Fluid and Electrolytes
● Fluid Volume Overload/FVE
1. What is it?
a. Excess fluid in the system
b. Dilute electrolytes
c. Fluid moves into cell, causing them to expand
d. Damage to the brain
2. Who is at risk?
a. Heart failure patients: blood backs up from improper pumping
b. Renal failure: kidneys cannot remove fluid
c. Polydipsia: consuming too much fluid
d. SIADH: inappropriate ADH secretion (ADH is water-retaining hormone)
e. Cushing’s syndrome: excessive cortisol causes water and sodium
retention
f. Cirrhosis: blood backs up in the liver
g. Excessive salt intake: causes fluid shift
h. Poorly controlled IV fluids
3. S/s:
a. Headaches: cells in the brain expand
b. Confusion
c. Lethargy
d. Edema
e. JVD
f. Full, bounding pulse
g. Dyspnea/crackles/pulmonary edema
h. Muscles spasms
i. Weight gain: fluid retention
j. Seizures/coma (if severe enough)
4. Treatment:
a. Fluid restriction
b. Diuretics (helps to body flush excess fluids)
c. Strict I’s and O’s
● Fluid Volume Deficit/FVD
1. What is it?
a. Dehydration
b. Lacking fluid causes the electrolytes to become concentrated
c. Fluid leaves the cells, causing them to shrink
d. Body will attempt to fix with the RAAS system
2. Who is at risk?
a. Excessive sweating
b. DI: polyuria from improper ADH balance
c. Hemorrhage (blood loss)
, d. GI losses (vomiting, diarrhea)
e. Overuse of diuretics
f. Third-space fluid shift
g. Ascites
3. S/s:
a. Weight loss
b. Decreased turgor
c. Oliguria
d. Dry and sticky mucus membranes
e. Hypotension: not enough fluid to maintain BP
f. Decreased cap refill
g. Restlessness/confusion/drowsiness: affects LOC
h. Tachycardia
i. RR increases: body trying to compensate for hypoxia
j. Flattened neck vessels
k. Vasoconstriction: body trying to compensate for hypotension
4. Treatment:
a. Strict I’s and O’s
b. Replace fluids using isotonic solutions
● Sodium:
1. Normal: 135-145
2. What is it?
a. Major cation of the extracellular fluid
b. Plays a role in:
I. Concentration of the ECF
II. Fluid distribution
III. Generation and transmission of nerve impulses
IV. Muscle contractility
V. Regulation of Acid/Base
VI. Na+ imbalances are typically associated with: imbalance in the
ECF volume
VII. Fluid and Na have an interdependent relationship
● Hypernatremia
1. Normal: 135-145
2. What is it?
a. Sodium in excess
b. Hypernatremia causes hyperosmolarity, which causes cellular
dehydration from the water leaving the cells in order to be with the excess
sodium.
c. This causes cell shrinkage, which is especially felt in the brain
3. Who is at risk?
a. Dehydration: not enough water to dilute properly
b. Hypertonic IV solutions
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller alauritsen. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $5.49. You're not tied to anything after your purchase.
