Hypervolemia: Too much fluid.
5) Physical assessemnt
* anytime there is an assessment or evaluation on the NCLEX, you should be looking for the presence or absence of the pertinent signs and symptoms
2) I&O and daily weights
* want them to have on the same clothes and to urinate first*
3) Take diuretics
* want to get the fluid out* - Loop diuretic ( lasix losing potassium - bumetanide can be given when lasix doesnt work - postassium sparing ( aldoctone) will limit postassium
Too much ADH
- Retain water - Leave you in Fluid Volume Excess -SIADH -Urine is decreasing -Blood is dilute
Aldosterone (Steroid, mineralocorticoid)
-Found in adrenal glands (on top of kindeys)
2) Atrial Natriurteic Peptide (ANP)
-Found in the atria of the heart - works opposite of alodertone - will cause excretion of NA and H2O
Too little ADH
-Lose (Diurese) of water -DIURESES: Excessive release of urine -Fluid volume deficit (Shock) - urine dilute -blood concentration
ADH (Anti-diuretic Hormone)
-Normally will make you retain water. -found in the pituitary gland
1) low NA diet/ restrict fluids
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4) bed rest includes diurese by relase of ANP and decrease in production of ADH
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Signs and Symptoms of Hypervolemia
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Treatment
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Hormonal Regulation of Fluid Volume
1) Aldosterone 2) Artrial Natriuretic Peptide 3) ADH
Disease with too little aldosterone
Addison Disease
Causes of Alka-Seltezer, Fleet enema, and IVF with Na
All 3 have a lot of sodium NA
Key words to think potential ADH problem:
Craniotomy, head injury, sinus surgery, transphenoidal hypophysectomy or any condition that could lead to increased ICP there is a risk of an ADH problem
Disease with too much aldosterone
Crushing disease : too many of all steroids Hyperaldosterione : corhns syndrome
Polyuira :
Kindeys trying to help diurese (get fluid out)
CVP
Measured at right atrium, the number will increase.
Causes : Renal Failure.
The kindeys are not working which means they are no putting anything in
Concentration will make the numbers go up Dilute will make the numbers go down
Urine specific gravity, sodium, and hematocrit
Define: Too much fluid in the
Vascular Space
Distended Neck Vein/ Peripheral Veins:
Vessels are full of fluid
Peripheral Edema, third spacing:
Vessels cant hold anymore to they start to leak
Blood Pressure
Would increase More volume = more pressure
Weight
Would increase any acute gain or loss isnt fat: its fluid
6) Give IVFs slowly to elderly
always push fluids on bed rest unless contradicted.
if the fluid doesnt go forward, it goes backward into the lungs
causes pulmonary edema
Causes: Heart Failure (HF) . The heart is weak which means the CO is low, the kidneys are not perfusing very well and there is a low urine output. The volume stays in the vascular space.
heart is weak, Cardiac Output is low, decreased kidney perfusion, Urine output is low.
Lung sounds:
wet (Crackled), SOB
Aldosterone normal action
when blood volumes get low (caused by vomiting or blood loss) the aldosterone secretions will increase and retain sodium and water this will cause the blood volumes to increase
