Patho Test 1 (9)

Edema•Intravascular= Fluid volume overload/hypervolemi

Fluid volume overload/hypervolemia

dehydration•Intravascular= Fluid volume deficit/hypovolemia

Fluid volume deficit/hypovolemia

sits at equilibrium, neutral, no fluid shifts (0.9% NS, lactated ringers's)

greater solute concentration (DSNS, 3% Saline)

lower solute concentration (0.45% saline)

• *Excessive sodium or water intake 
• *Inadequate sodium or water elimination

• 1.Generalized edema (fluid being pushed in, low protein) 
• 2.Localized edema (fluid being pushed in, low protein) 
• 3.Dyspnea (fluid volume overload) 
• 4.Bounding pulse (a lot of intravascular fluid) 
• 5.Tachycardia (heart pumps fast) 
• 6.Polyuria (excessive urination)
• 7.Rapid weight gain
• 8.JVD (jugular vein distention) (fluid volume excess)
• 9.Crackle (noise in lungs)

• *inadequate fluid intake 
• *excessive fluid or sodium losses

• 1.Thirst (osmoreceptors are stimulated) 
• 2.Altered level of consciousness
• 3.Hypotension
• 4.Tachycardia (heart will pump fast to get water/ oxygen to places)
• 5.Weak, thread pulse
• 6.Flat jugular veins (dry mucous membrane) 
• 7.Dry mucous membranes
• 8.Decreased skin turgor
• 9.Oliguria (small amounts of urine) 
• 10.Weight loss (no fluid, lose weight)

A condition in which the force of the blood against the artery walls is too high. (high blood pressure)

abnormally low blood pressure.

136-145 mEq/ L

• *Serum Sodium < 135 mEq/L 
• *related to sodium loss or water gain (all about deletion) 
• *Water moves from ECF to ICF. Why?
• -Sodium deficits cause plasma hyposmoality and cellular swelling

• •Low sodium diets
• •Vomiting
• •Diarrhea
• •Renal disease
• •Adrenal insufficienty
• •Loop diuretics
• •SIADH
• •water intoxication

• 1. Lethargy
• 2. confusion
• 3. decreased reflexes
• 4. seizures
• 5. coma 
• 6. musice cramps and fatigue

cramps and fatigue

cerebral edeam and increased intracranial pressure

osmolality (do this slowly)

• *Cells are shrinking*
• *Serum Sodium > 145 mEq/ L
• -Related to: sodium gain, water loss
• -Water movement from the ICF to the ECF WHY?
• ~sodium overload causes plasma hyperosmolality and cellular shrinking

• •Inadequate water intake•Excessive sweating (fever)
• •Renal concentrating disorders
• •Diarrhea, vomiting
• • diabetes insipidus (because you lose a lot of fluid)

• *weight loss
• *abounding pulse 
• *increase of blood pressure (from sodium)
• CENTRAL NERVOUS SYSTEM IS MOST SERIOUS
• *muscle twitching and hyperreflexia (hyperactive reflexes)
• *confusion (because cells are shrinking)
• *coma
• *convulsions
• *cerebral hemorrhage

3.5-5.0 mEq/L; normal cardiac rhythms

< 3.5 mEq/L

• •reduced intake of potassium
• •dietary
• •increased entry of potassium into the cells
• • Acid base balance 
• •Increased levels of aldosterone
• •insulin over use (insulin pushes potassium in to the cell)
• •increased loss of potassium
• •burns
• •Vomiting and diarrhea
• •NG suctioning (nasogastric tube)
• •Use of Non-Potassium sparing Diuretic (#1 CAUSE)

• •Skeletal muscle weakness
• •Loss of smooth muscle tone
• •Cardiac dysrhythmias
• * sinus brady 
• *AV block 
• *EKG- prolonged PR interval, flat T wave, prominent U wave

Potassium level > 5.5 mEq/L

• *increased intake 
• *Shift of k+ from ICF to ECF
• *decreased lenal excretion 
• *insulin deficiency 
• *large infusion of stored blood
• *cell trauma (crush injury) potassium is inside the cell