answers, and detailed rationales.
What solution/fluids should we use for patients in mild Na deficit?
Normal saline
A patient who has blood loss or diarrhea, can benefit from what type of fluids?
Lactated Ringers
Approximately 2/3 of body fluid is in the _______________________
compartment.
Approximately 1/3 of body fluid is in the _______________________
compartment.
Intracellular fluid (ICF)
Extracellular fluid (ECF)
Which compartment contains the intravascular (blood), interstitial, and trans
cellular fluid spaces?
ECF
Total body water makes up approximately how much body weight?
60%
What are the 3 divisions of ECF?
1. Intravascular space (plasma)
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,2. Interstitial space (fluid which surrounds cell i.e. lymph)
3. Transcellular space (CSF, pericardial, synovial, intraocular, pleural fluids, sweat,
and digestive secretions)
Third-space fluid accumulates within membrane-bound spaces in the body. What
are examples of third-spacing fluid?
- ascites
- pleural effusion
- pericardial effusion
- angioedema
What is serum osmolality?
A measure of the solute concentration of the blood
(usually sodium, BUN, and glucose)
What is urea?
Waste! BUN measures urea
1. Protein is digested
2. turned into ammonia
3. liver turns ammonia to urea for excretion
Will your HCT be higher or lower of you are dehydrated?
Higher
*HCT measures percentage of RBCs in whole blood
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,Will your HCT be higher or lower of you are overhydrated?
Lower
What lab measures muscle breakdown which is excreted by kidneys?
Creatinine
The body does not retain sodium in fluid volume deficit. T/F?
False. It does. Dehydration causes cells to become hypertonic.
What study is best to measure fluid status and most indicative of sodium?
Urine osmolality
What does urine specific gravity measure?
Density of urine compared to water. It includes glucose and protein.
What is the difference between hypovolemia and dehydration?
Hypovolemia indicates equal parts of electrolyte and water loss while dehydration
refers to loss of water alone with increased Na levels.
ADH and aldosterone tell our kidneys to _______ onto water.
hold
Can ADH deficiency or resistance cause hyper- or hypovolemia?
Hypovolemia
* ADH means "anti" + "excessive urine" which means when we have a defect in
ADH, we are urinating excessively and losing fluid.
What is the #1 sign of hypovolemia? It is also our first intervention.
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, Weight loss
* daily weights every 24hrs at the same time of day
I have:
- high HCT
- high BUN
- high Na+
- Increased urine specific gravity + osmolality
Am I hypovolemic or hypervolemic?
Hypovolemic
How do we medically manage hypovolemia?
- if not severe, oral hydration preferred
- isotonic or hypotonic IV (helps excrete metabolic waste)
What is nursing management of hypovolemia?
1. I+O q8h or hourly
2. daily weights
3. V/S q4h
4. observe for weak, rapid pulse, and orthostatic hypo
5. skin turgor and mucus membranes
6. id risk factors (treat the cause)
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