Fluids/Electrolytes I am doomed!

I felt the same way last year. You'll do fine. It's more than knowing lab values as you have already found out. This stuff you just have to know and I promise, you'll see it again in your next semesters. Acronymns worked well for me, GOOD LUCK!! You can do it!

I have a test tomorrow... I have studied my butt off & I don't really think I get it!I know my lab values but I don't think I know what to do for the imbalances. Acid bases I got, overhydration/deyhadration kinda :imbar . If any of you have any tips of any kind on this stuff....I am all ears.

See if these old notes help.

Fluid volume excess:hypervolema - think CHF, aldosterone, ADH or Renal Failure. If CHF then you have decreased cardiac output-decreased kidney output- decreased urine output.

Renal Failure- If blood is not making it to the kidneys you are NOT making urine. Remember IVF with NA, alkaseltzer and fleets are high in Na.

Aldosterone is a steroid that maintains blood volume. When blood volume is low the aldosterone is secreted and you retain water and Na.

*Too much aldosterone: Cushings or hyperaldosteronism.

ADH (antidiuretic hormone)- think "retain"

Too much ADH- water in vascular space. (SIADH) urine decreased and blood is diluted- If blood is diluted your electrolytes are probably going to fall into lower numbers.

*Too little ADH- Think diabetic insipidus- lose or diurese water- start thinking shock- blood becomes concentrated. People with DI will continue to diurese without being given fluids "shocky". start giving them fluids!

s/s: distended neck veins, edema, crackles, pulse-bp-weight increase.

tx: Diuretic: loops watch for hypokalemia, aldactone watch for hyperkalemia, Thiazides watch for hypokalemia.

Bedrest- increases kidney perfusion.

Hypovalemia- think "shocky"

think ascites- 3rd spacing- belly looks like pooh. burns- fluid leaves vascular space. Polyuria "diabetes"

s/s: decreased weight, skin turgor, dry mucous membranes, pulses weak and thready, low BP. Neck veins get tiny, Peripheral perfusion goes to the kidneys trying to save the organs so hands and feet are cold and clammy.

tx: encourage oral fluids. Severe cases give IV fluids.

*** Isotonic solutions are balanced so they will stay in the vascular space better- Lactated Ringers would be your best choice. (I think it has all the electrolytes)

See if these old notes help.

Fluid volume excess:hypervolema - think CHF, aldosterone, ADH or Renal Failure. If CHF then you have decreased cardiac output-decreased kidney output- decreased urine output.

Renal Failure- If blood is not making it to the kidneys you are NOT making urine. Remember IVF with NA, alkaseltzer and fleets are high in Na.

Aldosterone is a steroid that maintains blood volume. When blood volume is low the aldosterone is secreted and you retain water and Na.

*Too much aldosterone: Cushings or hyperaldosteronism.

ADH (antidiuretic hormone)- think "retain"

Too much ADH- water in vascular space. (SIADH) urine decreased and blood is diluted- If blood is diluted your electrolytes are probably going to fall into lower numbers.

*Too little ADH- Think diabetic insipidus- lose or diurese water- start thinking shock- blood becomes concentrated. People with DI will continue to diurese without being given fluids "shocky". start giving them fluids!

s/s: distended neck veins, edema, crackles, pulse-bp-weight increase.

tx: Diuretic: loops watch for hypokalemia, aldactone watch for hyperkalemia, Thiazides watch for hypokalemia.

Bedrest- increases kidney perfusion.

Hypokalemia- think "shocky"

think ascites- 3rd spacing- belly looks like pooh. burns- fluid leaves vascular space. Polyuria "diabetes"

s/s: decreased weight, skin turgor, dry mucous membranes, pulses weak and thready, low BP. Neck veins get tiny, Peripheral perfusion goes to the kidneys trying to save the organs so hands and feet are cold and clammy.

tx: encourage oral fluids. Severe cases give IV fluids.

*** Isotonic solutions are balanced so they will stay in the vascular space better- Lactated Ringers would be your best choice. (I think it has all the electrolytes)

God bless your soul! Yes it helps...Thank you

Thanks for your support/help... I PASSED!!!!! :balloons: I was terrified. Whew glad that is over. Now on to the Endorcine/Diabetes.

Good job!!

Does anybody know what happens with WBC in the case of HYPOvalemic shock? Do they increase or decrease?? Thank You!

If a pt is losing whole blood, and it is causing hypovolemic shock, the ratio of WBCs should stay the same. So the levels would stay the same. I think?!?

Thanks for taking the time to answer my thread. This is what my actual exam question was: How do you know if somebody has an AAA that has ruptured? Amongst other answers, one of the answers was an increased OR decreased WBC. I have really looked into this and can't seem to find a definite solid answer.

I realize that nobody cares what the WBC is but apparently my instructor thinks it's important. The only two answers that could have been correct included multiple symptoms: decreased BP, pain, decreased H&H. Then, one included increased WBC and the other included decreased WBC.