FLUID & ELECTROLYTES
I. FLUID AND ELECTROLYTES
Please note that all normal ranges for blood tests will depend on the lab performing
the test. The normal values listed in this book are to be used as reference only.
A. Fluid Volume Excess/Hypervolemia:
•
VASCULAR SPACE
Define: Too much fluid in the ___________________
________________.
1. Causes:
a. Heart Failure (HF): Heart is __________, Cardiac Output _______,
Kidney perfusion _____________, Urinary Output __________.
*The volume stays in the ____________________ ________________.
b. Renal Failure (RF): Kidneys aren’t ____________________________.
c. Three things with a lot of sodium:
Rx
1) Effervescent soluble medications
2) Canned/processed foods
Rx
3) IVF with sodium
2. Hormonal Regulation of Fluid Volume:
Rx
a. Aldosterone (steroid, mineralocorticoid):
•
Where is aldosterone found? ______________ ___________
•
Normal action: When blood volume gets low (vomiting, hemorrhage, etc.)
Aldosterone secretion increases  retain sodium/water
blood volume goes _________.
**Diseases with too much aldosterone:
__________________________________________
__________________________________________
**Disease with too little aldosterone:
__________________________________________
b. Anti-diuretic Hormone (ADH):
•
Normally makes you retain or diurese? ____________________
•
Retain __________________________
A CLINICAL JUDGMENT APPROACH | STUDENT MANUAL
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FLUID & ELECTROLYTES
TWO ADH PROBLEMS
Too Much ADH
Not Enough ADH
Retain _________________________
Lose (diurese) _______________
Fluid Volume ___________________
Fluid Volume ________________
SIADH
DI _________________________
Syndrome of Inappropriate ADH
Secretion
Diabetes Insipidus
(TOO MANY ________________,
TOO MUCH _________________)
Urine ______________________
Urine _______________________
Blood ______________________
Blood ______________________
*Concentrated makes the #s go up
Urine specific gravity, sodium,
and hematocrit
*Dilute makes the #s go down
•
ADH is found in the ______________.
•
Key words to make you think potential ADH problem:
craniotomy, head injury, sinus surgery, transsphenoidal hypophysectomy, or any condition that can lead to an increased ICP can lead to an ADH problem.
•
Trans-______________________________, sphenoid _______________,
hypophysis ______________, ectomy _____________________________
Rx
*Another name for anti-diuretic hormone (ADH) is vasopressin
(Pitressin®). The drug vasopressin (Pitressin®) or desmopressin
acetate (DDAVP®) may be utilized as an ADH replacement in
diabetes insipidus.
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