1- Fluid & Electrolytes HURST review-
FINAL
Define Fluid Volume Excess/Hypervolemia - correct answer Too much fluid in the vascular space
Causes of FVE: (3) - correct answer Heart Failure
Renal Failure
Sodium
Heart Failure characteristics - correct answer Heart is weak; cardiac output decreases
decreased kidney perfusion; urinary output decreases
Volume stays in the vascular space
Three things with a lot of sodium - correct answer Effervescent soluble medications (Alka-seltzer)
Canned/processed foods
IVF with sodium
3 Main Hormonal Regulation of Fluid Volume - correct answer Aldosterone Atrial Natriuretic Peptide (ANP)
Anti-diuretic hormone (ADH)
Where is aldosterone found - correct answer adrenal glands
Normal action of aldosterone - correct answer blood volume gets low (vomiting, hemorrhage) >> aldosterone secretion increases >> retain Na & water >>blood volume goes up
Diseases with too much aldosterone - correct answer Cushings hyperaldosteronism (Conns syndrome)
Characteristics of Cushings and Conns - correct answer too much aldosterone
too much sodium & water
hypervolemia
Disease with too little aldosterone - correct answer Addisons disease
Characteristics of Addisons - correct answer too little aldosterone
too little sodium/water
hypovolemia
Where is ANP (atrial natriuretic peptide) found? - correct answer Atria of the heart
How does ANP (atrial natriuretic peptide) work? - correct answer Opposite of aldosterone
causes excretion of sodium & water
Explain ANP release - correct answer Atrial chambers expand due to increase fluid in vascular space and chambers of the heart
atria releases ANP >> causes kidneys to excrete excess fluid.
Function of ADH (anti-diuretic hormone) - correct answer makes you retain water
Two ADH (anti-diuretic hormone) Problems - correct answer SIADH
DI
Too much ADH (anti-diuretic hormone) causes (3) - correct answer water retention
fluid volume excess
SIADH (too many letters, too much water) SIADH characteristics - correct answer Urine output decreases; urine is concentrated (urine sodium increases)
blood is dilute (serum sodium decreases)
SIADH sodium & water DO NOT follow each other
Not enough ADH causes (3) - correct answer Lose (diurese) *water*
fluid volume *deficit* (can cause shock)
Diabetes Insipidus (has nothing to do with blood sugar)
DI (think *DI*uresis)
Diabetes Insipidus characteristics - correct answer Urine output *increases*; Urine is *diluted* (Urine sodium decreases)
Blood is *concentrated* (serum sodium increases)
large amount of urine output can lead to what complication? - correct answer shock
urine specific gravity, Na, and hCT rule with ADH - correct answer *Concentrated* makes the #'s go *UP*
*Dilute* makes the #'s for *DOWN*
ADH is found in the ? - correct answer Pituitary
Key words to think potential ADH problems (5) - correct answer craniotomy
head injury
sinus surgery
transsphenoidal hypophysectomy
*any condition that can lead to an increased ICP can lead to an ADH problem*
Trans = - correct answer going all the way through
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