4360069
Fluid Imbalance #1
- ISOTONIC IMBALANCE when
WATER & ELECTROLYTES are -
or + in = PROPORTIONS
- OSMOLAR IMBALANCE is the - or + of ONLY
WATER SUCH AS??????
- osmolality of body is
altered.
- osmolar means
measure of SOLUTE
Concentration
- solutes include
particles like
ELECTROLYTES
- solutes include
particles like
ELECTROLYTES
- osmolality of body is
altered.
- osmolality of
body remains
constant
- Hyper-VOLEMIA the + of H2O &
ELECTROLYTES in the
intravascular fluid or blood
- this excess of fluid build up causes
Edema & Third-spacing fluid (peripheral
edema, ascites, & pulmonary edema)
- caused by over ingestion
of sodium & fluid (IV
solution with high
concentration of solutes
like sodium chloride,
potassium chloride &
glucose
- also caused by impaired fluid
balance regulation by the
body organs i.e. heart failure,
renal failure, & liver failure
- S & S: VITALS - tachycardia, bounding
pulse, hypertension, tachypnea, increased
venous pressure. NEUROMUSCULAR -
confusion, muscle weakness, lethargy
RESP -increased rate, shallow
respirations, dyspnea, orthopnea, crackles,
diminished breath sounds. GI - weight gain
& ascites could also include dependent
edema & distended neck vein
- LABS - decreased HCT,
dec serum osmolarity,
dec urine specific gravity
& dec serum sodium
- this excess of fluid build up causes
Edema & Third-spacing fluid (peripheral
edema, ascites, & pulmonary edema)
- Hypo-VOLEMIA - low
vascular vol, especially
pertaining to the plasma
- Caused by Abnormal GI losses - such as vomiting,
nasogastric suctioning (NG tube, or gastric lavage),
diarrhea. Abnormal skin fluid loss - such as
diaphoresis. Abnormal Renal losses - such as diuretic
therapy, BI, renal disease, adrenal insufficiency, or
osmotic diuresis
- NG tube: Nasogastric suction
involves removing solids, liquids,
or gasses from the stomach or
small intestine by inserting a
tube through the nose and
suctioning the gastrointestinal
material through the tube.
- NG tube: Nasogastric suction
involves removing solids, liquids,
or gasses from the stomach or
small intestine by inserting a
tube through the nose and
suctioning the gastrointestinal
material through the tube.
- Also caused by HEMORHAGE, movement of fluid
into a third space, dehydration & Enteral
Feeding without sufficient water intake
- enteral feeding - directly
into the stomach,
duodenum or jejunum.
- enteral feeding - directly
into the stomach,
duodenum or jejunum.
- S & S: Vitals - Tachycardia, thready pulse,
orthostatic hypotension, tachypnea, hypoxia.
NEUROMUSCULAR- dizziness, syncope
(fainting), confusion, weakness & fatigue. RESP
- inc'd breathing rate (trying to get more o2),
GI - thirst, dry furrowed tongue, N & V,
anorexia, acute weight loss
- S & S of renal impairment due to HypoV.
incl OLIGURIA, diminished cap refill, dry, scaly
skin, dry mucous membranes, poor skin
turgor, sunken eyeballs, flattened neck and
veins
- Oliguria = low urine output
- Oliguria = low urine output
- S & S of renal impairment due to HypoV.
incl OLIGURIA, diminished cap refill, dry, scaly
skin, dry mucous membranes, poor skin
turgor, sunken eyeballs, flattened neck and
veins
- LABS - Inc'd HCT, inc'd serum
osmolarity,, inc'd urine-specific
gravity, inc'd serum sodium
- Caused by Abnormal GI losses - such as vomiting,
nasogastric suctioning (NG tube, or gastric lavage),
diarrhea. Abnormal skin fluid loss - such as
diaphoresis. Abnormal Renal losses - such as diuretic
therapy, BI, renal disease, adrenal insufficiency, or
osmotic diuresis
- OSMOLAR IMBALANCE is the - or + of ONLY
WATER SUCH AS??????
- "ISO" = the value is
considered to have the
same solute concentration as the blood
- "HYPO" the value is
considered to be lower than
the normal values
- "HYPER" the value is
considered to be
higher than normal values
- Hypo-NATREMIA - low sodium imbalance
- Caused by gain of water or loss of sodium rich foods.
this causes water to move from the ECF (which is
where we take our measurements from) where the
Na+ is low into the ICF where it is higher, in an attempt
to dilute the Na+ of the ICF to reach equilibrium
- this movement of fluid
causes cells to swell =
cellular edema
- this movement of fluid
causes cells to swell =
cellular edema
- Causes GI - abnormal losses such as vomiting, NG suctioning, diarrhea,
tap water enemas & gastrointestinal obstructions. RENAL losses -
diuretics, kidney disease, adrenal insufficiency. SKIN losses - diuresis,
burns, wounds. Excessive oral water intake
- Also caused by oedematous states
such as heart failure, cirrhosis of the
liver, nephrotic syndrome
- Excessive HYPOTONIC IV
fluids & inadequate
sodium intake
- S & S lethargy, confusion,
apprehension, muscle
twitching, anorexia, N & V,
headache, seizure, & coma
- Labs - dec serum sodium
- Caused by gain of water or loss of sodium rich foods.
this causes water to move from the ECF (which is
where we take our measurements from) where the
Na+ is low into the ICF where it is higher, in an attempt
to dilute the Na+ of the ICF to reach equilibrium
- Hyper-NATREMIA - high sodium - fluid moves
out of the cells and into the ECF. as a result
the cells become dehydrated.
- Causes - water deprivation (NPO), excessive
sodium retention due to renal failure, cushion's,
syndrome, aldosteronism, some medications
such as glucocovrticosteroids
- Causes - Fluid losses - due to fever,
diaphoresis, burns, respiratory
infection, diabetes insidious,
hyperglycaemia, and watery
diarrhea
- AGE-Related Changes -
older adults have
decreased total body
water content and
inadequate fluid intake
- S & S thirst, dry, st icky mucous
membranes; tongue is red, dry, swollen;
weak, fatigue, restlessness, decreasing
LOC, disorientation, convulsions
- LABS - inc serum sodium
- Causes - water deprivation (NPO), excessive
sodium retention due to renal failure, cushion's,
syndrome, aldosteronism, some medications
such as glucocovrticosteroids
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