4 - Fluid Balance & Fluid Overload .pdf

Fluid & Electrolyte Basics IV Fundamentals of Nursing Factors that Influence Fluid Balance Muscle (more fluid) Body Fat (less fluid) Gender (men retain more fluid) Age Key Terms...

Fluid & Electrolyte Basics IV Fundamentals of Nursing Factors that Influence Fluid Balance Muscle (more fluid) Body Fat (less fluid) Gender (men retain more fluid) Age Key Terms Osmosis: Diffusion: Filtration: Osmolality: Examples: - Isotonic solutions: The movement of fluid The movement of Equal osmolality The movement of 270 - 300 millimoles / kg from an area of solutes from an area of The concentration of LOWER concentration to GREATER concentration BOTH fluid & solutes from (same as blood concentration) an area of HIGH a solution. - Hypertonic solutions: an area of to an area of HIGHER LESSER concentration, hydrostatic pressure to Higher osmolality = High osmolality (heavy & thick Higher solutes (heavy) concentration) OVER 300 concentration, leading to leading to equalization. an area of low pressure. millimoles / kg equalization. Lower osmolality = - Hypotonic solutions: Example: exchange of Example: Kidneys that Example: Large intestines Lower solutes Lower osmolality O2 & CO2 inside the filter the blood. that absorb high nutrients (light & dilute) (lighter & dilute) lungs. & balance fluids. Less than 300 millimoles / kg Fluid Volume Overload - Overhydration Overhydration for Other Names: Clients puff up like a big water balloon manifesting as edema (the swelling of soft tissues from excess fluid). Overload! Fluid Volume Excess Hypervolemia FVO (Fluid Volume Overload) Edema: The swelling of soft tissues as a result of excess fluid accumulation Grading the Pitting Edema 4 Main Causes of Edema Edema makes the skin look like a memory foam 2. Decreased colloid osmotic pressure 1. Increased hydrostatic pressure TEST TIP mattress, ranging from 0+ to 4+ pitting edema. Increased volume Low Albumin (Low plasma proteins) Manifestations: Memory Trick 0+ No pitting edema High blood pressure (BP) A - Albumin A - Attracts fluid Pitting edema Examples: 2 mm or less Mild Examples: 1+ (immediate rebound) Renal Failure Cirrhosis (liver disease) Starvation Heart Failure 3. Increased capillary permeability 2+ 3-4 mm Moderate (15 seconds rebound) Memory Trick HF - heart failure Examples: Bacteria (infection) HF - heavy fluid Burns 5-6 mm Moderately Severe 3+ (30 seconds to rebound) 4. Obstruction of the lymphatic system Cancer (tumor blockage) 8 mm or deeper SEVERE! 4+ (1-2 minutes to rebound) HIGH Infection (big lymph nodes) PITTING EDEMA BLOOD PRESSURE 0+ 1+ 2+ 3+ 4+ NORMAL HIGH LOW 2mm 4mm 6mm 8mm