Nursing 3366 Pathologic Processes: Alterations in Fluids and
Solutes Questions With Complete Solutions
Aldosterone Correct Answers "salt-retaining hormone" which
promotes the retention of Na+ by the kidneys. na+ retention
promotes water retention, which promotes a higher blood
volume and pressure
antidiuretic hormone (ADH) Correct Answers A hormone
produced by the neurosecretory cells in the hypothalamus and
stored in the posterior pituitary gland that stimulates water
reabsorption from kidney tubule cells into the blood and
vasoconstriction of arterioles.
blood-to-tissue (B to T) fluid shift Correct Answers water is
pathologically gained by the body or protein is lost, so that the
concentration of the plasma space (blood) is decreased
S&S caused by B-to-T fluid shifts
a. in "nurseland", we generally think of a person with B-to-T
fluid shifts as being in a state of "fluid volume overload or
excess."
b. as tissues "pull in" water from the diluted vascular system,
they eventually show their water overload as edema that can
occur anywhere in body; examples:
1) under skin: skin appears tight & puffy; assessed by pushing
into skin & seeing indentation ("pitting edema")-- rated on scale
from 1+ to 4+
, 2) in lung tissue—pulmonary edema ("wet lungs"): manifested
as cough and/or SOB &/or crackles while listening with
stethoscope.
3) acute CNS (central nervous system) changes related to
swelling of brain cells -- restlessness, confusion,
unconsciousness, convulsions.
c.if we did lab work, we would see a low serum osmolality (we
would consider this patient's blood to be hypoosmolar,
hypotonic, have low oncotic pressure, and low osmotic pressure
—all similar terms-- compared to normal blood)
Diuresis Correct Answers increased output of urine
Edema Correct Answers puffy swelling of tissue from the
accumulation of fluid
fluid volume deficit Correct Answers DEHYDRATION: fluid
intake is not sufficient to meet the fluid needs of the body
hydrostatic pressure Correct Answers the pressure within a
blood vessel that tends to push water out of the vessel. "pushing
pressure"
Hypertonic (and/or hyperosmolar) Correct Answers if the
tonicity of the blood is higher than 0.9%; the blood is in some
way MORE concentrated than usual.
Hypertonic IV Correct Answers fluid has a higher tonicity than
normal blood; ex—a bag of 3% NaCl (AKA 3%NS).
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