Term
| How much of the body is comprised of water and what is the division of water weight in the body? |
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Definition
| The body is about 60% water. 35 to 40% is intracellular(within cells), 5% is extracellular (intravascular) fluid, and 10 to 15% is extracellular (insterstitial) fluid. |
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Term
| What is the standard formula for avg. fluid intake? |
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Definition
1)100mL/kg for the first 10kg of weight,plus
2)50mL/kg for the next 10kg of weight ,plus
3)15mL/kg per remaining kilograms of weight |
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Term
| What is the purpose of fluids, electrolytes, acids-bases in our bodies? |
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Definition
| To maintain or restore equilibrium in fluid volume |
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Term
| What mechanisms maintain normal fluid volume and electrolyte concentrations? |
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Definition
1)osmoreceptors
2)the renin-angiotensin-aldosterone system
3)atrial natriuretic peptide (ANP) |
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Term
| What role do osmoreceptors play in the regulation of fluid and electrolyte balance? |
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Definition
| osmoreceptors reside in the hypothalumus and regulate fluid volume by excretion of water and the promotion of thirst. They also sense serum osmolality and are sensitive to changes in blood volume and BP. Baroreceptors trigger the thirst response |
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Term
| What role does the renin-angiotensin-aldosterone system play in the regulation of fluid and electrolyte balance? |
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Definition
This is a chain reaction of chemicals that increases both BP and blood volume.It is triggered by the juxtaglomerular apparatus,a ring of pressure sensing cells that surround the arterioles leading to each glomerulus in the kidneys. Angiotensin II Raises BP via vasoconstriction
Aldosterone increases blood volume via sodium reabsorption |
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Term
| How is hypovolemia different from dehydration? |
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Definition
| With hypovolemia only the blood volume is low, in dehydration, all fluid compartments are effected by deficiency. |
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Term
| What is the pathophysiology and Etiology of hypovolemia? |
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Definition
1)Inadequate fluid intake
2)Fluid loss in excess of intake; 3)Translocation (as in third spacing) |
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Term
| What you expect to see in an assessment of a patient suspected of suffering from hypovolemia? |
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Definition
1)Thirst would be the earliest sign
2)Hemoconcentration
3)Concentrated urine(specific gravity is higher than normal)
4)Serum electrolyte levels normal because they are depleted in proportion to water loss |
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Term
| What is the medical management (treatment) for a hypovolemia patient? |
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Definition
1)Increasing oral intake volume
2)IV fluid replacement
3)Controlling fluid loss(Treat diarrhea/vomiting) |
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Term
| What nursing management should be followed for suspected hypovolemia? |
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Definition
Gather assessment data
Fluid deficit: Measures to restore balance
Teaching plan: Prevent hypovolemia |
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Term
What is the Pathophysiology and Etiology
of hypervolemia? |
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Definition
1)Fluid intake > fluid loss
2)Heart failure
3)Renal disease
4)Corticosteroid drugs
5)Fluid retention
6)Circulatory overload |
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Term
| What would an assessment yield typically for a hypervolemic patient? |
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Definition
1)Weight gain
2)Elevated BP
3)Dependent edema (Fluid migrates to areas of the body most effected by gravity)
4)Low blood cell count due to Hemo-dilution
5)Dilute urine |
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Term
| Medical management of hypervolemic patient entails? |
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Definition
1)Treat etiology
2)Monitor weight daily
3)Restrict fluids
4)Diuretics to increase urine output
5)Limit salt (sodium) intake |
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Term
| What could you expect to see in a third-spacing fluid imbalance? |
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Definition
| Fluid translocation to intracellular compartments where it is trapped & useless; Colloid loss |
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Term
| When we speak of electrolytes what are we talking about? |
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Definition
1)Ions (including Bicarbonate; Protein; Organic acids)
2)Extracellular fluid (more conc.): Sodium, Calcium; Chloride
3)Intracellular fluid (more conc.): Potassium; Magnesium; Phosphate |
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Term
| What are the electrolytes that are of most concern to us? |
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Definition
| Sodium, Potassium, Calcium, & Magnesium |
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Term
| What are the normal value ranges for Sodium, Potassium, Calcium, & Magnesium? |
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Definition
1) Sodium - 135 to 145mEq/L
2) Potassium - 3.5 to 5.2mEq/L
3) Calcium - 9 to 11mg/dL
4) Magnesium - 1.3 to 2.1mEq/L |
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Term
| What would an assessment yield in which 3rd spacing was suspected? |
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Definition
1)Hypovolemia symptoms [Thirst, urine concentration, hemoconcentration (except weigh loss)]
2)Ascites - enlargement of organ cavities if they fill with fluid
3)Generalized edema in all interstitial spaces (brawny edema) |
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Term
| How would you medically manage third spacing? |
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Definition
Restore circulatory volume and eliminate trapped fluid by;
1) IV solutions
2)Blood products & albumin to draw fluid back into the intravascular space
3)IV diuretic to reduce the potential for circulatory overload |
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Term
| Hyponatremia assessment findings? |
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Definition
| Mental confusion; Elevated body temp; Tachycardia; N/V; Personality changes; Coma |
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Term
| Medical management of Hyponatremia? |
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Definition
| Treat underlying cause; Sodium administration via high sodium food, water w/added salt, salt tablets, or if severe IV solutions containing sodium chloride |
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Term
| Hypernatremia assessment findings? |
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Definition
| Dry, sticky mucous membranes; Decreased urine output; Fever; Lethargy |
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Term
| Medical management of Hypernatremia? |
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Definition
Treat underlying cause; Restrict sodium
Treatment depends on the cause and includes oral administration of plain water or IV administration of a hypo-tonic solution,such as 0.45% sodium chloride or 5% dextrose |
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Term
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Definition
1)Potassium-wasting diuretics
2)Loss of fluid from the GI tract (vomiting/diarrhea, GI suctioning)
3)Large corticosteroid doses |
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Term
| What would an assessment of a hypokalemic patient reveal? |
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Definition
| Fatigue; N/V; Cardiac dysrhythmias; Paresthesias; Leg cramps |
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Term
| Medical management of Hypokalemia |
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Definition
Treat underlying cause; Potassium sparing diuretic substitution
1)Potassium-rich foods
2)Oral potassium supplement |
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Term
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Definition
1)Severe renal failure
2)Severe burns
3)Overuse of potassium supplements 4)Potassium-sparing diuretics
5)Addison’s disease |
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Term
| Assessment findings on a Hyperkalemic patient? |
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Definition
| Diarrhea, Nausea; Muscle weakness; Paresthesias; Cardiac dysrhythmias |
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Term
| Medical Management of Hyperkalemia? |
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Definition
Treatment dependent on cause, severity: Decrease potassium-rich foods; Kayexalate (cation exchange resin)
IV-insulin; Peritoneal dialysis; Hemodialysis |
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Term
| Nursing management for Potassium imbalances? |
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Definition
1)Assess potassium imbalances
2)Monitor: Laboratory findings - serum potassium
3)Consults with the physician
4)Prolonged IV fluid therapy without added potassium
5)Client education
6)Potassium-excreting medications
7)Food sources: Vegetables, dried peas and beans, wheat bran, bananas, oranges (and juice), melon, prune juice, potatoes, milk
8)Supplements |
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Term
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Definition
Vitamin D deficiency; 1)Hypoparathyroidism
2)Severe burns
3)Acute pancreatitis
4)Corticosteroids |
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Term
| Hypocalcemia assessment findings? |
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Definition
Tingling in extremities, around mouth; 1)Abdominal and muscle cramps 2)Trousseau’s sign
3)Mental changes
4)Positive Chvostek’s sign
5)Tetany |
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Term
| Medical Management of hypocalcemia? |
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Definition
Mild: Oral calcium, Vitamin D
Severe: Calcium salt (IV) |
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Term
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Definition
1)Parathyroid gland tumors
2)Paget’s disease
3)Hyperparathyroidism
4)Chemotherapeutic agents
5)Specific malignancies
6)Prolonged immobilization |
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Term
| Assessment Findings for hypercalcemia? |
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Definition
| Polyuria; Constipation; N/V; Thirst; Mental changes |
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Term
| Medical management of hypercalcemia? |
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Definition
Treat underlying cause when possible; 1)Increase oral fluid intake
2)Limit calcium consumption |
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Term
| Causes of Hypomagnesemia? |
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Definition
1)Excessive diuresis
2)Prolonged gastric suction
3)Chronic alcoholism
4)Severe burns and renal disease |
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Term
| What typically would be expected in an assessment of a patient suspected of suffering from Hypomagnesemia? |
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Definition
1)Cardiac dysrhythmias
2)Paresthesias
3)Leg and foot cramps
4)Hypertension
5)Mental changes
6)Positive Chvostek’s
7)Trousseau’s signs |
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Term
| Medical management of Hypomagnesemia? |
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Definition
| Dietary (magnesium rich foods); Severe: Magnesium sulfate (IV) |
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Term
| Causes of Hypermagnesemia? |
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Definition
| Renal failure; Excessive antacid or laxative use |
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Term
| What typically would be expected in an assessment of a patient suspected of suffering from Hypermagnesemia? |
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Definition
| Flushing, warmth; Hypotension; Lethargy; Bradycardia; Depressed respirations; Coma |
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Term
| Medical management of Hypermagnesemia? |
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Definition
| Decrease magnesium intake; Discontinue parenteral replacement; Hemodialysis |
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Term
| Nursing Management for Magnesium Imbalances? |
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Definition
Monitor vital signs closely
Client education |
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