Term
| What are factors that effect the body's weight in water? |
|
Definition
Fat: holds very little water
Muscle mass: holds more water
Sex: females have less muscle and more fat and therefore females have less body water than males
Age: elderly have less muscle and therefore less body water than young people
Newborns have the highest proportion of body water: 70-80% of newborn weight is water. |
|
|
Term
| What are the 2 major compartments of body fluids? |
|
Definition
| Extracellular and Intracellular. |
|
|
Term
| The extracellular compartment is subdivided into three compartments which are? |
|
Definition
| Interstitial, intravascular, and transcellular. |
|
|
Term
| Where is the most of the body's water? |
|
Definition
| is inside the cell (intracellular fluid)—about 70% in the adult. |
|
|
Term
| About ____% of the body's water is outside the cell. |
|
Definition
|
|
Term
| The interstitial space is the space... |
|
Definition
| between the cells….not inside the cells. |
|
|
Term
| Of the extracellular fluid, about __% is in the interstitial space |
|
Definition
|
|
Term
| Of the extracellular fluid, only about __% of the body’s fluid is in the blood vessel (intravascular space). |
|
Definition
|
|
Term
| What is transcellular fluid? |
|
Definition
| cerebrospinal canals, lymphatic tissues, synovial joints, and in the eye |
|
|
Term
| The total blood volume of an adult is about ______. Only about ___% is in the blood stream. |
|
Definition
|
|
Term
| ___% loss of body fluids is considered serious and ___% of body fluids is considered fatal. |
|
Definition
|
|
Term
| Fluid in the transcellular space is not available for... |
|
Definition
| circulation or nutrient exchange. |
|
|
Term
|
Definition
| fluid accumulating in spaces where fluid normally should not be (eg: peritoneal space—in abdomen—called ascites; pleural cavity—in membranes surrounding lungs). |
|
|
Term
|
Definition
| the molecules or particles that are dissolved |
|
|
Term
|
Definition
| the liquid that dissolves the solute molecules |
|
|
Term
|
Definition
| a liquid that contains solute and solvent |
|
|
Term
|
Definition
|
|
Term
| The solutes in the body include |
|
Definition
| electrolytes, glucose, urea, amino acids, other proteins, and gases such as oxygen (O2) and carbon dioxide (CO2). |
|
|
Term
| What are electrolytes and examples? |
|
Definition
Dissociates in solution
Examples: NaCl, KCl |
|
|
Term
| What are non-electrolytes and examples? |
|
Definition
Do not dissociate in solution
Examples:
Glucose
Urea
Creatinine
Protein |
|
|
Term
| What are electrolytes measured in? |
|
Definition
| Measured in mEq/L, mg/dL, or millimoles /L |
|
|
Term
| What are non-electrolytes measured in? |
|
Definition
|
|
Term
|
Definition
| hat the membrane will allow certain molecules to pass through but not others. |
|
|
Term
| The cell’s semipermeable membrane is permeable to ______ but selectively permeable to ______. |
|
Definition
|
|
Term
| Movement of water across the semipermeable membrane is called... |
|
Definition
|
|
Term
| Movement of solutes across the semipermeable membrane is called... |
|
Definition
| diffusion or active transport |
|
|
Term
| Movement of a substance against a concentration gradient is called... |
|
Definition
|
|
Term
| _________ is found in the plasma membrane of virtually every human cell and is common to all cellular life. |
|
Definition
|
|
Term
|
Definition
| a concept of concentration not an actual number. Also the term “tonicity” is in reference to normal body fluids. |
|
|
Term
|
Definition
| an actual number that gives a value to the concentration |
|
|
Term
| If a solution is hypertonic it is also _________. |
|
Definition
|
|
Term
| If a solution is hypo-osmolar it is also ________. |
|
Definition
|
|
Term
| The concentration of solutes in the body fluids is usually expressed as the... |
|
Definition
|
|
Term
|
Definition
| number of particles or molecules (solutes) per kg of H2O (solvent). |
|
|
Term
| _______ is by far the greatest determinant of osmolality. Although ________ and ________________ also contribute. |
|
Definition
| Sodium; glucose; blood urea nitrogen (BUN) |
|
|
Term
| Normal plasma osmolality = |
|
Definition
|
|
Term
| Osmotic pressure is a _______ pressure. |
|
Definition
|
|
Term
| Plasma proteins (colloids) exert a type of osmotic pressure called the .... |
|
Definition
| Colloid Osmotic Pressure or the Oncotic Pressure |
|
|
Term
| Plasma proteins are found in larger amounts in the ____________ space |
|
Definition
|
|
Term
| If intravascular bloodstream becomes hypotonic and water moves out of the bloodstream into the tissues and cells, what will happen to the blood pressure? |
|
Definition
| The blood pressure will drop. |
|
|
Term
| If the amount of plasma proteins drop, what will happen to the BP? |
|
Definition
|
|
Term
| Hydrostatic pressure is the pressure exerted by a fluid within a closed system ________ on the walls of the container in which it is contained. |
|
Definition
|
|
Term
| The hydrostatic pressure of blood is the force exerted by blood .... |
|
Definition
| pushing against the blood vessel walls |
|
|
Term
| arterial blood pressure is.... |
|
Definition
| The hydrostatic pressure of blood in the aorta |
|
|
Term
| filtration pressure is... |
|
Definition
| The pressure that results in the movement of the fluid and solutes out of a compartment |
|
|
Term
|
Definition
| Hydrostatic pressure – Osmotic pressure. |
|
|
Term
| What is the net direction of filtration on the arterial end of the capillary? |
|
Definition
| out of the capillary into interstitial space |
|
|
Term
| Arterial hydrostatic pressure is about... |
|
Definition
|
|
Term
| Colloid osmotic pressure is... |
|
Definition
|
|
Term
| Venous hydrostatic pressure is about... |
|
Definition
|
|
Term
| What is the net direction of filtration on the venous end of the capillary? |
|
Definition
| out of the interstitial space into the capillary |
|
|
Term
| Isotonic/ Iso-osmolar Solutions are described as... |
|
Definition
| a solution contains the same concentration of salt and solutes as human cells, there is very little osmosis pull |
|
|
Term
| Examples of Isotonic/ Iso-osmolar Solutions... |
|
Definition
0.9% Normal Saline (NS)
5% Dextrose in 1/4 Normal Saline (D5 1/4NS)
5% Dextrose in Water (D5W)
Lactated Ringers (LR) |
|
|
Term
| D5W is avoided in clients at risk for... |
|
Definition
| increased intracranial pressure because it can increase cerebral edema. |
|
|
Term
| What solution is isotonic/iso-osmolar on intial administration? |
|
Definition
|
|
Term
| Lactated Ringers is a balanced electrolyte solution composed of.... |
|
Definition
| sodium chloride, sodium lactate, potassium chloride, calcium chloride |
|
|
Term
| Lactated Ringers is used for? |
|
Definition
| balancing fluid and electrolytes and as an alkalizing agent. |
|
|
Term
| When a solution contains a lower concentration of salt than other solutions, it is... |
|
Definition
|
|
Term
| Hypotonic/ Hypo-osmolar can lead to |
|
Definition
| Cellular swelling and lysis |
|
|
Term
| Examples of Hypotonic/ Hypo-osmolar Solutions... |
|
Definition
| 0.45 Normal Saline (1/2 NS) |
|
|
Term
| Hypotonic solutions are used to |
|
Definition
| provide free water and treat cellular dehydration. |
|
|
Term
| Hypotonic solutions should not be administered to |
|
Definition
| clients at risk for increased intracranial pressure or third-space fluid shift. |
|
|
Term
| When a solution has a higher concentration of solutes than another solution it is.... |
|
Definition
| Hypertonic/ Hyper-osmolar Solutions |
|
|
Term
| Hypertonic/ Hyper-osmolar Solutions cause cells to |
|
Definition
|
|
Term
| Hypertonic solutions should not be administered to |
|
Definition
| to clients with kidney or heart disease or clients who are dehydrated. |
|
|
Term
| Examples of Hypertonic/ Hyper-osmolar Solutions... |
|
Definition
- 5% Dextrose in Lactated Ringers (D5LR)
- 5% Dextrose in .45 Normal Saline (D5.45NS)
- 5% Dextrose in 0.9% Normal Saline (D5NS)
- 10% Dextrose (D10W) |
|
|
Term
|
Definition
| results when the IV catheter is dislodged and fluid infuses into the tissue |
|
|
Term
|
Definition
| an agent capable of causing blistering, tissue sloughing or necrosis when it escapes from the intended vascular pathway into surrounding tissue |
|
|
Term
|
Definition
| the inadvertent infiltration of vesicant solution or medication into surrounding tissue. |
|
|
Term
|
Definition
| is inflammation of a vein. It is usually associated with acidic or alkaline solutions or solutions that have a high osmolarity |
|
|
Term
| Circulatory overload is... |
|
Definition
| results from administration at a rate or volume greater than can be accommodated by the circulatory system |
|
|
Term
|
Definition
- Hydrostatic Pressure
- Oncotic Pressure
- Block in the lymph system
- Anything that impacts the integrity of the cell membrane (ex: infection and sepsis) |
|
|
Term
| Iv Therapy causes a increased potential for... |
|
Definition
|
|
Term
| You always need to check the __________ of fluids and medications. |
|
Definition
|
|
Term
| Pediatric IV Therapy Safety Points are... |
|
Definition
•Use max of 500 ml bags of IV fluids
•Use infusion pump or buretrol
•Monitor IV site closely—usually every 1 hr
•Medications may require further dilution |
|
|
Term
| Patient Education Regarding IV Therapy is... |
|
Definition
- What is the IV for?
- What is IV therapy
- How long will you be receiving the IV
- What you should report to the nurse?
- How to care for an IV and IV site.
- Risks and complications associated with it
- The procedure |
|
|
Term
| Antidiuretic Hormone (ADH) is released by... |
|
Definition
| posterior pituitary gland |
|
|
Term
| Release of Antidiuretic Hormone (ADH) is stimulated by |
|
Definition
| decreased BP, decreased fluid volume, increased sodium |
|
|
Term
| Antidiuretic Hormone (ADH) causes... |
|
Definition
| an Increase H2O reabsorption in renal tubules & collecting ducts |
|
|
Term
| If no ADH, urine volume... |
|
Definition
|
|
Term
| Aldosterone is produced and released by... |
|
Definition
|
|
Term
| Aldosterone is stimulated by... |
|
Definition
| a decrease in Blood Pressure, decreased sodium |
|
|
Term
| When blood pressure falls what is released by the kidneys? |
|
Definition
|
|
Term
| Explain the renin - angiotensinogen system |
|
Definition
Angiotensinogen (released by liver)
+
Blood pressure falls
+
Kidney releases Renin
+
Renin converts angiotensinogen to angiotensin 1
+
Angiotensin 1 is converted by Angiotensin Converting Enzyme (ACE) into Angiotensin 2
+
Angiotensin 2 raises blood pressure and causes the adrenal gland to release aldosterone
+
Aldostrone cause the kidney to retain Na
+
Causes blood pressure to increase |
|
|
Term
| Natriuretic Peptides 2 types |
|
Definition
| ANP (Atrial) and BNP (Brain) |
|
|
Term
| Natriuretic Peptides cause |
|
Definition
|
|
Term
| Minimum ml/kg and average urine output in ml per hour |
|
Definition
| Minimum 0.5 ml/kg, 30-35 ml hr |
|
|
Term
| Urine output of child should ____ mL/kg/hr |
|
Definition
|
|
Term
| Helpful lab tests to analyze fluid volume balances |
|
Definition
-Serum electrolytes, esp. Na+
-Glucose
-Osmolality
-Blood Urea Nitrogen (BUN) & creatinine
-Serum albumin
-Hematocrit & Hemoglobin
-Urine specific gravity |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| When do you see a change in Serum Albumin? |
|
Definition
•Kidney Disease; Liver Disease; Heart Failure
•Malnutrition
•Extensive Burns |
|
|
Term
|
Definition
|
|
Term
| Normal Serum Glucose (fasting) |
|
Definition
|
|
Term
| Normal Urine Specific Gravity |
|
Definition
|
|
Term
| Normal Hemocrit in a male % |
|
Definition
|
|
Term
| Normal Hemocrit in a female % |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Normal BUN/Creatinine Ratio |
|
Definition
|
|
Term
| Water & dissolved electrolytes lost in equal proportions is.... |
|
Definition
| Deficient Fluid Volume: Isotonic |
|
|
Term
| In Deficient Fluid Volume: Isotonic Serum Na+ & BUN ______ _______ ______; Hct may be _______ ___ _______. |
|
Definition
| within normal range; increased or normal |
|
|
Term
| Other names for Deficient Fluid Volume: Isotonic |
|
Definition
| Hypovolemia; Isonatremic deficit. |
|
|
Term
| Deficient Fluid Volume: Isotonic results in |
|
Definition
| decreased circulating blood volume and inadequate tissue perfusion. |
|
|
Term
| When Water loss exceeds electrolyte loss... |
|
Definition
| Deficient Fluid Volume: Hypertonic |
|
|
Term
| Deficient Fluid Volume: Hypertonic causes blood to become |
|
Definition
concentrated
•Increased Na+, Hct, & BUN |
|
|
Term
| Other names for Deficient Fluid Volume: Hypertonic |
|
Definition
| Hyper-osmolar deficit; Hypernatremic deficit |
|
|
Term
| In Deficient Fluid Volume: Hypertonic fluid moves from __________ ______ into _______ _______ ___ ________. |
|
Definition
| intracellular space; interstitial space and plasma |
|
|
Term
| Electrolyte loss exceeds water loss results in |
|
Definition
| Deficient Fluid Volume: Hypotonic |
|
|
Term
| Deficient Fluid Volume: Hypotonic causes blood to become |
|
Definition
•Blood is more dilute
•Decreased serum Na+ |
|
|
Term
| Other names for Deficient Fluid Volume: Hypotonic |
|
Definition
|
|
Term
| In Deficient Fluid Volume: Hypotonic fluid moves from _____ ___ _________ _____ ______ into the _________ _______. |
|
Definition
| plasma and interstitial fluid spaces; intracellular space |
|
|
Term
| Causes of Deficient Fluid Volume |
|
Definition
-Vomiting and/or Diarrhea
-GI suctioning
-Ileostomy/Colostomy drainage
-Draining wounds, burns, fistulas
-Increase U.O from diuretics
-Inadequate intake
-Diabetes Insipidus (DI) |
|
|
Term
| Renal Signs/Symptoms of Deficient Fluid Volume |
|
Definition
- decreased urine output
- increased specific gravity
- increased intake of water
- concentrated looking urine |
|
|
Term
| Cardiovascular Signs/Symptoms of Deficient Fluid Volume |
|
Definition
• Tachycardia -> weak thready pulse
• Flattened neck veins
• Normal BP -> Orthostatic hypotension -> Decreased BP -> Shock (Systolic < 90)
**BP may remain normal initially even with hypovolemia therefore BP is not the best indicator of fluid volume deficit. |
|
|
Term
| Respiratory Signs/Symptoms of Deficient Fluid Volume |
|
Definition
• SOB (r/t decreased tissue perfusion)
• Tachypnea |
|
|
Term
| Neurologic Signs/Symptoms of Deficient Fluid Volume |
|
Definition
• Hyper-osmolar dehydration leads to cell shrinking (crenation)
• weakness
• Change in mental status
• Decreased tissue perfusion (2ndary to vasoconstriction |
|
|
Term
| Integumentary Signs/Symptoms of Deficient Fluid Volume |
|
Definition
• Poor turgor—tenting
• Dry oral mucosa
• Warm dry skin cool moist skin |
|
|
Term
| Weight Signs/Symptoms of Deficient Fluid Volume |
|
Definition
• Loss (< 2lbs/day)
• 1 kg (2.2 lbs) = 1 L of fluid loss |
|
|
Term
| Other Patient Symptoms Signs/Symptoms of Deficient Fluid Volume |
|
Definition
|
|
Term
| Lab findings of Deficient Fluid Volume |
|
Definition
• Elevated Hct & BUN
• Urine Specific Gravity high (SG > 1.025)
• Serum Na+ may be high
• Increased serum osmolality |
|
|
Term
| Renal Signs/Symptoms of Excess Fluid Volume |
|
Definition
• Intake > Output
• Increased urine output
• Dilute looking urine |
|
|
Term
| Cardiovascular Signs/Symptoms of Excess Fluid Volume |
|
Definition
• Tachycardia; Pulse full and bounding (“Racing Heart”)
• Distended neck (jugular) veins
• Increased BP |
|
|
Term
| Respiratory Signs/Symptoms of Excess Fluid Volume |
|
Definition
• SOB and orthopnea(r/t pulmonary edema)
• Moist Crackles
• Cough
• Tachypnea (shallow resps) |
|
|
Term
| Neurologic Signs/Symptoms of Excess Fluid Volume |
|
Definition
• Hypo-osmolar water intoxication leads to cellular swelling and lysis
• weakness
• headache
• Change in mental status
• Cerebral edema (2ndry to increased hydrostatic pressure) |
|
|
Term
| Integumentary Signs/Symptoms of Excess Fluid Volume |
|
Definition
• Dependent Edema
• Pale, cool skin |
|
|
Term
| Weight Signs/Symptoms of Excess Fluid Volume |
|
Definition
• Gain (> 2lbs/day)
• 1 kg (2.2 lbs) = 1L of fluid retention |
|
|
Term
| Other patient symptoms of Excess Fluid Volume |
|
Definition
• Anxiety
• Water intoxication: Headache, nausea, dizziness |
|
|
Term
| Lab Findings of Excess Fluid Volume |
|
Definition
• Decreased Hct & BUN
• Urine Specific Gravity low (SG < 1.010)
• Serum Na+ may be low
• Decreased serum osmolality |
|
|
Term
| A syndrome characterized by decreased tissue perfusion and impaired cellular metabolism is... |
|
Definition
|
|
Term
|
Definition
|
|
Term
| One cause of shock is inadequate blood volume this is called |
|
Definition
|
|
Term
|
Definition
| Shifting of fluid out of the intravascular space. |
|
|
Term
| The fluid in third spacing is... |
|
Definition
| unavailable for function use. |
|
|
Term
| Manifestations of third spacing |
|
Definition
|
|
Term
|
Definition
| refers to abnormal accumulation fluid in the abdominal (peritoneal) cavity |
|
|
Term
|
Definition
•Lowered plasma proteins
•Increased capillary permeability
•Increased vascular hydrostatic pressure
•Lymphatic blockage |
|
|
Term
|
Definition
•Loss: from intravascular space causes s/s fluid volume deficit
•Resorption: fluid moves into intravascular space causes s/s fluid volume excess |
|
|
Term
| Assessment for s/s of decreased volume includes... |
|
Definition
•vital signs
•mucous membranes
•skin turgor
•weigh daily
•I and O
•urine S.G. |
|
|
Term
| Excess Fluid Volume: Isotonic is also called |
|
Definition
|
|
Term
| Excess Fluid Volume: Isotonic may result in |
|
Definition
| circulatory overload, interstitial edema, and pulmonary edema. |
|
|
Term
| Excess Fluid Volume: Isotonic causes Increased isotonic fluid in... |
|
Definition
| the extracellular space only. |
|
|
Term
| Hypotonic Overhydration is also called |
|
Definition
| water intoxication; excess hypotonic fluid volume; hyponatremic fluid volume excess |
|
|
Term
|
Definition
|
|
Term
| Causes of Excess Fluid Volume |
|
Definition
Excess administration of oral / IV fluids
Excessive irrigation of body cavities ( tap water enemas)
Decreased kidney function
Congestive heart failure (CHF)
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) |
|
|
Term
| Syndrome of Inappropriate Antidiuretic Hormone (SIADH) causes decreased |
|
Definition
|
|
Term
| Causes of Syndrome of Inappropriate Antidiuretic Hormone (SIADH) |
|
Definition
•Acute infections
•Acute stress (trauma or surgery)
•Post-op excessive ADH occurs for 12-36 hrs
•Anesthetics/analgesics (MS or Demerol) |
|
|
Term
| Lab findings in Syndrome of Inappropriate Antidiuretic Hormone |
|
Definition
| Decreased serum sodium & serum osmolality |
|
|
Term
| Nursing Assessment of Fluid Volume Excess |
|
Definition
•Vital Signs
•Breath sounds
•Edema
•Weigh daily
•Semi-Fowler’s position
*with fluid overload, fluid shifts to ICF, cells swell |
|
|
Term
| Interventions of Fluid Volume Excess |
|
Definition
-Restrict fluids as prescribed
-Low salt diet as prescribed (teaching)
-Give diuretics as prescribed (monitor results!)
-Monitor labs: Hct and Lytes |
|
|
Term
| Outcome of Fluid Imbalances Depend on: |
|
Definition
Acuteness
Severity
Age
Health State
Degree to which compensatory mechanisms or therapies help problem |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| High phosphorus is called |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
• Conduction/transmission of nerve impulses
• Contraction of muscles
• Regulation of body fluid volumes |
|
|
Term
| What is the major extracellular cation is |
|
Definition
|
|
Term
Sodium-Potassium pump keeps most
Na+ |
|
Definition
outside of the cell (“active
transport”) |
|
|
Term
|
Definition
- Dilutional (increase of fluid)
• SIADH
- Loss of Na+
• Deficiency of Aldosterone
- Vomiting/Diarrhea
- Renal dysfunction
- Sweating
- Inadequate intake
- Medications
- Diuretics |
|
|
Term
Hyponatremia:
Assessment Findings |
|
Definition
- Depression of CNS (H/A, confusion)
- Generalized weakness
- Abdominal cramps, nausea/ vomiting
- Urine S.G < 1.003
- Low Hct |
|
|
Term
| You correct hyponatremia ______. |
|
Definition
|
|
Term
Hypernatremia (Na+ > 145):
Causes |
|
Definition
Lack of water intake
Excessive salt intake
Loss of body water
• Diabetes Insipidus
Retention of body sodium
• Increased Aldosterone |
|
|
Term
Hypernatremia:
Assessment Findings |
|
Definition
Intense thirst
Restlessness, Agitation
Lethargy, Weakness
Red, dry, swollen tongue
Flushed, dry, firm skin
Oliguria/Anuria
Urine S.G. > 1.030
High Hct |
|
|
Term
|
Definition
Monitor:
Treat underlying cause
If fluid volume is low, IV
fluids may be ordered
Loop diuretics can
increase Na excretion
Low Na diet
*avoid processed foods |
|
|
Term
|
Definition
Monitor: CNS, GI, Skeletal-Muscular, Vital signs
Correct hyponatremia
slowly
Treat cause of salt loss
or water overload
Water restriction
Salt replacement: oral;
NS, LR, 3% NaCl
Diuretic |
|
|
Term
| Major INTRACELLULAR cation |
|
Definition
|
|
Term
|
Definition
| neuromuscular irritability |
|
|
Term
| What Maintains fluid volume within cell? |
|
Definition
|
|
Term
| How does K+ Maintain hydrogen (H+) concentration in the body? |
|
Definition
• With acidosis, H+ “hides” in the cell and “kicks
out” the K+ causing hyperkalemia
• With alkalosis H+ moves out of cell and K+
moves into cell causing hypokalemia. |
|
|
Term
| Hypokalemia (K+ < 3.5): Causes |
|
Definition
- Body Loss of K+
• Loss of GI secretions: vomiting/diarrhea;
NG suction; GI wound drainage
• Renal disease
- Inadequate Intake: NPO
- Movement of K+ from ECF to ICF
• Alkalosis
- Meds: Diuretics; chronic corticosteroids |
|
|
Term
Hypokalemia:
Assessment Findings |
|
Definition
Anxiety; confusion; coma
Lethargy, weakness
Numbness/tingling in hands or feet
Weak, thready pulse
Prominent U wave; dysrythmias
Weak, shallow resp.
Constipation; N/V |
|
|
Term
Hypokalemia:
Management you monitor? |
|
Definition
| CNS, MS, CV, Resp, GI, VS |
|
|
Term
|
Definition
| beef, avocado, potatoes, spinach, bananas, sweet potato, yogurt, acorn squash, white beans, prunes |
|
|
Term
| Oral Supplement has a ________ ______ and causes ____ _____. |
|
Definition
| unpleasant taste (mix with juice), GI upset |
|
|
Term
| When giving potassium in IV you must |
|
Definition
Always dilute! if more than
10 mEq/hr needs cardiac
monitor. Administer slowly! |
|
|
Term
| Hyperkalemia (K+ > 5): Causes |
|
Definition
Pseudohyperkalemia
Excessive intake of K+:
Decrease K+ Excretion: renal insufficiency
Movement of K+ from ICF to ECF:
• Acidosis; Insulin deficiency (messes with the Na/K+ pump)
Medication:
K+ sparing diuretics
ACE inhibitors |
|
|
Term
| Pseudohyperkalemia is caused by |
|
Definition
| has to do with how the blood is drawn technique causing cells to burst. |
|
|
Term
Hyperkalemia:
Assessment Findings |
|
Definition
Muscle twitching, cramps, paresthesias
Tall peaked T waves
Irregular heart rate (Ventricular
fibrillation)
Hypotension; bradycardia
Hyperactive bowel tones; diarrhea |
|
|
Term
| Hyperkalemia: Management you monitor? |
|
Definition
|
|
Term
|
Definition
K+ restricted diet
Diuretics
Kayexalate enema
IV glucose & insulin
IV calcium gluconate
Sodium Bicarbonate
Dialysis |
|
|
Term
| Calcium/Phosphorus has a __________ relationship? |
|
Definition
|
|
Term
| ___________ is the most abundant cation in the body. |
|
Definition
|
|
Term
| Calcium 99% is in the ______. |
|
Definition
|
|
Term
| 55% of blood calcium is bound to _______. |
|
Definition
|
|
Term
| Need albumin levels when interpreting serum |
|
Definition
|
|
Term
| What maintains serum Ca2+? |
|
Definition
| Parathyroid hormone (PTH) |
|
|
Term
| What promotes Ca+ absorption from GI tract? |
|
Definition
|
|
Term
| What inhibits Ca+ absorption from GI tract? |
|
Definition
|
|
Term
| ______ and_______ promote Ca+ return to bone |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Calcium is Essential for: |
|
Definition
• Transmission of nerve
impulses
• Contraction of skeletal,
smooth, and cardiac
muscles
• Maintains cell permeability
• Coagulation of blood
• Bone Mineralization |
|
|
Term
|
Definition
• Decreased intake
• PTH or
- Vit. D deficiency
• Hyperphosphatemia
• Pancreatic disease |
|
|
Term
| Assessment Findings Hypocalcemia |
|
Definition
• Anxiety; irritability
• Tetany; seizures
• Trousseau’s and
Chvostek’s sign
• Decreased HR, BP
• Diarrhea |
|
|
Term
|
Definition
Chovsteck”s Sign and Trousseau’s
Sign |
|
|
Term
|
Definition
- If mild, high calcium diet or
oral calcium salts
- Vit. D
- Aluminum Hydroxide
- Move patient carefully
- Seizure precautions
- If acute, treat with Calcium
Gluconate or Calcium Chloride IV |
|
|
Term
|
Definition
| spinach, collard greens, sardines, cheese, yogurt |
|
|
Term
|
Definition
• Excessive intake of Ca++, Vit. D
• Hyperparathyroidism
• Cancer
• Conditions that promote release of
Ca+ from bones: immobilization,
glucocorticoids |
|
|
Term
| Assessment Findings of Hypercalcemia |
|
Definition
• Confusion; coma
• Muscle
fatigue/weakness
• Bradycardia; cardiac
arrest
• Nausea;constipation
• Kidney stones |
|
|
Term
| Hypercalcemia: Management |
|
Definition
Treat underlying cause
Hydration with NS
Calcitonin (inhibits resorption
from bone)
Loop diuretics (enhances Ca+
excretion) |
|
|
Term
| Causes of Hypophosphatemia |
|
Definition
• Decreased absorption
• Increased excretion
• Intracellular shift |
|
|
Term
| What do you Assess with Hypophosphatemia? |
|
Definition
• Confusion; Seizures
• Decreased CO
• Muscle weakness
• Bleeding |
|
|
Term
| Management of Hypophosphatemia |
|
Definition
• DC antacids
• Administer phosphorus & Vit. D
• Increase foods high in phosphorous: |
|
|
Term
| Causes of Hyperphosphatemia |
|
Definition
• Increased intake
• Decreased excretion |
|
|
Term
| What do you Assess with Hyperphosphatemia? |
|
Definition
the same signs of hypocalcemia
• Anxiety; irritability
• Tetany; seizures
• Trousseau’s and
Chvostek’s sign
• Decreased HR, BP
• Diarrhea |
|
|
Term
| Management of Hyperphosphatemia |
|
Definition
• Phosphate-binding meds
• Avoid phosphate containing meds
• Low phosphate diet |
|
|
Term
| Magnesium is required for |
|
Definition
|
|
Term
| Magnesium is Important in |
|
Definition
- protein metabolism
- Plays a significant role in nerve cell conduction
-Important in transmitting CNS messages and maintaining neuromuscular activity
- Regulation of PTH secretion |
|
|
Term
|
Definition
• Insufficient intake
•Alcoholism
• Increased secretion
• Intracelluar shift |
|
|
Term
| With Hypomagnesemia you assess for |
|
Definition
• Confusion
• Neuromuscular excitability
• Dysrythmias |
|
|
Term
| Management of Hypomagnesemia |
|
Definition
• Restore K+ &/or Ca++ levels if low
• Give magnesium
• Foods high in magnesium |
|
|
Term
| Causes of Hypermagnesemia |
|
Definition
• Increased Intake
• Renal failure |
|
|
Term
| With Hypermagnesemia you assess for |
|
Definition
• Bradycardia, hypotension; cardiac arrest
• Decreased neuromuscular; coma
• Respiratory depression |
|
|
Term
| Management of Hypermagnesemia |
|
Definition
• Hydration &
diuretics
• IV calcium
• Avoid laxatives & antacids containing magnesium
• Restrict foods with magnesium |
|
|
Term
The concentration of hydrogen (H+) ions
determines the |
|
Definition
| acidity or alkalinity of body fluids |
|
|
Term
| Normal pH of body fluids is |
|
Definition
|
|
Term
| Mechanisms for regulating acid-base balance |
|
Definition
• Buffer system
• Bicarbonate-carbonic acid buffer system
• Phosphate buffer system
• Proteins
• Respiratory system
• Renal system |
|
|
Term
| Respiratory (Lungs) Control of Acid-Base Balance |
|
Definition
• Helps maintain acid-base through the control of carbon dioxide (CO2)
• Increased retention of CO2 in the blood results in acidosis
• Increased excretion of CO2 results in
alkalosis |
|
|
Term
Metabolic (Renal) Control of Acid-Base Balance
|
|
Definition
• Kidneys eliminate either hydrogen ions (H+) or bicarbonate ions (HCO3-)
• Retention of H+ results in acidosis
• Retention of HCO3- results in alkalosis |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
Four types of acid-base
imbalances by ABG analysis |
|
Definition
Respiratory Acidosis
Respiratory Alkalosis
Metabolic Acidosis
Metabolic Alkalosis |
|
|
Term
| What is Caused by retaining CO2? |
|
Definition
|
|
Term
| What is Caused by “blowing off” CO2? |
|
Definition
|
|
Term
| Caused by retaining too much H+ or excreting too much HCO3-? |
|
Definition
|
|
Term
| Caused by excreting too much H+ or retaining too much HCO3-? |
|
Definition
|
|
