NUR 631 - Week 5 Quiz Review GASTROENTERITIS?? Metabolic acidosis FLUID REPLACEMENT purple tab 3, p. 108 ISOTONIC ALTERATIONS – occur when changes in total body water (TBW) are accompanied by proportional changes in the
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NUR 631 - Week 5 Quiz Review GASTROENTERITIS?? Metabolic acidosis FLUID REPLACEMENT purple tab 3, p. 108 ISOTONIC ALTERATIONS – occur when changes in total body water (TBW) are accompanied by proportional changes in the amounts of electrolytes and water Ex: individual loses pure plasma or extracellular fluid (ECF) – fluid volume is depleted but the number and type of electrolytes and osmolality remain WNL Excessive amounts of isotonic body fluids can result from excessive administration of normal saline or oversecretion of aldosterone with renal retention of both sodium and water Isotonic fluid loss results in hypovolemia
CAUSES: hemorrhage, severe wound drainage, diaphoresis Loss of extracellular volume results in weight loss, dry skin and mucous membranes, decreased urine output, increased HCT, symptoms of hypovolemia Rapid heart rate, flattened neck veins, normal or decreased BP Isotonic fluid excess results in hypervolemia CAUSES: excess IV fluids, hypersecretion of aldosterone, medications (cortisone), renal failure Weight gain, decreased HCT, decreased plasma concentration caused by diluting effect of excess plasma volume
Distended neck veins, increased BP Increased capillary hydrostatic pressure leads to edema Pulmonary edema and heart failure if plasma volume is great enough HYPERTONIC ALTERATIONS (p. 110) – develop when the osmolality of the ECF is elevated above normal (greater than 294) CAUSES: hypernatremia, deficit of ECF free water Hypertonicity of the ECF attracts water from the intracellular space, causing ICF dehydration A primary increase in the amount of ECF sodium causes an osmotic attraction of water and symptoms of hypervolemia
A hypertonic state caused primarily by free water loss leads to hypovolemia
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