N112 Fluids Test
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| A. Indications of fluid volume deficiency may include decreased urine, output, drop in systolic BP, weak rapid pulse, dry mucous membranes, last stages include cold, clammy skin, olguria, stupor & coma.B. A decrease in serum protein (albumin), as in malnutrition, burns or liver damage result in low colloid osmotic pressure.C. Aldosterone causes the kidney to retain sodium & water.D. More water in the interstitial spaces would create a lower blood volume.E. Inflammation, burns or allergic reactions cause vasodilation and increased capillary permeability, causing both water & solutes to move into the tissues creating edema.F. Determine renal function, isotonic electrolyte solution (lactated ringers), followed by a hypotonic solution. Continue fluids, evaluate lung sounds & BP for indications of overload.G. A reduced circulating blood volume can be caused by blood loss, reduced fluid intake, excessive fluid loss, fluid lost to interstitial space.H. Third spacing is a shift of fluid from the vascular bed to the interstitial space. The vascular volume is reduced, but the person will have edematous tissue.I. An increase in capillary hydrostatic pressure will cause fluid & solutes to be forced into interstitial space or prevent colloid osmotic pressure from pulling water in.J. Colloid osmotic pressure is the pulling force of albumin (protein) in the intravascular space.K. Damage to blood vessels causes proteins to leak into the interstitial space, the result is edema since the protein in the interstitial space attracts water.L. Decreased vascular colloid pressure, increased capillary hydrostatic pressure, increased capillary permeability, lymph obstruction.M. An increase in ADH will cause the kidney to retain fluid and a decrease in ADH will cause the kidney to excrete fluid.N. Less water would be pulled into the blood vessels from the interstitial spaces.O. Weight gain, peripheral edema, distended neck & peripheral veins, bounding full pulse, polyuria, pulmonary edema, moist rales. Serum sodium levels may be normal or decreased due to dilution. |
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