Fluid Volume Overload and Renal Failure - Vocabulary Flashcards

A comprehensive set of 200 vocabulary-style flashcards derived from the lecture notes on fluid volume overload, edema, CKD, electrolyte disturbances, and dialysis. Each card presents a term and its concise definition.

Fluid volume overload

A condition with excess fluid accumulating in the intravascular and interstitial spaces, leading to edema and potential organ congestion.

Tachycardia

Elevated heart rate often seen with increased intravascular volume and cardiac workload.

Hypertension

Elevated blood pressure associated with fluid overload and vascular congestion.

Tachypnea

Rapid breathing, typically in response to dyspnea or hypoxia from fluid overload.

Dyspnea/shortness of breath

Difficulty breathing common with pulmonary edema and fluid overload.

Orthopnea

Need to sit up to breathe due to breathing difficulty when lying flat.

O2 saturation

Percentage of hemoglobin saturated with oxygen; may be reduced in edema or lung congestion.

Temperature unaffected

Body temperature may remain normal despite fluid overload in many cases.

Feeling cold

External sensation of chill or coolness due to altered perfusion or edema.

Pulmonary edema

Fluid accumulation in the lungs that causes dyspnea, crackles, and frothy sputum.

Crackles

Adventitious lung sounds indicating fluid in the airways or alveoli.

Frothy pink-tinged sputum

Sputum from pulmonary edema that is frothy and may be pink due to blood.

Wet cough

Productive cough associated with lung fluid overload.

Weight gain

Increase in body weight from fluid accumulation (third spacing).

Third spacing

Fluid shifts from the intravascular space to interstitial spaces (edema).

Pitting edema

Edema that leaves a persistent indentation when pressed.

Ascites

Fluid accumulation in the abdominal cavity due to third spacing.

Percussion tympani

High-pitched hollow sound on abdominal percussion suggesting distention or ileus.

Ileus

Decreased bowel motility often associated with abdominal distension and fluid shifts.

Distended abdomen

Abdominal enlargement due to ascites or gas from fluid shifts.

Fluid wave test

Physical exam test to detect ascites by feeling a wave of fluid across the abdomen.

Anasarca

Generalized, severe edema affecting the whole body.

JVD (jugular venous distension)

Visible neck venous distension indicating elevated central venous pressure.

AMS (altered mental status)

Change in cognition or consciousness due to perfusion or electrolyte issues.

Cerebral edema

Brain swelling that can occur with severe fluid overload or electrolyte disturbances.

Bounding pulse

Strong, forceful pulse that can accompany high-volume status.

Hyponatremia

Low serum sodium often due to dilutional fluid overload.

Oliguria

Reduced urine output, common in kidney failure and fluid overload.

Seizures (hyponatremia risk)

Seizure activity that can occur with severe low sodium levels.

Anasarca (generalized edema)

A phrase used to describe widespread edema across the body.

4+ pitting edema

Severe edema with deep skin indentation lasting upon pressing.

Weeping edema

Edematous skin that oozes fluid due to skin stretch from fluid overload.

Yellowish weeping fluid

Edema effluent that may appear yellow and is not urine.

Generalized edema

Widespread fluid accumulation throughout the body (similar to anasarca).

Neuro checks

Neurological assessments to monitor mental status and orientation during edema management.

Fluid restrictions

Limitations on oral/infused fluid intake to reduce volume overload.

Sodium restriction

Limiting dietary sodium to reduce fluid retention.

Hypertonic fluids vs fluid restriction

Debate about using hypertonic fluids; emphasis often on restricting free water to balance sodium.

Diuretics

Medications that promote urine production to remove excess fluid.

Loop diuretics

Diuretics that act on the loop of Henle to promote rapid diuresis.

Furosemide (Lasix)

A loop diuretic commonly used to treat fluid overload.

Spironolactone

A potassium-sparing diuretic used in some edema management to prevent potassium loss.

Daily weight

Daily body weight measurement to monitor fluid balance and response to therapy.

Strict I&O (intake and output)

Close monitoring of all fluids consumed and excreted to guide therapy.

Elevate legs

Positioning to promote venous return and reduce edema in the legs.

Elevate head of bed

Positioning to improve diaphragmatic excursion and oxygenation.

Vital signs monitoring

Ongoing assessment of heart rate, blood pressure, respirations, and temperature.

Cardiac perfusion assessment

Monitoring heart function and signs of congestion during edema management.

Skin breakdown risk

Risk of skin damage from edema and weeping fluid; requires skin care.

Dialysis (last resort)

Renal replacement therapy used when diuretics and conservative measures fail.

Mannitol

An osmotic diuretic used to draw fluid into the vasculature and aid dialysis.

Osmotic diuretic

Diuretic that increases osmolarity to pull water from tissues into circulation.

Albumin

Plasma protein given to enhance intravascular volume and aid dialysis effects.

Oxygen (O2) therapy

Supplemental oxygen to improve oxygenation when lungs are fluid-filled.

Ambulation

Ability to walk; part of mobility planning in edema management.

Activity as tolerated

Plan encouraging movement if safe, otherwise rest is recommended.

Hyperkalemia

Elevated potassium levels, common in kidney failure and can cause arrhythmias.

Peaked T waves

ECG finding associated with hyperkalemia and risk of rhythm disturbances.

Wide QRS complex

ECG change that can occur with worsening hyperkalemia.

Prolonged PR interval

ECG change indicating slowed atrioventricular conduction in electrolyte disorders.

U waves

ECG change often associated with hypokalemia but noted in electrolyte discussions.

Short QT interval

ECG finding that can accompany certain electrolyte disturbances.

Muscle cramps

Common symptom of electrolyte imbalance, especially with potassium shifts.

Seizures (electrolyte-related)

Seizure activity can occur with severe electrolyte disturbances.

Nausea and vomiting

Gastrointestinal symptoms that can accompany electrolyte disorders.

Chest pain (hypokalemia/hyperkalemia)

Chest discomfort that may signal ischemia or electrolyte disturbances.

Paralysis

Muscle weakness or paralysis in severe electrolyte disturbances.

Kayexelate (sodium polystyrene sulfonate)

Oral or enema resin that binds potassium in the GI tract for excretion.

Lokelma (sodium zirconium cyclosilicate)

Oral potassium binder; alternative to Kayexelate with different side effects.

Lokelma powder form

Powder form of sodium zirconium cyclosilicate used for potassium binding.

Lokelma stirring instructions

Dissolve and mix thoroughly before administration to ensure uniform distribution.

Lokelma NG tube administration

If given via NG tube, shake and push to ensure proper delivery.

Mannitol administration details

Osmotic diuretic given IV; must manage crystallization risk.

Mannitol crystallization

Crystallizes at room temperature; warming the solution dissolves crystals.

Mannitol warming method

Place container in warm water and cover to re-dissolve crystals.

IV filter for mannitol

Use a filter when infusing mannitol to prevent crystals from entering circulation.

Osmolarity concept

Diffusion principle: solutes move from high to low concentration to reach balance.

Diasylate

Dialysis solution on the opposite side of the semipermeable membrane.

Semipermeable membrane

Barrier that allows selective passage of solutes during dialysis.

Diffusion (dialysis)

Movement of solutes from higher to lower concentration across the membrane.

Osmosis (dialysis)

Movement of water across a membrane to balance solute concentrations.

Potassium movement during dialysis

Potassium moves from blood to diasylate to be removed from the body.

Normal potassium target (dialysis)

Typical goal is around 4 mEq/L in the diasylate to balance blood levels.

Dialysate composition

Diasylate contains electrolytes (K, Ca, phosphate, bicarbonate) in normal ranges.

Dialysis flow rate

Dialysate flow typically around 400 mL/min during HD.

Dialysis duration

Most sessions run 3–4 hours to achieve solute and fluid balance.

Blood flow through dialyzer

Blood is circulated through the dialyzer for clearance of toxins and fluids.

Return of blood to patient

Dialyzed blood returns to the patient after passing through the dialyzer.

Equilibration concept

Process by which concentrations equalize across the membrane during dialysis.

Potassium clearance during dialysis

Dialysis removes excess potassium from the blood to normalize levels.

Calcium movement with dialysis

Calcium in diasylate can move across the membrane to balance serum calcium.

Renal replacement therapy (RRT) access

Vascular access needed for hemodialysis (e.g., fistula, graft, catheter).

Central line vs midline

Central line provides reliable access for vesicants; midline has limited use for certain therapies.

Vesicant

Acaudate drug that can cause tissue damage if infused into tissues.

Calcium gluconate

Medication used to protect the heart during hyperkalemia; may be vesicant.

Calcium chloride

Vesicant calcium preparation used in certain emergencies; requires precautions.

Calcium carbonate (Tums)

Calcium supplement or binder used in CKD; binds phosphorus in gut when used as binder.

Calcium acetate (PhosLo)

Phosphate binder that binds phosphate in the GI tract.

Sevelamer (Renagel/Renvela)

Non-calcium phosphate binder; binds phosphate in the GI tract.

Lanthanum carbonate (Fosrenol)

Phosphate binder used to reduce phosphate absorption in CKD.