid hormone that acts primarily in renal collecting ducts to stimulate reabsorption of sodium as well as secretion of potassium and hydrogen
The diabetic patient will develop polyuria. Why?
The body is trying to rid itself of excess glucose in vascular space. Glucose is excreted through urine
How can ADH cause hypervolemia?
Too much ADH causes retention of too much in the vascular space (SIADH)
What will the effects be on the body if a client is producing too much ADH? What is the name of this disease?
Too much ADH causes too much retention of too much water and they may start to vomit/nausea and headache ... SIADH
What is FLUID VOLUME EXCESS?
Too much fluid in the blood which is increased wirh sodium
If a patient is hypovolemic and is just experiencing a mild fluid volume deficit, what might be done to replace fluids?
Two peripheral IV lines that's used to infuse large volumes of fluid
What is going to happen to the urine specific gravity if a patient is hypovolemic?
Urine specific gravity increases if patient is hypovolemic (>1.015) normal: 1.003-1.030
How does this polyuria affect the vascular space?
Vascular space depletes causing patient to be shocky
What happens to your veins when you're hypervolemic?
Veins become filled with fluid (distended)
Why does the hypervolemic patient develop edema?
Veins retain salt, they increase the body's total sodium content which increase your fluid content and causes edema
What happens to your veins? Explain why
Venous restriction due to lowered volume of blood.
How can fleet enemas throw you into hypervolemia?
Water follows sodium therefore client retains fluid
How can aldosterone cause hypervolemia?
When blood volume gets low the aldosterone secretions will increase and retain sodium and water this will cause the blood volume to rise
What is third spacing?
When fluid leaves the vascular space and goes into interstitial space. The interstitial space is the space in between the cells, outside of the blood vessels.The fluid leaves the vascular space and goes into the tissues
How can congestive heart failure throw you into hypervolemia or fluid volume excess?
When the heart weakens, blood flow returns to the heart slows down, backing up into the veins and causing fluid build up in tissues. Kidneys eliminate less sodium and water
Why does the hypervolemic patient develop ascites?
When the liver cannot properly store and process nutrients and filter toxins, it causes fluid retention. Buildup in abdominal area is when ascites happen
What is ascites?
accumulation of fluid in the peritoneal cavity
What is another term for fluid volume excess?
hypervolemia or fluid overload
Where is ADH stored?
pituitary gland
