HURST REVIEW WITH COMPLETE
SOLUTIONS 2023
fluid volume excess also another word for ? - ANS-- HYPERvolemia
definition of fluid volume excess - ANS-- too much fluid in the vascular space ( any
vessel in our body ex: vein , artery)
what are 2 causes of fluid volume excess? - ANS-- heart failure
- renal failure
heart failure ( HF) means what? - ANS-- the heart is weak
- the cardiac output is DOWN
- kidney perfusion is DOWN
- urinary output is DOWN
- the volume stays in the vascular space
renal failure( RF) means what? - ANS-- kidneys arent working
what are three things that contain A LOT of sodium? - ANS-- canned process foods
- IVF with sodium
- fleet enemas
Aldosterone ( steroid, mineralocorticoid) is found where? - ANS-- adrenal glands ( on
top of the kidneys)
what is the normal action of aldosterone ? - ANS-When your blood volume gets low
through for example vomiting or hemorrhage, the aldosterone secretion increases and
makes your body retain sodium and water and therefore increases the blood volume
aldosterone makes us retain what? - ANS-SODIUM AND WATER
when aldosterone secretion increases ----> retain sodium/water---> blood volume goes
________ ----> retain in ______________________ - ANS-- up
- vascular space
what two diseases have too much aldosterone? - ANS-- cushings ( too much steroids)
- hyperaldosterosteronism ( aka: CONNS)
what disease has too little aldosterone? - ANS-- Addisons disease ( not enough
aldosterone means you lose NA & water directly from the vascular space)
when taking a Anti-diuretic hormone ( ADH) do you retain or diurese? - ANS-- retain
,when taking a anti-diuretic what do you retain ? - ANS-- water
when you have too much ADH what happens in the body ? - ANS-- RETAIN water
- fluid volume EXCESS
- Syndrome of inappropriate ADH ( TOO MANY LETTERS TOO MUCH WATER )
- urine is CONCENTRATED ( too much ADH and NA )
- blood is DILUTED
when you have not enough ADH what happens in the body ? - ANS-- DIURESE water
- fluid volume DEFICIT
- DI ( diabetes insipidus) DIurese
- urine is DILUTED
- blood is CONCENTRATED
when checking the urine specific gravity, sodium, and hematocrit on lets say a urine test
strip if the urine is concentrated will it make the numbers go up or down? - ANS-- UP
when checking the urine specific gravity, sodium, and hematocrit on lets say a urine test
strip if the urine is diluted will it make the numbers go up or down? - ANS-- down
where is ADH found ? - ANS-- pituitary gland
what should you think about first when you think your patient has a ADH problem? -
ANS-head injuries ( craniotomy, increase ICP )
transsphenoidhypophysisectomy - ANS-all the way through ( across) sinus pituitary
removal
what are some drugs that are anti diuretic hormones ( ADH) - ANS-- vasoPRESSIN
*ends in PRESSINS)
what are some S?S of fluid volume excess? - ANS-- distended neck veins/ peripheral
veins ( VESSELS ARE FULL)
- third spacing
- lungs are CRACKLED
- polyuria
- pulse INCREASED ( palpate the artery)
- Blood pressure INCREASES ( more volume = more pressure )
- weight INCREASES
what is the treatment for fluid volume excess? - ANS-- low NA diet
- restrict fluids
- daily I& Os and weights
what are some diuretics you can give to help FVE? - ANS-- FurosemIDE ( lasix ) (
DECREASES K+)
,- drugs that end in IDE !!!!!
what is an example of a potassium spraing drug ? - ANS-- spironolactone ( retain K+)
when thinking of fluid retention you should think what first? - ANS-- HEART PROBLEMS
bed rest induces _________ by the release of ___________- and lowers the production
of ____________- - ANS-- diurese
- ANP
- ADH
what is another word for fluid volume deficit? - ANS-- HYPOvolemia
when you have a big time deficit you should think what first ? - ANS-- SHOCK
what are the three causes of Fluid volume deficit? - ANS-- loss of fluid from annywhere
- third spacing
- diseases with polyuria
what is third spacing? - ANS-- when fluid is in a place that does you no good
ex: burns, ascites ( measure abdominal girth daily/ worry about HYPOtension)
what is an example of a disease that deals with polyuria? - ANS-- diabetes mellitus
when you see the word POLYURIA what should you think of first? - ANS-- SHOCK
what are some S/S of fluid volume deficit ? - ANS-- weight DOWN
- decreased skin turgor
- dry mucous membranes
- urine output DECREASED ( kidneys arent being profused or they are trying to hold on
to fluid ( compensate))
- blood pressure is DOWN ( less volume, less pressure )
- pulse is INCREASED ( heart is trying to pump what little fluid is left ) ( weak and
thready in FVD)
respirations are INCREASED ( hypoxia)
- veins are CONSTRICTED
- urine specific gravity is INCREASED and CONCENTRATED
what is the treatment for FVD ? - ANS-- prevent further losses
- replace volume
ex: mild deficit- PO fluids
severe deficit- IV fluids
what are patients are higher risk for when they are dealing with FVD? - ANS-- falls b/c
of changes in V/S & mental status
, what happens in the body when you are given isotonic solutions? - ANS-- goes into the
vascular space and stays there
what are some examples of isotonic solutions? - ANS-- normal saline
- lactated ringers
- D5W
which fluid is best for shock patients? - ANS-- Lactated ringers
what do you use isotonic solutions for ? - ANS-- pt's that lost fluids through nausea,
vomiting, burns, sweating, trauma
- normal saline is the basic solution when administering blood
DO NOT use isotonic solutions in clients with what? - ANS-- hypertensions, cardiac
disease or renal disease
isotonic solutions can cause what? - ANS-- FVE, hypertensions, or hypernatremia ( high
concentration of sodium in the blood)
hypotonic solution does what in the body? - ANS-- goes into the vascular space and
then shifts out into the cells to REPLACE CELLULAR FLUID
hypotonic solution rehydrates but does not cause _____________ - ANS-hypertension
what are some examples of hypotonic solutions ? - ANS-- 1/2 NS
- 0.33 % NS
when and on who do you use hypotonic solutions? - ANS-- pt's who have hypertension,
renal, or cardiac disease and needs fluid replacement because of nausea, vomiting,
burns, hemorrhage, etc.
- also used for dilution when a client has hypernatremia and cellular dehydration
what should you watch out for when adminstering HYPOtonic solutions? - ANS-- watch
for cellular edema because this fluid is moving out to the cells, which could lead to fluid
volume DEFICET and decreased blood pressure
HYPERtonic solutions does what in the body ? - ANS-- volume expanders that will draw
fluid into the VASCULAR SPACE from the CELL
what are some examples of hypertonic solutions? - ANS-- TPN, albumin
what do you use hypertonic solutions for ? - ANS-- clients with HYPONATREMIA or a
client who has shifted large amts of vascular volume to a 3rd space or has severe
edema, burns, or ascites
- hypertonic solutions will return the fluid volume to the vascular space
SOLUTIONS 2023
fluid volume excess also another word for ? - ANS-- HYPERvolemia
definition of fluid volume excess - ANS-- too much fluid in the vascular space ( any
vessel in our body ex: vein , artery)
what are 2 causes of fluid volume excess? - ANS-- heart failure
- renal failure
heart failure ( HF) means what? - ANS-- the heart is weak
- the cardiac output is DOWN
- kidney perfusion is DOWN
- urinary output is DOWN
- the volume stays in the vascular space
renal failure( RF) means what? - ANS-- kidneys arent working
what are three things that contain A LOT of sodium? - ANS-- canned process foods
- IVF with sodium
- fleet enemas
Aldosterone ( steroid, mineralocorticoid) is found where? - ANS-- adrenal glands ( on
top of the kidneys)
what is the normal action of aldosterone ? - ANS-When your blood volume gets low
through for example vomiting or hemorrhage, the aldosterone secretion increases and
makes your body retain sodium and water and therefore increases the blood volume
aldosterone makes us retain what? - ANS-SODIUM AND WATER
when aldosterone secretion increases ----> retain sodium/water---> blood volume goes
________ ----> retain in ______________________ - ANS-- up
- vascular space
what two diseases have too much aldosterone? - ANS-- cushings ( too much steroids)
- hyperaldosterosteronism ( aka: CONNS)
what disease has too little aldosterone? - ANS-- Addisons disease ( not enough
aldosterone means you lose NA & water directly from the vascular space)
when taking a Anti-diuretic hormone ( ADH) do you retain or diurese? - ANS-- retain
,when taking a anti-diuretic what do you retain ? - ANS-- water
when you have too much ADH what happens in the body ? - ANS-- RETAIN water
- fluid volume EXCESS
- Syndrome of inappropriate ADH ( TOO MANY LETTERS TOO MUCH WATER )
- urine is CONCENTRATED ( too much ADH and NA )
- blood is DILUTED
when you have not enough ADH what happens in the body ? - ANS-- DIURESE water
- fluid volume DEFICIT
- DI ( diabetes insipidus) DIurese
- urine is DILUTED
- blood is CONCENTRATED
when checking the urine specific gravity, sodium, and hematocrit on lets say a urine test
strip if the urine is concentrated will it make the numbers go up or down? - ANS-- UP
when checking the urine specific gravity, sodium, and hematocrit on lets say a urine test
strip if the urine is diluted will it make the numbers go up or down? - ANS-- down
where is ADH found ? - ANS-- pituitary gland
what should you think about first when you think your patient has a ADH problem? -
ANS-head injuries ( craniotomy, increase ICP )
transsphenoidhypophysisectomy - ANS-all the way through ( across) sinus pituitary
removal
what are some drugs that are anti diuretic hormones ( ADH) - ANS-- vasoPRESSIN
*ends in PRESSINS)
what are some S?S of fluid volume excess? - ANS-- distended neck veins/ peripheral
veins ( VESSELS ARE FULL)
- third spacing
- lungs are CRACKLED
- polyuria
- pulse INCREASED ( palpate the artery)
- Blood pressure INCREASES ( more volume = more pressure )
- weight INCREASES
what is the treatment for fluid volume excess? - ANS-- low NA diet
- restrict fluids
- daily I& Os and weights
what are some diuretics you can give to help FVE? - ANS-- FurosemIDE ( lasix ) (
DECREASES K+)
,- drugs that end in IDE !!!!!
what is an example of a potassium spraing drug ? - ANS-- spironolactone ( retain K+)
when thinking of fluid retention you should think what first? - ANS-- HEART PROBLEMS
bed rest induces _________ by the release of ___________- and lowers the production
of ____________- - ANS-- diurese
- ANP
- ADH
what is another word for fluid volume deficit? - ANS-- HYPOvolemia
when you have a big time deficit you should think what first ? - ANS-- SHOCK
what are the three causes of Fluid volume deficit? - ANS-- loss of fluid from annywhere
- third spacing
- diseases with polyuria
what is third spacing? - ANS-- when fluid is in a place that does you no good
ex: burns, ascites ( measure abdominal girth daily/ worry about HYPOtension)
what is an example of a disease that deals with polyuria? - ANS-- diabetes mellitus
when you see the word POLYURIA what should you think of first? - ANS-- SHOCK
what are some S/S of fluid volume deficit ? - ANS-- weight DOWN
- decreased skin turgor
- dry mucous membranes
- urine output DECREASED ( kidneys arent being profused or they are trying to hold on
to fluid ( compensate))
- blood pressure is DOWN ( less volume, less pressure )
- pulse is INCREASED ( heart is trying to pump what little fluid is left ) ( weak and
thready in FVD)
respirations are INCREASED ( hypoxia)
- veins are CONSTRICTED
- urine specific gravity is INCREASED and CONCENTRATED
what is the treatment for FVD ? - ANS-- prevent further losses
- replace volume
ex: mild deficit- PO fluids
severe deficit- IV fluids
what are patients are higher risk for when they are dealing with FVD? - ANS-- falls b/c
of changes in V/S & mental status
, what happens in the body when you are given isotonic solutions? - ANS-- goes into the
vascular space and stays there
what are some examples of isotonic solutions? - ANS-- normal saline
- lactated ringers
- D5W
which fluid is best for shock patients? - ANS-- Lactated ringers
what do you use isotonic solutions for ? - ANS-- pt's that lost fluids through nausea,
vomiting, burns, sweating, trauma
- normal saline is the basic solution when administering blood
DO NOT use isotonic solutions in clients with what? - ANS-- hypertensions, cardiac
disease or renal disease
isotonic solutions can cause what? - ANS-- FVE, hypertensions, or hypernatremia ( high
concentration of sodium in the blood)
hypotonic solution does what in the body? - ANS-- goes into the vascular space and
then shifts out into the cells to REPLACE CELLULAR FLUID
hypotonic solution rehydrates but does not cause _____________ - ANS-hypertension
what are some examples of hypotonic solutions ? - ANS-- 1/2 NS
- 0.33 % NS
when and on who do you use hypotonic solutions? - ANS-- pt's who have hypertension,
renal, or cardiac disease and needs fluid replacement because of nausea, vomiting,
burns, hemorrhage, etc.
- also used for dilution when a client has hypernatremia and cellular dehydration
what should you watch out for when adminstering HYPOtonic solutions? - ANS-- watch
for cellular edema because this fluid is moving out to the cells, which could lead to fluid
volume DEFICET and decreased blood pressure
HYPERtonic solutions does what in the body ? - ANS-- volume expanders that will draw
fluid into the VASCULAR SPACE from the CELL
what are some examples of hypertonic solutions? - ANS-- TPN, albumin
what do you use hypertonic solutions for ? - ANS-- clients with HYPONATREMIA or a
client who has shifted large amts of vascular volume to a 3rd space or has severe
edema, burns, or ascites
- hypertonic solutions will return the fluid volume to the vascular space
