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Fluid and Electrolyte Med Surg ATI 2024/2025 graded A+ by experts
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Fluid and Electrolyte Med Surg ATI 2024/2025 graded A+ by experts
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Fluid and Electrolyte Med Surg ATIHomeostasis 277 - ANSCharacteristics of body fluid remain in balance
Intracellular Fluid 277 - ANSTwo-thirds of body water, body fluids within the cell
Extracellular Fluid 277 - ANSOne-third of body water, body fluids outside of the cell membrane
Intravascular Fluid 277 - ANSLiquid part of the blood or plasma
Interstitial Fluid 277 - ANSLocated between the cells and outside of the blood vessels
Transcellular Body Fluids 277 - ANSSecreted by epithelial cells (cerebrospinal, pleural,
peritoneal, synovial fluids)
Dehydration 277 - ANSLack of fluid in the body from insufficient intake or excessive loss
Relative Dehydration 277 - ANSInvolves a shift of water from the plasma (blood) to the
interstitial space
Hypovolemia/Isotonic Dehydration 277 - ANSLack of both water and electrolytes, causing a
decrease in circulating blood volume, AKA FVD
Risk Factors of Fluid Volume Deficit/Hypovolemia 277 - ANSExcessive GI loss: vomiting,
nasogastric suctioning, diarrhea
Excessive skin loss: diaphoresis without sodium and water replacement
Excessive renal system losses: diuretic therapy, kidney disease, adrenal insufficiency
Third spacing: burns
Hemorrhage or plasma loss
Altered intake: anorexia, nausea, impaired swallowing, confusion, NPO
Causes of Dehydration 277 - ANSHyperventilation or excessive perspiration without water
treatment, prolonged fever, diabetic keto acidosis, insufficient water intake (enteral feeding
without water administration, decreased thirst sensation, aphasia), diabetes insidious, osmotic
diuresis, excessive intake of salt, salt tablets, or hypertonic IV fluids
Hypovolemia Expected Findings 277 - ANSVital Signs: hyperthermia, tachycardia (in attempt to
maintain normal bp), thready pulse, hypotension, orthostatic hypotension, decreased central
venous pressure, tachypnea (increased respirations to compensate for lack of fluid volume
within the body), hypoxia
Neuromusculoskeletal: dizziness, syncope, confusion, weakness, fatigue
GI: thirst, dry furrowed tongue, nausea, vomiting, anorexia, acute weight loss
, Renal: Oliguria (decreased production and concentration of urine)
Diminished capillary refill, cool clammy skin, diaphoresis, sunken eyeballs, flattened neck veins,
poor skin turgor and tenting, weight loss, low central venous pressure
*In older adults the effects are greater due to the loss of skin elasticity, glomerular filtration and
concentrating ability of the kidneys, loss of muscle mass, and diminished thirst reflex*
Dehydration client can have an elevated temp, and relative dehydration induce seizure
Lab Test for Hypovolemia 278 - ANSHematocrit: increased in hypovolemia
BUN: Increased due to hemoconcentration
Urine Specific Gravity: greater than 1.030
Blood Sodium: Greater than 145 mEq/L with dehydration
Blood osmolality: greater than 295 most/kg with dehydration/hypernatremia
Client Education for Hypovolemia 278 - ANSDrink plenty of liquids to promote hydration, causes
of dehydration include vomiting, large, draining wounds, and diarrhea or excessive ostomy
losses
Hypovolemic Shock 278 - ANSOccurs with significant loss of body fluid, client's mean arterial
pressure decreases (which slows blood flow and perfusion to tissues of the body), and the cells
are no longer able to carry oxygen to the blood adequately (due to loss of red blood cells)
Nursing Actions for Hypovolemic Shock 278 - ANSAdminister oxygen, monitor oxygen
saturation (O2 less than 70% is a medical emergency), stay with an unstable client, monitor vital
signs *every 15 min*, provide fluid replacement with colloids (whole blood, packed RBCs,
plasma, synthetic, plasma expanders), crystalloids (lactated Ringer's, normal saline), administer
vasoconstriction, perform hemodynamic monitoring
Overhydration 278 - ANSToo much fluid in the body from excessive intake or ineffective removal
from the body, fluid overload is an excess of fluid of water, such as with water intoxications: this
includes hemodilution which makes the amount of blood components seem lower, hypervolemia
of fluid volume excess involves an excess of water and electrolytes so that the two are still in
the right proportions (ex. excessive sodium intake makes the body so that there is too much of
both), clients who have fluid overload are at risk for developing pulmonary edema or CHF, in
older clients the risk of fluid imbalance is greater due to changes in the body with age (such as
reduced kidney function)
Health Promotion and Disease Prevention Hypervolemia 278 - ANSWhen clients have known
heart disease and impairment of kidney function it is important to instruct them to consume a
diet low in sodium (consult with provider regarding dietary restrictions), restrict fluid intake
(consult with provider regarding prescribed restrictions)
Hypervolemia Risk Factors 279 - ANSCompressed regulatory systems (heart failure, kidney
disease, cirrhosis), overdose of fluids (oral, enteral, IV), fluid shifts that occur following burns,
prolonged use of corticosteroids, severe stress, hyperaldosteronism
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