Podcast
Questions and Answers
Which of the following findings would you expect in a patient experiencing fluid volume deficit (hypovolemia)?
Which of the following findings would you expect in a patient experiencing fluid volume deficit (hypovolemia)?
- Increased blood pressure
- Decreased skin turgor (correct)
- Decreased serum sodium
- Decreased hematocrit
A patient with hypervolemia is likely to exhibit which combination of vital sign changes?
A patient with hypervolemia is likely to exhibit which combination of vital sign changes?
- Increased heart rate, decreased blood pressure
- Decreased blood pressure, decreased respiration rate
- Decreased heart rate, increased blood pressure
- Increased blood pressure, increased respiration rate (correct)
What laboratory finding is most indicative of dehydration?
What laboratory finding is most indicative of dehydration?
- Decreased serum osmolality
- Increased hematocrit (correct)
- Decreased urine specific gravity
- Decreased serum sodium
Which assessment finding in an infant is most indicative of hypervolemia?
Which assessment finding in an infant is most indicative of hypervolemia?
In fluid volume excess, what causes the adventitious breath sounds (moist crackles/rales)?
In fluid volume excess, what causes the adventitious breath sounds (moist crackles/rales)?
A patient with a severe fluid volume deficit is likely to exhibit which percentage of weight loss?
A patient with a severe fluid volume deficit is likely to exhibit which percentage of weight loss?
Which of the following pulse characteristics is most likely associated with hypovolemia?
Which of the following pulse characteristics is most likely associated with hypovolemia?
Jugular vein distention at a 45º angle is a clinical sign associated with:
Jugular vein distention at a 45º angle is a clinical sign associated with:
What is the significance of a gallop heart rhythm (S3 heart sound) in the context of fluid volume status?
What is the significance of a gallop heart rhythm (S3 heart sound) in the context of fluid volume status?
Which mental status change is more likely to be observed in a patient with hypervolemia?
Which mental status change is more likely to be observed in a patient with hypervolemia?
Flashcards
Hypovolemia
Hypovolemia
A condition caused by excessive loss of body fluids, leading to decreased blood volume and inadequate tissue perfusion.
Orthostatic Hypotension
Orthostatic Hypotension
A decrease in blood pressure that occurs upon standing, leading to dizziness or lightheadedness.
Skin Turgor
Skin Turgor
A measure of skin elasticity, which is decreased in dehydration.
Decreased Tearing
Decreased Tearing
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Concentrated Urine
Concentrated Urine
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Hypervolemia
Hypervolemia
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Tachypnea
Tachypnea
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Dyspnea
Dyspnea
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Dependent Edema
Dependent Edema
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Jugular Vein Distention
Jugular Vein Distention
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Study Notes
Dehydration (Fluid Volume Deficit/Hypovolemia)
- Manifestations include decreased blood pressure, potentially leading to hypotension or orthostatic hypotension.
- Pulse pressure and volume are reduced.
- Skin turgor is diminished.
- Urine output falls below 30 mL/hour.
- Venous filling is reduced.
- Capillary refill is delayed.
- Tearing decreases.
- Weight loss occurs which relates to the severity: mild (2%), moderate (5%), severe (8%).
- Sunken eyeballs are observed in infants.
- Mucous membranes become dry.
- Skin becomes dry or scaly.
- Excessive thirst is experienced.
- Mental status changes, including confusion, can occur.
- Lightheadedness and dizziness are common.
- Neck and hand veins appear flat in any position.
- Hematocrit levels increase: >54% in men, >47% in women.
- Body temperature rises above 99.5°F, indicating a low-grade fever.
- Pulse rate increases, becoming weak/thready.
- Urine concentration increases (SG > 1.030), resulting in dark amber urine.
- Urine osmolality increases beyond 800 mOsm/kg.
- Serum osmolality exceeds 300 mOsm/kg.
- Serum sodium levels rise above 145 mEq/L.
- Levels of glucose, protein, and BUN increase.
- Respiration rate increases.
Overhydration (Fluid Volume Excess/Hypervolemia)
- Blood pressure increases, leading to hypertension.
- Respiration rate increases, resulting in tachypnea.
- Pulse pressure increases (systolic - diastolic pressure).
- Pulse rate increases, with a full, bounding volume.
- Capillary hydrostatic pressure increases, pushing fluid into interstitial tissues and causing dependent edema.
- Weight gain occurs relative to severity: mild (2%), moderate (5%), severe (8%).
- Gallop heart rhythm may be heard in adults (S3 heart sound).
- Adventitious breath sounds are present (moist crackles/rales).
- Dyspnea (SOB)/Orthopnea occurs.
- Jugular vein distention is visible at a 45º angle.
- Peripheral vein distention is present.
- Restlessness or lethargy may occur.
- Headaches are experienced.
- The skin becomes taut.
- Mental status changes, including confusion/seizures, can occur.
- Hematocrit levels decrease: <40% in men, <37% in women.
- Urine concentration decreases (SG ≤ 1.005).
- Urine osmolality decreases below 500 mOsm/kg.
- Serum osmolality decreases below 280 mOsm/kg.
- Protein and electrolyte levels decrease.
- Infants may show bulging fontanelles, intercostal/substernal retractions, and nasal flaring.
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