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Nursing Fundamentals - Fluids

Nursing23 CardsCreated 3 months ago

ADH helps regulate fluid balance, blood volume, and blood pressure. In high concentrations, it also acts as a vasoconstrictor to further support blood pressure maintenance.

What is the:

function of antidiuretic hormone (ADH)?

what is it controlled by?

what does it regulate?

​ADH:

function: to hold onto water only

controlled by: posterior pituitary and kidneys

regulates: blood pressure

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Key Terms

Term
Definition

What is the:

function of antidiuretic hormone (ADH)?

what is it controlled by?

what does it regulate?

​ADH:

function: to hold onto water only

controlled by: posterior pituitary and kidneys

regulates: blood pressure

What is the:

function of aldosterone?

what is it controlled by?

what does it regulate?

Aldosterone is a steroid hormone:

function: to hold onto sodium and water

controlled by: adrenals (on top of kidneys)

regulates: ...

What are the cascade of hormones that go into effect with low blood pressure which then helps the body hold onto fluid and increase the blood pressure?

renin: kidneys release this when it senses low blood pressure

angiotensin I: then the liver releases this hormone

angiotensin II: then ...

What are atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP)?

ANP and BNP are two hormones released by the heart when the heart tissue is stretched due to fluid volume overload.

They both help the body t...

What is the difference between intravascular, intracellular and extracellular fluid compartments?

intravascular (or vascular): are all the fluids in the blood vessels

intracellular: are all the fluids in the cells

extracellular (or t...

What is third-spacing?

A type of edema. It is extracellular fluid that has leaked out of the vessels and into the tissues due to a disease or injury.

This fluid shi...

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TermDefinition

What is the:

function of antidiuretic hormone (ADH)?

what is it controlled by?

what does it regulate?

​ADH:

function: to hold onto water only

controlled by: posterior pituitary and kidneys

regulates: blood pressure

What is the:

function of aldosterone?

what is it controlled by?

what does it regulate?

Aldosterone is a steroid hormone:

function: to hold onto sodium and water

controlled by: adrenals (on top of kidneys)

regulates: blood pressure

What are the cascade of hormones that go into effect with low blood pressure which then helps the body hold onto fluid and increase the blood pressure?

renin: kidneys release this when it senses low blood pressure

angiotensin I: then the liver releases this hormone

angiotensin II: then the lungs release this hormone

aldosterone: then the adrenals release this hormone, which helps the kidneys hold onto sodium and water causing an increase in blood pressure.

What are atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP)?

ANP and BNP are two hormones released by the heart when the heart tissue is stretched due to fluid volume overload.

They both help the body to get rid of extra fluids.

What is the difference between intravascular, intracellular and extracellular fluid compartments?

intravascular (or vascular): are all the fluids in the blood vessels

intracellular: are all the fluids in the cells

extracellular (or third space): are all the fluids outside the cells

What is third-spacing?

A type of edema. It is extracellular fluid that has leaked out of the vessels and into the tissues due to a disease or injury.

This fluid shift can cause fluid volume deficit.

What is central venous pressure and what does it indicate when it’s high and low?

CVP is blood pressure in the vena cava, which carries blood returning to the heart right near the right atrium. It is used to determine the severity of heart failure.

increased CVP: high blood pressure and too much fluid in the body

decreased CVP: low blood pressure and not enough fluid in the body

What is fluid volume overload (FVO) and what are 2 basic causes of it?

It’s when there is too much fluid in the vascular space. It is caused by:

holding onto fluids or

not getting rid of fluids

Overhydration and hypervolemia are other terms used to describe FVO.

What are the most common diseases that cause fluid volume overload from holding onto fluids?

Heart failure: the heart can’t pump the extra fluids through

Cirrhosis: the liver can’t make proteins, causing fluids to leak out of the vascular space and into the third space

Cushing’s: there are too many steroids and steroids hold onto fluids

What is the most common disease that causes fluid volume overload from the body not getting rid of fluid?

Chronic kidney failure: the kidneys no longer work, so the body doesn’t get rid of the fluids.

What are two common situations of a client getting too much fluid intake that worsens fluid volume overload?

the client eats salty food which causes thirst and fluid intake

the client receives too much IV fluids

What are the vital signs with fluid volume overload (FVO) and why do they occur?

↑ blood pressure: more fluid volume causes increased pressure

↑ heart rate: heart works extra hard to push fluids through

bounding pulse: more fluid volume stretches the vessels

Which way do the labs go with fluid volume overload?

hematocrit

BUN

serum osmolality

sodium

urine specific gravity

↓ hematocrit: also called hemodilution

↓ BUN

↓ serum osmolality: ↓ electrolytes and sugar in the blood

↓ sodium

↓ urine specific gravity: ↓ particles in the urine

Everything is diluted in the blood or urine due to the extra fluids.

What are the signs and symptoms of fluid volume overload?

cardiac: distended veins, dysrhythmias, ↑CVP

respiratory: increased and shallow respirations, dyspnea, moist crackles

renal: decreased or increased urine output (depends on cause)

skin: edema, pale and cool skin

gastrointestinal: increased weight

neuro & muscular: confusion, muscle weakness

The body has too many fluids in it and electrolytes can also become imbalanced.

What are the most common interventions to treat fluid volume overload?

Always treat the “cause” first

fluid restrictions

diuretics: meds that cause urination

possible dialysis: if there is chronic kidney disease

monitor intake and output

What is fluid volume deficit (FVD) and what are 2 basic causes of it?

It’s when there is not enough fluid in the vascular space. It is caused by:

not enough fluid intake by mouth or IV

getting rid of too many fluids

Dehydration and hypovolemia are other words for FVD.

What are the most common causes of fluid volume deficit?

(think of reasons of where the client would be getting rid of fluids)

vomiting

polyuria

diarrhea or laxative overuse

drainage from fistulas (abnormal openings)

drainage from tubes

excessive sweating

hemorrhage

burns

What are two ways the kidneys can cause fluid volume deficit?

too many diuretics: the client urinates too much

Addison’s disease: the client doesn’t have enough steroids. Without enough steroids, the client won’t be able to hold onto fluids.

What are the vital signs with fluid volume deficit and why do they occur?

↓ blood pressure: less fluid volume causes decreased pressure

orthostatic hypotension

↑ heart rate: less fluid means less oxygen so the heart compensates to get oxygen to the vital organs

weak and thready pulse: less fluid volume in the vessels

↑ temperature: due to loss of fluids cooling the body down

Which way do the following labs go with fluid volume deficit?

hematocrit

BUN

serum osmolality

sodium

urine specific gravity

↑ hematocrit: also called hemoconcentration

↑ BUN

↑ serum osmolality: ↑ electrolytes and sugar in the blood

↑ sodium

↑ urine specific gravity: ↑ particles in the urine

Everything is concentrated in the blood or urine due to the decreased fluids.

What are the signs and symptoms of fluid volume deficit?

cardiac: flat veins, dysrhythmias, ↓CVP

respiratory: increased rate and depth of respirations, dyspnea

renal: decreased urine output, dark-yellow urine

skin: poor skin turgor

gastrointestinal: decreased weight

neuro & muscular: confusion, muscle weakness

The body doesn’t have enough fluids in it and electrolytes can also become imbalanced.

What are the most common interventions to treat fluid volume deficit?

Always treat the “cause” first

Increase fluid intake (especially IV fluids)

monitor intake and output

How are intake and output monitored by the nurse?

weighing the client daily at the same time

measuring the urine output (client may get a Foley)

measuring amount of fluids ingested by mouth or IV fluids

estimating fluid loss by sweating, breathing and bowel movements