Shared Flashcard Set

Details

Fluid and Electrolytes
From: Medical-Surgical Nursing (Ignatavicius)
109
Nursing
Undergraduate 3
02/09/2011

Additional Nursing Flashcards

 


 

Cards

Term
Functions of water
Definition
Balance-solvent and chemical
Transport nutrients to cells; waste away
Cushion, protect, lube, and insulate
Term
Causes of increased H2O loss
Definition
Fever, Diarrhea, diaphoresis, vomiting
Gastric suctioning, tachypnea
**Risk for dehydration
Term
Causes of water gain
Definition
Increased NA+ intake/retention
Excessive intake of water/secretion of ADH
**Risk for hyperhydration
Term
Fluid compartments
Definition
Intracellular-in cell
Extracellular-interstitial, intravascular
Term
Methods of body fluid regulation
Definition
filtration
secretion
reabsorption
excretion
Term
Diffusion
Definition
Movement of PARTICLES from greater to lesser concentration
Term
Facilitated diffusion
Definition
Requires carrier molecule
**Glucose transport is an example
Term
Osmosis
Definition
Movement of WATER from lesser to greater
Term
Osmolarity
Definition
Pressure exerted by water to equalize both sides
**Particle concentration
Also called Osmotic pressure
Term
Normal serum osmolarity
Definition
270-300 mOsm/L
>300=dehydration
<270=hyperhydration
Term
Isotonic SOLUTION
Definition
Osmolarity is same as ECF
*NS- 1L adds 250cc to ECF and 750cc to IF
****Given to increase blood volume
Term
Isotonic SOLUTION examples
Definition
NS, Lactated Ringers, D5W
Term
Hypotonic SOLUTION
Definition
Lower concentration of solutes
Cell swells; water moves in
Term
Hypotonic SOLUTION examples
Definition
1/2 NS, 1/4 D5W, 1/3 NS
Term
Hypertonic SOLUTION
Definition
Higher solute concentration
Cells shrink; water moves out
*Monitor for interstitial dehydration
**Used for CHF, brain swelling
Term
Hypertonic SOLUTION Examples
Definition
D5 1/2 NS, D5NS, D5RL
Term
Filtration
Definition
Movement of fluid through membrane as a result of liquid pressure differences on both sides of cell membrane
Term
Active Transport
Definition
Process by which some energy is spent to move lg. molecule or substance across an area of higher pressure
*Ex. Sodium-potassium pump
Term
Regulation of fluid examples
Definition
Filtration- BP
Secretion- movement of blood to tubules
Reabsorption- movement from tubules to blood
Excretion- movement from kidney to environment
Term
Routes of water loss
Definition
Kidneys:1-2L/day
Lungs:300-400mL/day
Skin:600mL/day
GI:100-200mL/day
*10% increase of water loss for every degree increase in temperature
Term
Isotonic DEHYDRATION
Definition
Loses F&E in same ratio
***Most common dehydration
Term
Isotonic DEHYDRATION result
Definition
Hypovolemia (decreased blood volume)
**Causes decreased tissue perfusion
Term
Isotonic DEHYDRATION causes
Definition
burns, hemorrhage, diuretics, diarrhea, NG suction, fistulas, severe wounds, long term NPO, ileostomy
Term
Hypertonic DEHYDRATION
Definition
Losing more fluid than electrolytes
**2nd most common
Term
Hypertonic DEHYDRATION: causes
Definition
Hyperventilation, renal failure, fever, tube feedings, DI, watery diarrhea, unconsciousness, excessive fluid replacement
Term
Hypertonic DEHYDRATION: dx results
Definition
Elytes will be normal or slightly elevated
Term
Hypertonic DEHYDRATION: tx
Definition
Give hypotonic solution
Term
Hypotonic DEHYDRATION
Definition
losing more elytes than fluid
*excessive Na+ or K+ loss from ECF
Term
Hypotonic DEHYDRATION: causes
Definition
chronic illness, renal failure, chronic or severe malnutrition, excessive fluid replacement
**First s/s are usually neurological
Term
Hypotonic DEHYDRATION: tx
Definition
use hypertonic solution
Term
Causes of hypovolemia
Definition
Fever
Diarrhea
Diaphoresis
Vomiting
NG Suctioning
Term
S/S Fluid deficit
Definition
Thirst, decreased capillary refill, cool hands or feet, decreased BP, increased pulse, rapid and weak respiration, decreased urinary output, confusion, dry membranes, constipation, decreased bowel sounds, orthostatic hypotension, flat veins, daily weights
Term
Nsg care of dehydration
Definition
Small, frequent oral rehydration
IV Fluids replacement
Term
Dehydration: Dx tests
Definition
Hgb, Hct, BUN, & creatinine- increased
WBCs normal or slightly elevated
Urine osmolarity- increased
Specific gravity- >1.030
Term
Fluid Overload: causes
Definition
Increased sodium intake/retention
Excessive intake of water
Excessive secretion of ADH
Term
Isotonic fluid OVERLOAD
Definition
**Excess fluid in ECF
Elytes normal
H&H low
Term
Isotonic OVERLOAD: Causes
Definition
excess IV, enemas, steroid therapy
Term
Isotonic OVERLOAD: Results
Definition
Circulatory overload
Pitting edema
Term
Hypotonic OVERLOAD
Definition
**Water intoxication
Term
Hypotonic OVERLOAD: causes
Definition
CHF, excessive water intake, irrigation w/ hypotonic fluid
Term
Hypotonic OVERLOAD: result
Definition
Cellular swelling, elyte dilution
Term
Hypertonic OVERLOAD
Definition
**increase in Na+ w/ water
ICF shifts to ECF
Cells shrink
Term
Hypertonic OVERLOAD: causes
Definition
Excessive Na+ intake/ retention
Rapid infusion of hypertonic solution
Term
Hypertonic OVERLOAD: result
Definition
Circulatory overload
Pitting edema
Term
S/S fluid overload
Definition
Leg/ankle edema
Wheezy, dry cough
Periorbital edema
Increased BP
Rapid respiratory rate
Moist coughing
Term
More s/s fluid overload
Definition
Frothy sputum
Maybe crackles
Hgb, Hct, protein decreased
Decreased urine gravity
Term
Nsg care for fluid overload
Definition
Monitor V/S
Check neck and hand veins
Respiratory status
I&O, daily weights, elevate HOB
Term
More nsg care for fluid overload
Definition
Diuretics, restrict fluids
Mouth care-because of fluid restriction
Peripheral edema
Term
1 kg of weight=
OR
1 lb of weight=
Definition
increase of 1L of fluid
OR
increase of 450mL of fluid
Term
Electrolytes
Definition
Elements or compounds that develop electrical charge when dissolved in water
Term
Anions
Definition
Negatively charged
**HCO3, Cl-
Term
Cations
Definition
Positively charged
**Na+, K+
Term
Sodium normal value
Definition
136-145 mEq/L
Term
Sodium functions
Definition
Muscle contraction
Heart contraction
Transmission of nerve impulses
Kidney urine concentration
Term
Hyponatremia
Definition
<136 mEq/L
low amounts of Na+ in blood
Results in drawing water back into cells
Term
Hyponatremia: s/s
Definition
Greatest indicator is neuro changes
Term
HypoNATREMIA: Causes
Definition
sweating
vomiting
diarrhea
diuretics
tap water enema
increased ADH
Term
HypoNATREMIA: S/S
Definition
H/a, lethargy, brain swelling, confusion, convulsions, coma
Rapid thready pulse, postural hypotension
N/V, diarrhea
Weakness, spasms
Decreased deep tendon reflexes
*Assess resp. status if muscle strength decreases
Term
HypoNATREMIA: tx
Definition
Intake and output, daily weights
Monitor lab values
Assess skin care
Monitor IVs
NGT- irrigate w/ NS, limit ice chips
Administer hypertonic solns
IV- NS, elyte diuretic (Mannitol)
Term
Hypovolemic shock
Definition
BP bottoms out
HR increases
*weak and thready
Term
HyperNATREMIA
Definition
145 mEq/L
*causes cells to shrink
Term
HyperNATREMIA: Causes
Definition
Excessive PO intake
Increased water loss
Hypertonic tube feedings w/o water following
Diabetes insipidus
Term
HyperNATREMIA: types
Definition
Gain of sodium in excess of water
Loss of water in excess of sodium
*Profuse watery diarrhea
*Hyperventilation w/ excessive insensible loss
Term
HyperNATREMIA: S/S
Definition
Dry, sticky mucus membranes
Elevated temperature
Confusion, seizures, and agitation
Increased heart rate
Oliguria or anuria
Mild- muscle twitches, spontaneous contraction
Severe- dim. deep tendon, musc. weakness
Term
Potassium: normal level
Definition
3.5-5 mEq/L
Term
Potassium: function
Definition
Transmission of nerve impulses
*promotes myocardial, skeletal, and smooth musc contraction
Aids in utilization of glucose
Term
Potassium in Acid-Base Balance
Definition
Increase= acidosis
Decrease= alkalosis
Term
Potassium rich foods
Definition
Bananas
cantaloupe
green leafy veg
dried fruit
Term
HypoKALEMIA: causes
Definition
<3.5 mEq/L
Decreased K+ intake
GI suctioning
K+ wasting diuretics
Vomiting and Diarrhea
Burns
Term
HypoKALEMIA: S/S
Definition
Fatigue, weakness, heaviness in legs
Decreased bowel motility
N/V
Postural hypotension
**Ventricular arrhythmias
Term
HypoKALEMIA: more S/S
Definition
Shallow respirations
Thready, weak pulse
HR-may be increased or decreased
Muscles may become weak
Term
Potassium Replacement
Definition
Foods high in K+
KCl by IV
*20-40 mEq/L of IVF
Take PO w/ a glass of water
Give K+ sparing diuretic
Term
HyperKALEMIA
Definition
>5.0 mEq/L
Term
HyperKALEMIA: Causes
Definition
Renal failure-most common cause
K+ sparing diurectics
Burns, tissue trauma
Rapid admin of K+
Metabolic acidosis
Term
HyperKALEMIA: S/S
Definition
Muscle weakness, cramps
N/V, diarrhea
Intermittent colic
ECG changes, arrhythmias
Low BP, bradycardia, irregular HR
Numbness, tingling of extrem, face, and tongue
Term
HyperKALEMIA: tx
Definition
Kayexalate: PO or rectal
IV Hypertonic glucose & insulin
IV NaHCO3
Decrease dietary intake of K+
Dialysis
Cardiac monitoring
Term
Kayexelate
Definition
Binds K+ in exchange for Na+
*excreted in stool
Term
IV Hypertonic Glucose & insulin
Definition
facilitates movement of K+ back into cell
Term
IV NaHCO3
Definition
corrects acidosis and moves K+ back into cell
*metabolic acidosis
Term
Drug high in K+
Definition
Potassium
Term
Calcium nl value
Definition
9.0-10.5 mg/dL
Term
Calcium: function
Definition
Teeth and bone formation
Contraction of the muscle
Blood clotting
Transmission of nerve impulses
*99% of Ca is in bone
Term
Ca and Phosphorous Relationship
Definition
Inverse relationship
Term
Calcium balance
Definition
Parathormone-released in response to low Ca levels
*increases Ca out of bone
Calcitonin- stimulated by increased Ca levels
Vitamin D- essential for absorption by GI tract
Term
HypoCALCEMIA: Causes
Definition
<9.0 mg/dL
Vitamin D deficiency
Pancreatitis
Multiple blood transfusions
Chronic renal failure
Removal of parathyroid gland
Term
HypoCALCEMIA: S/s
Definition
positive Chovestek's & Trousseau's
Tetany w/ hyperreflexia
Numbness and tingling in extrem, & around mouth
Muscle cramps
Depression, irritability, fatigue, anxiety
Term
HypoCALCEMIA: More s/s
Definition
Increased gastric motility
hyperactive bowel sounds
Decreased BP
Term
HypoCALCEMIA: Tx
Definition
Oral Calcium Supplements- TUMS
Vitamin D Replacements
IV Supplements- Cal Gluconate, Cal Chloride
Term
HypoCALCEMIA: Education
Definition
Re: foods high in Ca++
Pt. on seizure precautions
Term
HyperCALCEMIA: causes
Definition
>10.5 mg/dL
Hyperparathyroidism
Thiazide diuretic- holds on to Ca++
Reabsorption of the bone
Term
Reabsorption of the bone: causes
Definition
prolonged immobilization
Multiple fractures
bone tumors
Term
HyperCALCEMIA: S/S
Definition
Altered LOC, lethargy, confusion, blurred vision
Deep bone pain
Kidney stones
Constipation, anorexia, N/V
Term
HyperCALCEMIA: more S/S
Definition
Hypoactive or absent bowel sounds
Tachycardia(early sign)
Bradycardia(late sign)
Cardiac arrest
**Monitor dig levels
**Do Homan's sign
Term
HyperCALCEMIA: Tx
Definition
NS IVF
Loop diuretics
PO or IV PO4 preparation
Plicamycin-slows bone reabsorption
Calcitonin-slows bone reabsorption
Laxatives- for constipation
Dialysis for LT levels
Term
Phosphorous: Functions
Definition
3.0-4.5 mg/dL
Contributes to metabolism of glucose, fat and protein
Aids in acid-base balance
Muscle contraction
Conversion of glycogen to glucose
Function of RBCs
**Must have adequate renal function
Term
HypoPHOSPHATEMIA: Causes
Definition
<3.0 mg/dL
Alcoholism and malnutrition
DKA
Prolonged hyperventilation
Frequent use of TUMS
Term
HypoPHOSPHATEMIA: S/S
Definition
Muscle weakness, rhabdomyolysis, decr deep tendon,
bruising, decr musc. contractility, ataxia
Confusion, CNS depression, irritability
seizures, immunosuppression, shallow respirations
Term
HypoPHOSPHATEMIA: tx
Definition
Try dietary first
Oral supplement: K-phosphate
IV w/ K+ or NaPO4
IV PO4 given ONLY when levels: <1 mg
Infuse IV SLOWLY
Term
HyperPHOSPHATEMIA: Causes
Definition
>4.5 mg/dL
Renal failure
Chemotherapy
Increased phosphate intake and absorption
Term
HyperPHOSPHATEMIA: S/S
Definition
Tetany, numbness, cramps
Muscle twitch
Nervouseness
Irritability
Term
HyperPHOSPHATEMIA: tx
Definition
Dietary restriction of phosphates
PO4 binders(ex. amphogel, alternagel, basagel)
Correct underlying hypocalcelmia
Term
Magnesium: function
Definition
1.3-2.1 mg/dL
Aids in neuromuscular transmission
Aids in cardiac muscle contraction
Activates enzymes for cellular met of carbs&proteins
Maintaining active trans mech at cell level
Aids in DNA and RNA synth
Term
Hypomagnesmia: causes
Definition
<1.3 mEq/L
Malnutrition, alcoholism, IBD, fluid loss
Loop diuretics, ABX
Diarrhea, NG suction, fistulas
Severe dehydration
Term
HypoMAGNESMIA: S/S
Definition
Severe deep musc. depression
*Shallow resp
Apathy, depression, confusion, irritability
Musc. weakness, tremors and tetany
Hyperreflexia
LT cardiac arrhythmias, HTN
**Clinically resembles hypocalcemia
Term
HypoMAGNESMIA: tx
Definition
Diet: green veg, legumes, fruits, chocolate
IV or IM MgSO4
*1g/h
IV b/c IM causes pain and tissue damage
**Also tx for HYPOcalcemia
Term
HyperMAGNESMIA: causes
Definition
>2.1 mEq/L
Laxatives/antacids that contain Mg
Chronic renal failure
MgSo4 for eclampsia
Term
HyperMAGNESMIA:S/S
Definition
reduced deep tendon
Inability to swallow
Flushed skin
severe muscle weakness
Depressed resp
decreased BP, bradycardia
Term
Mg level >9 mEq/L
Definition
can lead to cardiac and resp arrest
Term
HyperMAGNESMIA: tx
Definition
d/c mg drugs
IV Cal Gluconate to counteract effects
Dialysis for chronic renal failure
Mechanical vent if resp arrest
Supporting users have an ad free experience!