NUR 416 Lecture Notes - Lecture 2: Oliguria, Metabolic Acidosis, Hematocrit
5 Feb 2020
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Document Summary
Common body fluid disturbance encountered in the care of infants & children. Occurs when total output exceeds total intake. Early compensatory mechanisms: interstitial fluid moves in to the vascular compartment in response to hemoconcentration, vasoconstriction of peripheral arterioles maintains blood pressure. When fluid losses exceed the body"s ability to compensate: bp falls which results in tissue hypoxia, accumulation of lactic acid, pyruvate, & other acid metabolites, contributes to the development of metabolic acidosis. Impaired blood flow to the kidneys causes decreased urine output. Increased serum osmolality stimulates the secretion of adh: which conserves fluid & initiates the renin-angiotensin mechanism in the kidney, causing further vasoconstriction. Aldosterone is released to promote sodium retention & conserve water in the kidney. Cessation of intake or prolonged diminished intake: loss from gi tract. Disturbed body fluid chemistry: inappropriate adh secretion. Excessive renal secretion: glycosuria in diabetes. Loss through skin or lungs: excessive perspiration or evaporation. Fever, hyperventilation, increased activity: impaired skin integrity.
