Fluid & Electrolytes
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| What is hypovolemia? | Abnormal loss of normal body fluids
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| What is hypervolemia? | Abnormal retention of water & sodium
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| What are the risk factors for hypervolemia? | Cirrhosis; Heart failure; Renal failure; Too much salt
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| What are the risk factors for hypovolemia? | Diabetes Insipitus; Adrenal Insufficiency; Diuresis; Hemorrhage; Coma
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| What is orthopneic position? | Version of high-fowlers; for patients who are SOB
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| Where is sodium found? | Extracellular fluid.
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| Where is potassium found? | Intracellular fluid.
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| How is fluid lost from the body? | Skin; Lungs; Feces; Kidneys
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| What are the clinical manifestations of hypovolemia? | Decreased BP; increased RR; Postural hypotension; Weak, rapid heart rate;Increased temperature; Dry mouth; thirst; Oliguria; concentrated urine; Decreased bowel sounds; Constipation; Decreased skin turgor; Flattened neck veins; Acute weight loss
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| What are the clinical manifestations of hypervolemia? | Tachycardia; bounding pulse; Increased blood pressure; Decreased temperature; Edema; pitting edema; Distended neck veins; SOB; crackles; Increased weight; Increased urine output; HA; visual disturbances
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| What happens to the BUN level when a patient is hypervolemia? | BUN decreased (diluted)
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| What happens to the HCT level when a patient is hypervolemia? | HCT decreased (diluted)
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| When a patient is hypervolemic, is the urine NA+ level increased or decreased? | Generally increased, but this depends on the cause of the hypervolemia.
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| What nursing interventions would you implement for a patient with hypervolemia? | Monitor vital signs; Monitor lung sounds; Elevate HOB or Orthopneic position; Oxygen; Monitor I&O; Monitor daily weights; Monitor labs; administer diuretics as ordered; Restrict fluid & Na intake as ordered.
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| What nursing interventions would you implement for a patient with hypovolemia? | Monitor vital signs; Monitor skin turgorMonitor oral cavity; Monitor I&O; Monitor daily weights; Mental functioning; Encourage PO fluids; Administer IVFs as ordered.
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| What nursing diagnoses would be appropriate for a patient with hypovolemia? | Fluid volume, Deficient; Cardiac output, Decreased; (Potential complication: Hypovolemic shock); Oral Mucous Membrane, Impaired; Tissue Perfusion, Ineffective
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| What nursing diagnoses would be appropriate for a patient with hypervolemia? | Excess fluid volume; Ineffective airway clearance; Skin Integrity, Risk for Impaired; Body Image, Disturbed; (Potential complications: pulmonary edema, ascites)
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| What happens to the BUN level when a patient is hypovolemia? | BUN – elevated
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| What happens to the HCT level when a patient is hypovolemia? | HCT – increased
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| What happens to the urine specific gravity when a patient is hypovolemia? | Urine specific gravity increases (urine concentration)
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| What happens to the urine specific gravity when a patient is hypervolemia? | Urine specific gravity decreases (urine diluted)
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| What is the normal value of urine specific gravity? | 1.010-1.025
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| What is the normal value of BUN? | 10-30 mg/dl
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| What is the normal value of creatinine? | 0.5-1.5mg/dl
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| What does urine specific gravity measure? | Urine concentration
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| What does the serum creatinine lab test measure? | Renal function
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| What happens to serum creatinine levels when a patient suffers from hypovolemia? | Increased
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| What does HCT measure? | The amount of space (volume) red blood cells take up in the blood.
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