Fluids, Electrolytes & Urinary Elimination – NURSN 5400

Vocabulary flashcards summarizing core terms related to body fluid compartments, fluid imbalances, IV solutions, urinary assessment, and elimination concepts presented in the lecture notes.

Interstitial Fluid

Fluid that surrounds and bathes the body’s cells in the tissue spaces.

Urine Specific Gravity (USG)

Measure of urine concentration; normal 1.010–1.025 (↑ = dehydration, ↓ = over-hydration).

Hypovolemia

Deficient fluid volume characterized by lowered BP, tachycardia, ↑ BUN & USG, ↓ skin turgor.

Hypervolemia

Excess fluid volume producing edema, bounding pulse, crackles, weight gain, JVD.

Third Spacing

Shift of fluid into transcellular spaces (e.g., pleural effusion, ascites) causing ECF deficit.

Hyponatremia

Serum sodium < 135 mEq/L; can cause confusion, seizures, muscle cramps.

Hypernatremia

Serum sodium > 145 mEq/L; manifests as thirst, restlessness, dry mucous membranes.

Isotonic Solution

IV fluid with same tonicity as blood (e.g., 0.9 % NaCl, LR, D5W initially).

Hypotonic Solution

Lower osmolality than blood; water moves into cells (e.g., 0.45 % NaCl, 0.33 % NaCl).

Hypertonic Solution

Higher osmolality than blood; pulls water out of cells (e.g., D10W, 3 %–5 % NaCl, D5 0.9 % NaCl).

Anuria

Urine output < 50 mL/24 h; often seen in renal failure or obstruction.

Oliguria

Urine output < 0.5 mL/kg/hr; early warning sign of renal perfusion issues.

Polyuria

Excessive urine output; can result from diabetes, diuretics, or polydipsia.

Dysuria

Painful or difficult urination; common in lower UTI or bladder inflammation.

Frequency (Urinary)

Need to void more often than every 3 h; may indicate infection or obstruction.

Hesitancy

Delay or difficulty initiating urine flow; often associated with prostate enlargement.

Nocturia

Waking at night to void; common in older adults or heart failure.

Hematuria

Blood in the urine; may signal infection, stones, or malignancy.

Proteinuria

Protein in urine; marker for kidney disease or nephrotic syndrome.

Bacteriuria

≥ 100,000 CFU/mL bacteria in urine; indicates urinary infection.

Pyuria

Presence of pus (WBCs) in urine; suggests bacterial infection.

Glucosuria

Glucose in urine; often due to uncontrolled diabetes mellitus.

Urinary Retention

Inability to empty bladder completely; may require catheterization.

Functional Incontinence

Urine loss caused by environmental or mobility barriers, not urinary tract issues.

Overflow Incontinence

Leakage due to overdistended bladder and incomplete emptying.

Stress Incontinence

Involuntary urine loss with increased intra-abdominal pressure (e.g., coughing).

Urge Incontinence

Sudden strong urge to void followed by leakage; overactive bladder.

Reflex Incontinence

Automatic bladder emptying without sensation, often from spinal cord lesions.

Suprapubic Catheter

Catheter inserted surgically through abdominal wall into bladder for long-term drainage.

PureWick External Catheter

Non-invasive female urine collection device replaced every 8–12 h.

Bladder Scanner

Ultrasound device estimating post-void residual volume non-invasively.

Pelvic Floor Muscle Training (PFMT)

Exercises (Kegels) to strengthen pelvic muscles and reduce incontinence.

Bladder Retraining

Timed voiding program to increase bladder capacity and control urgency.

Metabolic Water

Water generated from nutrient metabolism (~200 mL/day) contributing to intake.

Normal Urine Output

≈ 1 mL/kg/hr for adults; concern if < 0.5 mL/kg/hr (oliguria).

BUN (Blood Urea Nitrogen)

Lab marker of renal function; elevated in dehydration or renal impairment.

Jugular Venous Distention (JVD)

Visible bulging neck veins indicating elevated central venous pressure in hypervolemia.

Edema

Accumulation of fluid in interstitial spaces; graded 1+ to 4+ by depth of pitting.

Crackles

Abnormal lung sounds caused by fluid in alveoli; heard in fluid overload.

Ascites

Fluid accumulation in peritoneal cavity; a form of third spacing.

Pleural Effusion

Excess fluid between pleural layers around lungs; example of third spacing.

Urinary Diversion

Surgical rerouting of urine flow (e.g., ileal conduit) when bladder function is lost.

Hypovolemia symptoms

Decreased blood pressure

Increased heart rate

increase BUN test

Increase urine specific gravity greater than 1.0035

Decreased hematocrit

Signs of hypovolemia

Tongue fissures

Tenting

Dizziness and headache

Decrease urine output ( Andria oliguria)

Concentrated urine

Decreased weight

Symptoms of hypervolemia

Edema

JVD

Crackles lung sounds

Increased heart rate

Increase blood pressure

Increase weight

Increase urine output (polyurea)

Taught skin

When should you give a hypotonic IV solution?

When sodium is high

Hypotonic solution has more fluid less salt

.45% normal saline .33% normal saline

When would you give a hypertonic IV solution?

When sodium is low

Hypertonic IV solution has high solute low fluids look for increased normal saline percent

Reasons for catheterization

Retention

Prolonged to immobilization

Obtaining urine specimen when patient is unable to void voluntarily

Accurate measurements

Assist in healing open sacral and perennial wound

Improved comfort for end of life care