Term
| Hypovolemia Definition and PE Signs |
|
Definition
Deficiency of TB(Na)
orthostatic changes in pluse and bp
Flat neck veins
Dry mucous membranes
decreased skin turgor |
|
|
Term
| Hypervolemia Definition and PE symptoms |
|
Definition
Excess TB(Na) causes fluid overload
Lower extremity edema
Pulmonary rales
Elevated neck veins
ascites
Pleural effusions
S3 gallop on Cardiac exam |
|
|
Term
| Euvolemia Definition and PE signs |
|
Definition
Normal TB(Na)
findings of volume depletion and fluid overload are absent |
|
|
Term
| Hyponatremia Pathogenesis |
|
Definition
| Decrease of [Na] of ECF decreases shifting water into cells-->cellular swelling (cerebral edema)-->CNS manifestations |
|
|
Term
|
Definition
↓ [Na]=↓↓TB(na)/↓ TB H20
Extrarenal: vomiting, diarrhea, blood loss, excessive sweating, third-space losses, nasogastric suction-->Una or Ucl <10 mEq/L
Renal Losses: diuretic use, osmotic diuresis, Addison's disease, acute/chronic interstitial nephritis (all cause renal salt wasting)--> Una and Ucl >20mEq/L
Treatment: Volume expansion w/ Normal Saline |
|
|
Term
| Hypervolemic Hyponatremia |
|
Definition
↓ [Na]=↑ TBna/↑↑ TB H2O
Extrarenal: CHF, Nephrotic Syndrome, Decompensated Cirrhosis--> Urine [Na]<20mEq/L
Renal Cuases: ARF, CRF-->Urine [Na]>20mEq/L
Treatment: Salt Restriction & diuretics (TBna), Fluid restriction (TBH2O) |
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|
Term
Hypervolemic Hyponatremia Pathophysiologic Abnormalities
|
|
Definition
Impairement of kidney ability to excrete salt-->fluid overload
Imparment of kidney's ability to excrete free water-->decreased osmolality |
|
|
Term
|
Definition
↓ [Na]= NI TBna/ ↑↑ TB H2O
impair free water clearnace by causing non-osmotic release of ADH or by making tubules permeable to H2O in absence of ADH
Causes: SIADH, Nausea, postop, hypothyroidism, psychosis, drugs
Urine [Na]>20mEq/L
Treatment: Fluid Restriction |
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