NUR 355 exam 4
1. biggest indicator monitoring weight and I/Os
of fluid status
2. osmolarity the concentration of a solution as determined by the number of solutes in a
kilogram of water in blood and urine
3. hypovolemia decreased fluid = increased osmolality (We have less fluid so we have a greater
concentration of particles/solutes in the fluid because we still have the same
expected number of particles as usual)
4. hypervolemia increased fluid = decreased osmolality (We have the same number of parti-
cles/solutes but now there is more fluid so there is less concentration
5. hypovolemia decrease in fluid in the body and can occur in the interstitial, intravascular, or
intracellular spaces
6. causes of hypov- Gastrointestinal loss of fluid through vomiting, diarrhea, and nasogastric suction
olemia Increased perspiration during strenuous exercise or extreme heat without ade-
quate fluid replacement
hemorrhage, diabetes insipidus, diabetic ketoacidosis, adrenal insufficiency.
7. intravascular within blood vessels
8. interstitial between blood vessels and cells
9. intracellular within the cell
10. third spacing Fluid shifts into the interstitial space (in between vascular & cells) or third spacing
occurs when fluid leaves the vascular space and enters the space between cells,
becoming unavailable to support normal physiological activities
Patients can become hypotensive, tachycardic, or restless and have decreased
urine production
, NUR 355 exam 4
11. where can fluid abdomen, pleural space, soft tissues
shift into?
12. hypovolemia labs elevated BUN, creatinine, sodium, H+H
13. S/S hypovolemia weight loss, loss of skin turgor, concentrated UO, oliguria, thirst, dry mucous
membranes, weak + rapid pulses, flattened neck veins, hypotension, anxiety,
restlessness, cool, clammy skin
14. hypovolemia intake of fluid, IV isotonic solutions, such as 0.9% normal saline (NaCl) or lactated
treatment Ringer's solution, expands plasma volume and corrects hypotension
15. hypervolemia fluid volume excess occurs as a result of increased water and sodium retention
16. hypervolemia cirrhosis, heart failure, stress conditions causing a release of ADH and aldos-
causes terone, adrenal gland disorders, and the use of corticosteroids
17. hypervolemia S/S hypertension, tachycardia, elevated central venous pressure, development of S3
heart sounds, and jugular vein distention, cough, tachypnea, adventitious breath
sounds (i.e., crackles, wheezing), orthopnea, and decreased oxygen saturation
18. hypervolemia renal dialysis, diuretics, notify doctor if weight gain of 3-4 pounds over 3 days is
treatment noted
19. hypervolemia Hematocrit and BUN may be low secondary to dilution
labs hyponatremia and low serum osmolatiry may be present in renal failure
20. crystalloids composed of electrolytes dissolved in water and include dextrose solutions, sodi-
um chloride solutions, balanced electrolyte solutions, and alkalizing and acidifying
solutions (NS, D5W, LR etc.)
21. colloidals composed of larger molecules, usually protein or starch, suspended in fluid and
are not a true solution
, NUR 355 exam 4
frequently referred to as plasma volume expanders because the larger molecules
do not diffuse through cell membranes and draw fluid into the intravascular
space
used to maintain intravascular volume and prevent shock after major blood or
fluid losses
Examples include albumin, dextran, and mannitol
22. osmolality Concentration of solutes per kilogram of solution
23. osmolarity Concentration of solutes per liter of solution
Osmolarity can vary related to temperature so osmolality is preferred in medicine
24. isotonic fluids stays where I put it
stays in vascular space - does not cause fluid shift
0.9% NaCl, LR
Vascular expansion (they add volume to the vessels); used to treat hypovolemia
and electrolyte replacement
25. hypotonic solu- goes out of vessel into cells
tions
Have a lower concentration of solutes than within the cell, causing fluid movement
into cells
hydrates cells, provides calories and free water, treats hyperkalemia
D5w, 0.45% NaCl, 0.25% NaCl
26. hypertonic fluids enters the vessel
pulls fluid from interstitial and intracellular space and pushes into intravascular
Have higher concentrations of solutes than within cells, causing fluids to shift out
of the cell and into the ECF (extracellular fluid, fluid not in cells), causing cells to
1. biggest indicator monitoring weight and I/Os
of fluid status
2. osmolarity the concentration of a solution as determined by the number of solutes in a
kilogram of water in blood and urine
3. hypovolemia decreased fluid = increased osmolality (We have less fluid so we have a greater
concentration of particles/solutes in the fluid because we still have the same
expected number of particles as usual)
4. hypervolemia increased fluid = decreased osmolality (We have the same number of parti-
cles/solutes but now there is more fluid so there is less concentration
5. hypovolemia decrease in fluid in the body and can occur in the interstitial, intravascular, or
intracellular spaces
6. causes of hypov- Gastrointestinal loss of fluid through vomiting, diarrhea, and nasogastric suction
olemia Increased perspiration during strenuous exercise or extreme heat without ade-
quate fluid replacement
hemorrhage, diabetes insipidus, diabetic ketoacidosis, adrenal insufficiency.
7. intravascular within blood vessels
8. interstitial between blood vessels and cells
9. intracellular within the cell
10. third spacing Fluid shifts into the interstitial space (in between vascular & cells) or third spacing
occurs when fluid leaves the vascular space and enters the space between cells,
becoming unavailable to support normal physiological activities
Patients can become hypotensive, tachycardic, or restless and have decreased
urine production
, NUR 355 exam 4
11. where can fluid abdomen, pleural space, soft tissues
shift into?
12. hypovolemia labs elevated BUN, creatinine, sodium, H+H
13. S/S hypovolemia weight loss, loss of skin turgor, concentrated UO, oliguria, thirst, dry mucous
membranes, weak + rapid pulses, flattened neck veins, hypotension, anxiety,
restlessness, cool, clammy skin
14. hypovolemia intake of fluid, IV isotonic solutions, such as 0.9% normal saline (NaCl) or lactated
treatment Ringer's solution, expands plasma volume and corrects hypotension
15. hypervolemia fluid volume excess occurs as a result of increased water and sodium retention
16. hypervolemia cirrhosis, heart failure, stress conditions causing a release of ADH and aldos-
causes terone, adrenal gland disorders, and the use of corticosteroids
17. hypervolemia S/S hypertension, tachycardia, elevated central venous pressure, development of S3
heart sounds, and jugular vein distention, cough, tachypnea, adventitious breath
sounds (i.e., crackles, wheezing), orthopnea, and decreased oxygen saturation
18. hypervolemia renal dialysis, diuretics, notify doctor if weight gain of 3-4 pounds over 3 days is
treatment noted
19. hypervolemia Hematocrit and BUN may be low secondary to dilution
labs hyponatremia and low serum osmolatiry may be present in renal failure
20. crystalloids composed of electrolytes dissolved in water and include dextrose solutions, sodi-
um chloride solutions, balanced electrolyte solutions, and alkalizing and acidifying
solutions (NS, D5W, LR etc.)
21. colloidals composed of larger molecules, usually protein or starch, suspended in fluid and
are not a true solution
, NUR 355 exam 4
frequently referred to as plasma volume expanders because the larger molecules
do not diffuse through cell membranes and draw fluid into the intravascular
space
used to maintain intravascular volume and prevent shock after major blood or
fluid losses
Examples include albumin, dextran, and mannitol
22. osmolality Concentration of solutes per kilogram of solution
23. osmolarity Concentration of solutes per liter of solution
Osmolarity can vary related to temperature so osmolality is preferred in medicine
24. isotonic fluids stays where I put it
stays in vascular space - does not cause fluid shift
0.9% NaCl, LR
Vascular expansion (they add volume to the vessels); used to treat hypovolemia
and electrolyte replacement
25. hypotonic solu- goes out of vessel into cells
tions
Have a lower concentration of solutes than within the cell, causing fluid movement
into cells
hydrates cells, provides calories and free water, treats hyperkalemia
D5w, 0.45% NaCl, 0.25% NaCl
26. hypertonic fluids enters the vessel
pulls fluid from interstitial and intracellular space and pushes into intravascular
Have higher concentrations of solutes than within cells, causing fluids to shift out
of the cell and into the ECF (extracellular fluid, fluid not in cells), causing cells to
