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Body fluid distribution
- Extracellular Fluid (ECF)
- Intracellular Fluid (ICF)
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Fluid volume deficits include:
-
Hypovolemia can lead to:
Hypovolemic shock
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Abnormal Skin Losses include:
-
Abnormal Renal losses
- Diuretic therapy
- Diabetes Insipidus
- Renal disease
- Adrenal insufficiency
- Osmotic diuresis
-
GI Losses include:
- Vomiting
- Suctioning
- Diarrhea
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Third spacing Losses include:
- Peritonitis
- Intestinal obstruction
- Ascites
- Burns
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Risk factors for Hypovolemia
- GI - Vomitting
- Skin - Diaphoresis
- Renal - Diabtes insipidus
- Third spacing
- Hemmorhage
- NPO
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Risk factors for Dehydration
- Hyperventilation
- Diabetes Ketoacidosis
- Enteral feeding w/o sufficient water intake
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Expected finding for dehydation
- Increased hemoconcentration
- Osmolarity >300 mOsm/L
- Protein
- BUN
- Glucose
- Urine specific gravity
- Serum sodium
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Expected Clinical findings of dehydration
- Tachycardia
- Hypotension
- Syncope
- Confusion
- Weakness
- Oliuria
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Expected finding of hypovolemia
- Increased:
- Hemoglobin (Hgb)
- Hematocrit (Hct)
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Hypovolemic shock
- Organ hypoxia/anoxia
- Decreased O2 saturation
- Pulse Pressure
- Administer Oxygen
- Fluid replacement (fluid rescusitation):
- Colloids (plasma, blood, packed RBC)
- Crystalloids (ringers lactate, NS)
-
Fluid Volume Excess include:
- Hypervolemia
- Overhydration
-
Causes of overhydration
Water replacemnt w/o electrolyte replacement
-
Causes of Hypervolemia
- Excessive sodium intake
- Abnormal renal function
-
Expected finding for overhydration
- Decreased:
- Hgb
- Hct
- Osmolarity <270 mOsm/L
- Serum sodium
-
Expected findings for hypervolemia
- Increased:
- BUN
- Creatinine
- Electrolytes
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Clinical findings for FVE
- Tachycardia
- hypertension
- Tachypnea
- Confusion
- Crackles
- Orthopnea
- Edema
-
Tx for Pulmonary edema
- Give morphine and diuretic
- Place Pt in high fowler's
- Prepare for intubation and mechanical ventilation
- Signs and symptoms is crackles, dyspnea at rest
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