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Continuation….INTENSE Review Packet Questions and Answers🤩

20. Why does the hypervolemic patient develop ascites?

21. What is ascites?

22. When you have a patient who is developing ascites, you know you are supposed
to measure the abdominal girth every day. If the abdominal girth increases every
day, what does that tell you about the vascular space?
23. Define CVP. Where is CVP measured?

24. What is normal CVP?

25. If a patient is hypervolemic, what will happen to the CVP?

26. If a patient is hypovolemic, what will happen to the CVP?

27. If a patient has a high CVP, what does that tell us is probably going on in the
vascular space?

28. If a patient is hypervolemic, what are the lung sounds like and why?

29. Why does the patient who is hypervolemic develop polyuria?

30. What happens to the blood pressure and pulse with hypervolemia and explain
why?

31. What happens to the weight in hypervolemia? Why?

32. What kind of diet are you going to place a hypervolemic patient on? Explain why.

33. If you put a hypervolemic patient on a high-sodium diet, what would happen?

34. Diuretics are given to the hypervolemic patient. Explain why.

35. Lasix is a common diuretic. What is the major electrolyte imbalance you have to
watch for?

36. What is the major electrolyte imbalance you have to watch for with thiazide
diuretics?

37. Aldactone is a potassium-sparing diuretic. What is the major electrolyte
imbalance you have to watch for with this drug?

38. Why do we want a hypervolemic patient to be on bed rest?

39. Why is it so important to give IV fluids very slowly to the elderly?

40. Which two organs are affected by FVE/FVD? Are they weakened by aging?

41. What is another name for fluid volume deficit?

42. Define fluid volume deficit.

43. How can GI losses affect your vascular space?

44. What is third spacing?

45. How can ascites induce hypovolemia?

46. How can burns induce hypovolemia?

47. The diabetic patient will develop polyuria. Why?

48. How does this polyuria affect the vascular space?

49. The person with polyuria will eventually develop what life threatening
complication?

50. What changes will you see in the urine output that will indicate the body is
compensating?

ANSWERS🤩🤩🤩

20. Vascular space gets so full it can’t hold any more so the fluid leaks into
the abdomen. Therefore, the vascular volume goes down.

21. Fluid in the abdomen (peritoneum), third spacing

22. There is still too much fluid in the vascular space and the excess is
pouring over into the abdomen

23. Central Venous Pressure. Right atrium of the heart

24. 2-6 mmHg (if measured by a monitor); 3-8 cm H20 is measured with a
manometer

25. Increases (More volume = more pressure)

26. Decreases (Less Volume = less pressure)

27. The vascular space is overloaded with fluid.

28. Wet: Shortness of Breath can occur; fluid in the lungs

29. Kidneys are trying to compensate by getting rid of the fluid

30. Blood pressure increases because there is so much volume; the pulse
increase; heart is trying to pump faster and harder to keep the blood
moving forward; we would rather the blood go forward instead of
backwards into the lungs

31. Increases- excess fluid makes weight increase rapidly

32. Sodium restricted to decrease fluid retention

33.The patient will retain more fluid and the condition would worse

34. Because the patient has too much volume and they need to diurese

35. Hypokalemia

36. Hypokalemia

37. Hyperkalemia

38. Bed rest induces diuresis by increasing kidney perfusion- when you are
supine you perfuse the kidneys more

39. Their heart and kidneys are weak. The heart may not be able to pump
the excess forward and the kidneys may have problems excreting the
excess.

40. Heart and Kidneys; yes

41. Hypovolemia

42. Loss of water & NA from vascular space equally

43. Excessive GI loss can reduce the volume in the vascular space (anytime
you lose fluid from your body, no matter where it comes from, the
vascular space can eventually be depleted)

44. Fluid leaves the vascular space and goes somewhere where if does you
no good (tissue and abdomen)

45. Fluid leaves vascular space and goes out into the abdomen; therefore the
vascular volume goes down.

46. Fluid leaves vascular space and goes to the tissue (edema occurs) or out
of the body completely.

47. Because they are trying to get rid of the particles (excess glucose
particles) in the vascular space. The glucose has to go out in volume
(with fluid). You have never just excreted a sugar particle!

48. It decreases volume in the vascular space.

49. Shock

50. After someone has had polyuria for a long time the vascular volume will
eventually deplete and now the patient is shocky. The kidneys are not
being perfused well at this point so therefore they make less urine. Also,
the kidneys could start trying to conserve what little fluid is left in the
body therefore decreasing urine output as well. With either of these
conditions the urine output will switch to oliguria and could possibly go
all the way to anuria. If either of these occur, I would have to start
worrying about renal failure.