Exam 2 Med Surg 1 - Exam 2 Med Surg 1, Preparation Study Guide.

Exam 2 - Medsurg 1Chapter 161. Gerontologic considerations: fluids and electrolytesIncrease susceptibility to fluid and electrolyte imbalances. Decrease glomerular filtration rate. (increased GFR in pregnancy and decrease in BUN)Hormonal changes: decrease in renin and aldosterone and increase in ADH and ANP. Subq tissue loss and thinning of the dermis, will lead to increased moisture loss through the skin. Inability to respond quickly to heat or cold. 2. Hypervolemia vs Hypovolemia -Hypovolemia: Fluid volume deficit - abnormal loss of body fluids (diarrhea, vomiting, hemorrhage, polyuria) Shift from plasma to interstitial fluid. Fluid volume deficit and dehydration are NOT the same. Dehydration refers to loss of pure water alone without a corresponding loss of sodium.Causes: increase insensible water loss or perspiration (high fever, heatstroke), diabetes insipidus, uncontrollable diabetes mellitus, osmotic diuretics, hemorrhage, vomiting/diarrhea, NG suction/fistula drainage, inadequate fluid intake with too much sodium consumption, burns. Manifestations: restlessness/confusion, thirst/dry mucous membranes, swollen red tongue, weaky thready pulse, flushing, decreased skin turgor, increase RR, weight loss, seizure/coma, mild: skin is warm, dry and wrinkles. Severe: coolTx: PO, blood products, IV. Interventions: Daily weights are the most accurate measure of volume status *1kg(2.2 lbs) = 1000 mL.Weigh the patient at the same time every day,