Define: too much volume in the __________________ _________________
l. Causes:
a. CHF: heart is__________, CO__________, decreased__________ perfusion, UO__________
*the volume stays in the _________________ ________
...
Define: too much volume in the __________________ _________________
l. Causes:
a. CHF: heart is__________, CO__________, decreased__________ perfusion, UO__________
*the volume stays in the _________________ _______________
b. RF: Kidneys aren't____________________
c. Alkaseltzer
Fleets enemas All 3 have a lot of_______________
IVF with Na
d. Aldosterone (steroid, mineralocorticoid)
Where does aldosterone live?
-Normal action: when blood volume gets low (vomiting, blood loss, etc.) →aldosterone
secretion increases→ retain Na/water→ blood volume ______
** Diseases with too much aldosterone:
-also seen with liver disease and heart disease
1._________________________
2._________________________
**Disease with too little aldosterone:
1._________________________
Hurst Review Services 4
e. ADH (anti-diuretic hormone)
Normally makes you retain or diurese?
Retain? _________________________
2 ADH problems
Too Much Not enough
Retain Lose (diuese)
Fluid Volume _________ Fluid Volume __________
SIADH DI
Syndrome of Inappropriate ADH Secretion Diabetes Insipidus
Urine Urine
Blood Blood
*Concentrated makes #’s go up specific gravity, Na
*Dilute makes #’s go down
ADH lives in pituitary; key words to make you think potential ADH problem: craniotomy, head
injury, sinus surgery, transphenoidal hypophysectomy
*Another name for anti-diuretic hormone (ADH) is Vasopressin. The drug Vasopressin (Pitressin
or DDAVP (Desmopressin acetate) may be utilized as an ADH replacement in Diabetes Insipidus.
Hurst Review Services 5
f. S/Sx of FVE:
Distended neck veins/peripheral veins: vessels are_______________
Peripheral edema, third spacing: vessels can't hold anymore so they start to _______________
CVP: measured where? ____________________; number goes_________
More____________________....More____________________
Lung sounds:
Polyuria: kidneys trying to help you_________________________
Pulse: _______________; your heart only wants fluid to go__________________
If the fluid doesn't go forward it's going to go______________into the_____________
BP: _______________ move volume.....more_______________
Weight: _______________ any acute gain or loss isn't fat-it’s fluid
g. Treatment:
Low Na diet
Diuretics
Loop *Bumex® may be given when Lasix® doesn’t work.
Thiazide (HCTZ) * Watch lab work with all diuretics
*Dehydration and electrolyte problems
K-sparing
Bed rest induces____________________
*when you are supine you perfuse your kidneys more
h. Interventions:
Physical Assessment
Give IVF’s slowly to elderly
Hurst Review Services 6
FLUID VOLUME DEFICIT: HYPOVOLEMIA
Big Time Deficit=Shock
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