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Fluid & Electrolytes
F & E exam
109
Nursing
Not Applicable
02/10/2013

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Cards

Term
homeostasis
Definition
dynamic process through which the body maintains balance by adjusting internal and external stimuli
Term
function of water
Definition
  • transport of nutrients, electrolytes, and oxygen to cells 
  • acid base balance 
Term
Interstitial fluid is found
Definition
between cells
Term
watery fluid in blood known as plasma is what kind of fluid
Definition
Intravascular
Term
fluid found in the epithelial spaces
Definition
transcellular fluids
Term

water loss you can not count

ex: perspiration

Definition
insensible water loss
Term
which element/electrolyte promotes water retention
Definition
sodium
Term
how does Protein and albumin promote body fluid retention
Definition
  • Increases the oncotic pressure
  • oncotic pressure keeps fluid intravascular

albumin (a protein) pulls fluid into the veins 

Term
what is an example insensible water loss
Definition
water excreted from the skin through perspiration
Term
normal urine output
Definition
30 ml/day
Term

assessment of body fluids: Skin

 

Definition

appearance and turgor

(elasticity or tonus)

Term

assessing body fluid: Urine

what do we test

Definition

Specific gravity and Urine volume

(concentration of urine)

Term
fluid balance
Definition
the difference between intake and output
Term
what is the best indicator of fluid status
Definition
DAILY WEIGHTS
Term

ways to assess body fluids

name 4

Definition
  1. Skin - apperance and turgor
  2. Urine volume and specific gravity (urine concentration)
  3. Fluid balance - difference of intake and output
  4. Daily weights - best indicator of fluid status
Term
What is a common assessment for hydration or fluid loss status?
Definition
skin turgor
Term

Diagnostics for fluid status:

name 5

Definition
  1. BUN     6-20
  2. Crt     0.5-1.2
  3. CBC
  4. UA     1.005-1.030
  5. Total protein
Term

BUN

(blood urea nitrogen)

Definition

BUN 6-20

 

elevated BUN generally reflects intravascular depletion

Term

Crt

(Creatinine)

Definition

Crt 0.5 - 1.2

  • provides an indication of renal perfusion that is not affected by hydration status
  • kidney function
Term

CBC

(complete blood count)

Definition
  • May provide some indication of dehydratioin
  • Hematocrit and hemoglobin will be elevated in dehyration and hypovolemia
Term

Urinalysis

the specific gravity of the urine is related to the client's hydration state - what are normal values?

Definition

1.005 1.030

numbers go up in dehydration

urine ions can be specifically requested and are helpful in determining whether sodium is being retained or not

Term
total protein
Definition

3 - 5 g/dL

 

Term
what happens if serum protein levels drop?
Definition
the oncotic pressure goes down and fluid migrates to "third spacing"
Term
excess of water in the body
Definition
hypervolemia
Term

excess of accumulation of fluid in the

interstitial (tissue)spaces

Definition
edema
Term

assessing edema 

Definition

1 ,    2mm, immediate rebound

2 ,    4mm, a few seconds to rebound

3 ,    6mm, 10-12 seconds to rebound

4 ,     8mm, >20 seconds to rebound

Term

these symptoms are a sign of what condition

  • rapid breathing
  • dyspnea
  • crackles in lungs
  • hypertension ↑ b/p
  • JVD
  • moist skin
  • acute weight gain
  • edema 
Definition
hypervolemia
Term

the following treatments are for what condition

  • identify cause
  • fluid and sodium restriction
  • TED hose to mobilize fluids
  • assess amount of edema
  • administer plasma proteins and albumin if ordered
  • monitor VS and daily weight

 

Definition
hypervolemia
Term
body's output of water is greater than its intake
Definition
hypovolemia
Term
how does the body compensate if fluid intake can not keep up with fluid loss?
Definition
the body compensates by decreasing urine output
Term

these symptoms are signs of what condition

  • orthostatic hypotension
  • tachycardia
  • thirst
  • flattened jugular veins
  • sunken eyeballs
  • dry mucous membranes
  • rapid weight loss
  • decreased urine output
  • prolonged capillary refill 
Definition
hypovolemia
Term

the following treatment is appropriate for what condition:

 

administration of IV fluids

 

monitor for fluid overload

Definition
hypovolemia
Term
what are s/s of fluid overload
Definition
  • SOB
  • JVD
  • CRACKLES
  • ↑ B/P 
Term

passive transport

name 3 processes

Definition
  1. diffusion
  2. osmosis
  3. filtration  
Term

movement of particles

  • solutes move from area of higher concentration to lower concentration resulting in equal distribution

 

Definition
diffusion
Term

movement of water from an area of lower solute concentration to higher solute concentration

(higher water concentration to lower water concentration)

through a semipermeable membrane to equalize the concentration of ions or molecules

Definition
osmosis
Term
in what process can water move in and out of cells to correct imbalances in water concentration
Definition
osmosis
Term
  • same electrolyte concentration and same osmotic pressure as extracellular fluid
  • risk of fluid overload

Lactated Ringers is an example of what type of solution

(LR), NS (normal saline, or 0.9% saline in water)

Definition
isotonic
Term
  • water is pulled from vasucular compartment in the the interstitial fluid compartment

D5NS .45 (5% dextros in 1/2 normal saline) is an example of what type of solution

Definition
hypotonic
Term
  • pulls fluids and electrolytes from the intracellular and interstitial compartments into the intravascular compartment

2.0% NS, blood products and albumin are examples of what type of solution

 
 
Definition
hypertonic
Term

what is the substance that is sometimes called minerals, salts, or ions that develop electrical charges

Definition
Electrolytes
Term
  • sodium (Na)
  • chloride (cl)
  • calcium  (Ca)
  • Bicarbonate (HCO3)

are found where? (cellular)

Definition
extracellular
Term
  • Potassium (K )
  • Phoshorus
  • Magnesium (Mg ) 
  • Proteins

are found where? (cellular)

Definition
intracellular
Term
what is the most abundant electrolyte in the body?
Definition

Na - Sodium

135-145 mEq/dL

Term

 (Na) Sodium

normal values

 

Definition
135-145 mEq
Term
  • influences distribution of water
  • maintains nerve function
  • acid - base balance

are functions of what electrolyte?

Definition

sodium - Na

 

normal values 135-145 mEq

Term
what is the greatest influence of water movement in the body
Definition

Na

Soduim

135-145 mEq

Term
hyponatremia
Definition
Low Sodium (Na)
Term

confusion is a sign of what electrolyte deficiency

why

name

Definition

sodium (Na)

sodium maintains nerve function

hyponatremia

Term
hypernatremia
Definition
High Sodium (Na)
Term
restlessness and irritablility are sympoms of what electrolyte imbalance
Definition

high Sodium levels

hypernatremia

Term

potassium (k)

 

normal values

Definition
3.5 -5 mEq/L
Term
what electrolyte is the dominate intracellular cation ( )
Definition
potassium (k)
Term
which electrolyte is found primarily in the muscle tissue
Definition

potassium (K)

3.5 -5 mEq/L

Term
potassium (k) 3.5 -5 is important for which muscle
Definition
the heart muscle
Term
too much or to little of potassium (k) can lead to what?
Definition

increase cardiac muscle excitability leading to

arrhythmias

Term
hypokalemia
Definition

Low Potassium (k)

below 3.5

Term
risk factors for hypokalemia
Definition
older age due to diuretic and laxative use
Term
treatment for hypokalemia
Definition
  • encourage foods high in potassium (k)
  • oral potassium chloride liquid supplement (kcl) - mix with water or juice
  •  NEVER GIVE IV PUSH - cardiac arrest
Term
foods high in potassium
Definition
  • avocados
  • broccoli
  • dairy
  • dried fruit
  • cantaloupe
  • bananas 
Term
hyperkalemia
Definition

high potassium

above 5 mEq/L

Term

s/s of hyperkalemia

name 5

Definition
  1. nausea
  2. vomiting
  3. increase motility
  4. diarrhea
  5. hyperactive bowel sounds 
Term
what procedure may be needed if there is inadequate renal excretion in hyperkalemia
Definition
dialysis
Term

meds for hyperkalemia

name and type

name 2

Definition
  1. Lasix - urine
  2. Kayexalate - stool 
Term
Chloride
Definition

maintains acid base balance

 

Term
what element/electrolyte is a major component of gastric secretion: combines hydrogen in stomach to form hydrochloric acid
Definition
Chloride
Term
risk factors for hypochloremia
Definition
  • prolonged vomiting
  • diarrhea
Term

Calcium (Ca)

normal values

Definition
9.0 - 10.5 mg/dL
Term
where is calcuim found in the body
Definition
bone, cartilage and teeth
Term
calcium has an inverse relationship with.....
Definition
phosphorus
Term
hypocalemia
Definition
Low calcium (Ca)
Term

s/s of hypocalcemia

name 2

Definition
  1. Facial twitching (Chvostek's Sign)
  2. Carpopedial spasms (Trousseau's Sign) 
Term
treatment of hypocalcemia
Definition
  • oral or IV calcium
  • vitamin D to increase absorption
  • seizure precautions
  • encourage foods high in calcium - dairy, dark green vegetables 
Term

s/s of hypercalcemia

name 4

Definition
  1. lethargy
  2. irritability
  3. loss of energy
  4. confusion 
Term
treatment for hypercalcemia
Definition

calcitonin

(decreases serum calcium by putting it into the bones)

Term
what is the function of phosphorus
Definition
combines with calcium ions in the bone providing hardness, strength and durability
Term

hypomagnesemia s/s

name 2

Definition
  1. diminished reflexes
  2. muscle weakness 
Term

Bicarbonate HC03

normal values

 

Definition
22 - 26 mEq/L
Term
bicarbonate HC03 is regulated by:
Definition
the kidneys
Term
function of HC03
Definition
  • maintains the normal levels of acidity (pH) in blood and other body fluids  - neutralizes acids in the body
  • one of the 4 major buffers or buffer systems in the body
Term
acid base balance measured clinically by
Definition
pH
Term
normal pH levels
Definition
7.35 - 7.45
Term
renal mechanisms - urinary =
Definition

HCO3

22-26 mEq/L

Term
pulmonary mechanisms of pH - Lungs
Definition

PaC02

35-45 mm Hg

Term
what happens with a systemic increase in hydrogen ion concentration - lungs fail to eliminate C02
Definition
acidosis
Term
what is the result of excessive loss of C02 during hyperventilation, loss of acids during vomiting
Definition
alkalosis
Term
compensation is happening if pH is in ______ limits
Definition
normal
Term
decrease in pulmonary ventilation (not breathing) leads to
Definition
respiratory acidosis
Term
increase in pulmonary ventilation can lead to ....
Definition
respiratory alkalosis
Term

risk factors for respiratory alkalosis

name 5

Definition
  1. hypermetabolic states
  2. fever
  3. sepsis
  4. anxiety
  5. hepatic failure (increased ammonia(renal and kidney) → acidosis)
Term
having a patient breath into a paper bag is treatment for...
Definition
respiratory alkalosis
Term
metabolic (kidney) acidosis
Definition
kidney not producing bicarb
Term

risk factors for metabolic acidosis

name 4

Definition
  1. diarrhea
  2. intestinal malabsorption
  3. loss of HC03 (bicarb) by the intestine 
  4. salicylate intoxication, excess acids
Term
treatment of metabolic acidosis
Definition
IV sodium bicarbonate
Term

risk factors for metabolic alkalosis

name 5

Definition
  1. chronic vomiting
  2. nasogastic drainage or lavage without electrolyte replacement
  3. alkaline antacids
  4. low serum chloride
  5. low serum potassium

 

Term
cardiovascular abnormalties due to decrease in potassium (K ) can be a sign of.....
Definition
metabolic alkalosis
Term

Lab finding with metabolic alkalosis

name 4

Definition
  1. decrease chloride
  2. increase pH
  3. increase Hct
  4. decrease K (potassium) 
Term
when is Allen's Test performed
Definition
prior to puncture of an artery
Term
how do you know there sufficient collateral circutation through the Ulnar artery (Allen's Test )
Definition
no change in color
Term
what do you assess after the Alen's Test
Definition
CMST
Term
what test is the Allen's Test performed prior to
Definition

ABG

(arterial blood gas)

Term
what are the ABG normal values
Definition

pH        7.35 -7.45

PaCO2      35 - 45

HCO3       22 - 26

Term
  • renal failure
  • diabetic ketoacidosis
  • diarrhea

are possible causes of what

 

Definition
metabolic acidosis
Term
  • vomiting or
  • GI suctioning

are possible causes for what....

 

Definition
metabolic alkalosis
Term
hyperventilatin is a possible cause for
Definition
respiratiory alkalosis
Term
hypoventilation is a possible cause for what
Definition
resperiatory acidosis
Term
4 questions to ask in interpreting ABG's
Definition
  1. what is the pH
  2. what is the C02 - does it match the pH
  3. what is the HC03
  4. is pH normal

if CO2 does not match the pH it is metabloic

Term

math formula

 

gtt/min

Definition

amount to be infused

 

 

Term

math formula

 

mL/hr

Definition

volume

 

 

 

 

 

 

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