foundations

exam 3

Normal sodium

135-145

Renal fcts

Filter blood/waste

Excrete urine

Maintain fluid, electrolyte, acid-base balance

Urine pathway

Kidney filter

Ureters collect

Bladder holds

Urethra connects to outside

Fluid balance impacts

GI, GU (renal), cardiac, pulmonary, skin integrity

I and O

Intake and output

Anything that goes in - anything that goes out

Fluid I and O

Intake

Oral fluids (anything that melts in room temp)

IV fluids

Enteral or parenteral nutrition (tube feedings, made in pharmacy)

Output

Urine

Perspiration

Respiration

Feces and vomit

ADH

Promotes water reabsorption by the kidneys

Aldosterone

Promotes sodium and water retention

ANP

Promotes sodium and water excretion

Heart=stretch 

1 excess L of fluid in body

Weights 2.2 lbs

Heart failure

Causes fluid retention (edema, pleural, lung fluid accumulation)

Kidney disease

Affects filtering and excretion

Liver diseases

Alters protein levels, leading to fluid shifts out of the vascular compartment

Monitor for.. means fluid retention

Weight gain 2-3 lbs in a day, 5 lbs a week

Burns or trauma

Increases fluid loss through damaged skin

DM or DI

can lead to dehydration from excessive urination

Diuretics

Increase fluid loss

Steroids

Increases sodium and water retention

Laxatives or chemotherapy drugs

May increase fluid loss

Infants

Higher percentage of body water and faster turnover

• higher risk for imbalance

Older adults

reduced thirst sensation and kidney efficiency

• high risk for dehydration

High salt

Causes water retention

High protein/sugar

Increase water needs for metabolism and excretion

Protein/albumin

Maintains osmotic pressure, holds water where it needs to be

ICF

Makes up 2/3 of bodys fluids

Fluid INSIDE the cell

ECF

Fluid OUTSIDE the cell

More prone to loss

Interstitial fluid

Fluid around/btw cells

25%

Intravascular fluid

Plasma - fluid in vessels

7%

Transcellular fluids

CSF, synovial fluid

1%

Hydrostatic pressure

Pushes water

Osmotic pressure

Pulls water

Third spacing

Occurs when too much fluid moves from the intravascular space (blood vessels) into the interstitial or ‘third’ space - the nonfunctional area btw cells

The movement of bodily fluid from the blood, into the spaces btw the cells

• can cause problems like edema, hypotension, and decreased cardiac output

Can occur in brain as well

Shift of fluid into interstitial tissues decreases overall circulating volume → decreases BP

NG tube

Decompress or drain stomach of fluid or unwanted stomach contents

Used to allow GI tract to rest before or after abdominal surgery to promote healing

Insert to monitor GI bleeding

1 ounce

30 c

Why cath

Monitor critically ill pts

Urinary retention

Obtaining sterile urine specimen

Surgery

Not for incontinent pt unless extreme case

Cath balloon port

Will tell you how much to put in (and take out)

Straight cath

No balloon

Temporary

Balloon

Will hold the cath in place