Risks for Fluid imbalances.
4 Populations at risk for fluid imbalances.
Infants
Elderly
Obese
Ill
Edema Vs. Third-Spacing
Edema: interstitial fluid accumulation.
Third-spacing: trans cellular fluid accumulation which is in a small sub section of interstitial space. (between joints, the pericardial cavity, etc…)
2 Disorders of Na+ and H20 Imbalances
Hyponatremia and hypernatremia
Hypokalemia
<3.5 mmol/L
The “Push”
Capillary hydrostatic pressure
The organ that puts infants and the elderly at risk for fluid imbalances.
The kidneys.
Places that edema manifests in the body.
Brain, airway, lungs, intestine, abdomen, peripheral edema in feet and lungs.
Clinical Manifestations of hypernatremia.
Restlessness, confusion, weakness, twitching, thirst, and possible seizures.
Manifestations are r/t increased osmolality of the blood. symptoms are dependent on WHY the osmolality is increased.
Ca+ <2.1mmol/L
Hypocalcemia
The “Pull”
Capillary Colloidal Osmotic Pressure
The response that puts ill patients at risk for fluid loss.
Inflammatory response.
-intravascular fluid loss due to increased permeability.
Increased capillary permeability leading to edema.
Due to a loss of intravascular proteins and the solute keeps the fluid there.
-Too little Na+ in the ECF
-Too much H20
>5mmol/L K+
Hyperkalemia
In the brain edema is most frequently associated with…
Infections or trauma
Simple nursing intervention that can be implemented to reduce an
elderly patients risk of fluid imbalance.
Promote drinking water and fluids.
-typical to have a decreased thirst response.
Medications that can be given for edema treatment.
Diuretics which promote urination to excrete excess fluids.
Pt A: Na+ level of 115mmol/L
Pt B: Na+ level of 165mmol/L
The Condition that each patient is experiencing
Pt A: Hyponatremia (<135mmol/L Na+)
Pt B: Hypernatremia (>145mmol/L Na+)
Hypomagnesemia
<0.65mmol
The fluid balance receptors.
Osmoreceptors and Baroreceptors
The population that has a greater fluid loss through the skin due to greater body surface area.
Infants
Decreased plasma protein production leading to edema.
Due yo decreased capillary oncotic pressure so you pull in less fluids.
The typical lab findings that would be seen in hyponatremia vs hypernatremia.
Hypo= decrease in serum osmolality
-cause of dilution of these substances-hematocrit and BUN by lots of extra fluid.
Hyper= shows increase in Na+ concentration and increase is osmolality.
Hypercalcemia
>2.6mmol/l
_____ responds to changes in arterial blood pressure and Blood volume.
The sympathetic nervous system.