325 e 2 pt 2 Flashcards
this is the amt of pressure required to stop the osmotic flow of water
osmotic pressure
this measures the water balance in the body
osmolality
this is the force within a fluid compartment and the major source that pushes water out of the vascular system at the cap level
hydrostatic pressure
the is the force of fluid in a compartment pushing against a CM or vessel wall
hydrostatic pressure
this is also called colloidal pressure
oncotic pressure
this is the osmotic pressure exerted by colloids in a solution
oncotic pressure
_____ is the major colloid in vascular system contributing to total osmotic pressure
protein
two thirds of body water is ______
ICF
the body fluids within the cell is ___
ICF
one third of body water
ECF
body fluids outside the CM
ECF
intravascuar, interstitial , and transcellular fluids
what ECF divides into
the plasma is the liquid part of blood and also called ____
intravascular fluid
this is located between the cells and outside of the BVs
interstitial fluid
this is CSF, pleural, peritoneal, and synovial fluids are all
transcellular body fluids
this has excess fluid volume
hypervolemia
this is excess of water and electrolytes
hypervolemia
sodium follows water, so when there is excess water, there is excess ___
Na
VS for what imbalance are tachycardia and bounding pulse with vascular overload?(which volemia?)
hypervolemia
this has hypertension, tachypnea, and increased ICP
hypervolemia
there is weakness and visual changes with this
hypervolemia
paresthesias and altered LOC and seizures belong to what?
hypervolemia
if you are hypovolemic and have a seizure, you will become suddenly ____ and have excess water
hyponatremic
you see ascites, liver enlargement and have increased motility
hypervolemia
you see crackles, cough and dyspnea
hypervolemia
you see peripheral edema, weight gain, and cool pallor skin
hypervolemia
you see increased urine output and distended neck veins
hypervolemia
you see dependent edema and pulm edema when severe
hypervolemia
you see anxiety, increased vein distension, and premature ventricular contractions
pulm edema
you see a changed LOC, restlessness, and lethargy
pulm edema
you see ascending crackles and cough with sputum
pulm edema
if someone has pulm edema, put the ct in ____ to maximze ventilation and give O2
high fowlers
if someone has pulm edema; get a ___ airway pressure, and intubate and do ventilation
pos
if someone has pulm edema; give ___, nitrates, and diuretics if BP is good
morphine
you want to tell the pt to consume low Na diet and restrict fluid intake with ____. if they have a history of heart disease and impaired kidneys
hypervolemia
tell the pt to weigh daily and R a 1-2 lb gain in 24 h and 3 lb in 1 wk if they have ____
hypervolemia
fluid restriction, labs, and chest xray are the collab interventions for
hypervolemia
what the purpose of the xray for hypervolemia?
reveal pulm congestion
given by provider, take strict I & O, pt education and pace liquids out are
the fluid restrictions for hypervolemia
swab cold water into mouth if you have
fluid restrictions for hypervolemia
you expect to find decreased Hct, Hb and blood osmolarity for
hypervolemia
you expect to see fluid excess, decreased urine Na and specific gravity and BUN(due to plamsa dilution) for
hypervolemia
you want to mon I and O, mon daily weight, and assess breath sounds with
hypervolemia
you want to mon peripheral edema, maintain Na and fluid restriction for
hypervolemia
you want to encourage rest, mon diuretic pts, and put pt in semifolwers or fowlers position for
hypervolemia
you want to reposition the pt to prevent breakdown in edematous skin, and assess bony prominences for
hypervolemia
you want to mon blood sodium and K levels for
hypervolemia
you want to have pulmonology to be consulted in fluid in the lungs if its
hypervolemia
you see sudden weight loss and skin tenting with
hypovolemia
you see dry MM, lightheadedness, and oliguria with
hypovolemia
you see vascular underload and flat neck veins when supine with
hypovolemia
you see rapid thready vascular pulse, postural BP drop with HR increase with
vascular underload
you see syncope and circulatory shock if severe with
hypovolemia
isotonic dehydration is also called
hypovolemia
this is a lack of water and electrolytes
hypovolemia
this causes a decrease in blood volume
hypovolemia
this is also called fluid volume deficit
hypovolemia
you see hyperthermia and tachycardia with
hypovolemia
you see a thready pulse and hypotension with
hypovolemia
you see postural hypotension and decreased central venous pressure with
hypovolemia
you see tachypnea and hypoxia with
hypovolemia
you see dizziness and syncope with
hypovolemia
you see confusion and weakness and fatigue with
hypovolemia
you see thirst and dry furrowed tongue with
hypovolemia
you see nausea and vomit with
hypovolemia
you see anorexia and acute weight loss with
hypovolemia
you see oliguria and diminished cap refill with
hypovolemia
you see cool clammy skin and diaphoresis with
hypovolemia
you see sunken eye balls with
hypovolemia
the effects of fluid imbalance in ____ is greater bc of loss of elesticity of skin
older folk
the effects of fluid imbalance in ____ is greater bc of decrease in GFR and the concentrating ability of kidneys
older folk
the effects of fluid imbalance in ____ is greater bc loss of muscle mass and diminished thirst reflex
older folk
with dehyrdration, you see elevated temp and if severe u can have a seizure with
hypovolemia
complications of hypovolemia are _____/___________ _____
hypovolemic/circulatory shock
drink fluids to hydrate and know signs of dehydration is the ct teaching with
hypovolemia
vomit and large draining wounds are signs of
dehydration
diarrhea or excessive ostomy losses are signs of
dehydration
giving fluid replacement as a collab intervention with
hypovolemia
with lab tests you see a Na level of above 145, blood osmolality GT 295 with dehydration/hypernatremia, and urine gravity above 1030 for ____
hypovolemia
with lab tests, you see Hct increased in _____and BUN increases above 25 with ____
hypovolemia
you collab with HCP to determine fluid volume replacement and O2 management with _____
hypovolemia
as a nurse, you give oral and IV therapy; mon I and O; mon BP and HR; and mon for mentation and confusion to see worsening fluid imbalance for _______
hypovolemia
as a nurse you: weight every 8 hours while in fluid therapy; assess gait stability; encourage the pt to roll from side to side or stand up slowly for ____
hypovolemia
This is GT 145
Hypernatremia
This happens when there is an increased sodium causes hypertonicity of the blood
Hypernatremia
This causes a shift of water out of the cells resulting in dehydrated cells
Hypernatremia
This can significant neurological, endocrine, and cardiac disturbances
Hypernatremia
This is an elevated serum sodium that may occur with water loss or sodium gain
Hypernatremia
Symptoms of this are dehydration and volume deficit
Hypernatremia
Symptoms of this are postural hypotension, weakness, and decreased skin tugor
Hypernatremia
This is treated by cause…with water deficits, volume is _____. If sodium excess, _____ is accomplished with sodium free IV fluids
Replaced; dilution
Hyperthermia and tachycardia and orthostatic hypotension are EF for what imbalance?
Hypernatremia
Restlessness, fatigue and disorientation are signs of
Hypernatremia
Irritability and muscle twitching are signs of
Hypernatremia
Seizures and decreased LOC and absent DTRs are signs of
Hypernatremia
Thirst and dry & sticky MM are signs of
Hypernatremia
Dry and swollen tongue that’s red in color and increased motility are signs of
Hypernatremia
Hyperactive bowel sounds, Ab cramping, and nausea are signs of
Hypernatremia
Edema, warm flushed skin and oliguria are signs of
Hypernatremia
Seizures and coma are EF of
Hypernatremia
Diarrhea and anorexia are EF of
Hypernatremia
Nausea and vomiting are EF of
Hypernatremia
Urine gravity and osmolality are ____ in hypernatremia
Increased
You want to weigh daily and have a low sodium diet and adhere to fluid intake as prescribed are ct teaching for
Hypernatremia
You want to mon LOC and ensure safety with what imbalance?
Hypernatremia
Provide oral hygiene and other comfort measures to decrease thirst when dealing with
Hypernatremia
Mon I and O and do low sodium diet with
Hypernatremia
You want to encourage oral fluids (more water, less sodium) when you look at ____
Hypernatremia
Give hypotonic and isotonic IV fluids with what imbalance?
Hypernatremia
Give diuretics if impaired kidney excretion is the cause of this imbalance. What’s the imbalance?
Hypernatremia
Mon LOC and ensure safety for
hypernatremia
Mon VS and heart rhythm and auscultate lung sounds for
hypernatremia
Do good oral hygiene, decrease thirst, and mon I and O with
hypernatremia
Dextrose 5% in 0.45% solution NaCl is a hypertonic solution to give a pt with
hypernatremia
0.3 % NaCl is a hypotonic solution and provides a gradual reduction in blood Na levels an ____ the risk for cerebral edema
Reduces
0.3% NaCl for a _____ pt is preferred
Hyperglycemic
D5W and 0.9% NaCl are ____ solutions
Isotonic
With excess sodium, encourage ____ intake and reduce sodium intake
Water
Give diuretics for pt with ___ kidney excretion
Poor
body fluids are too dilute in
hyponatremia
swollen cell causes impaired cerebral function and that is the basis for
hyponatremia
people ate risk for this imbalance often had a rapid infusion of D5W or too much water in a few hours
hyponatremia
ppl who secrete excessive ADH develop this imbalance
hyponatremia
water excess from sodium free or hypotonic fluids are the common cause of this
hyponatremia
symptoms are manifested in the CNS or PNS for hyponatremia?
CNS
if the hyponatremia is from water excess, you do ____ restriciton. if fluid loss, you want to ___ with sodium containing solutions
fluid; replace
this is a net gain of water or loss of sodium rich fluids
hyponatremia
this delays and slows the depolarization of membranes
hyponatremia
the water moves from the ECF to the ICF and causes the cell to swell with this imbalance
hyponatremia
kidney salt wasting can occur with ____use
diuretic
this is caused by fluid imbalance and results in sodium loss with
hyponatremia
there is impaired cerebral function which leads to decreased LOC, nausea, severe(seizure) in what imbalance?
hyponatremia
this is less than 130 levels of Na
hyponatremia
results from an excess of water in plasma or loss of sodium rich fluids
hyponatremia
this delays and slows the depolarization of membranes
hyponatremia
this is where water moves from ECF to ICF that causes cells to swell
hyponatremia
you see a varied level of ECF volume with
hyponatremia
you see hypothermia and tachycardia with
hyponatremia
you see rapid thready pulse and hypotension with
hyponatremia
Orthostatic hypotension and headache are seen with
Hyponatremia
You see confusion and lethargy with
Hyponatremia
You seee muscle weakness with respiratory compromise with
Hyponatremia
Fatigue and decreased DTRs are seen with
Hyponatremia
Seizures and coma are seen with
Hyponatremia
You see increased GI motility and hyperactive bowel sounds with
Hyponatremia
You see Ab cramps and anorexia with
Hyponatremia
You see nausea and vomit with
Hyponatremia
Bounding pulse with Hyponatremia when the pt is ____
Hypervolemic
With Hyponatremia the pt teaching is to ______
Weigh daily 1-2 overnight or 3 in wk; do high sodium diet
if the pt can tolerate fluids, give food and fluid to replace ___ with hyponatremia
sodium
encourage beef broth and _____ juice for a pt with hyponatremia
tomato
give what IV fluids for hyponatremia?
lactated ringers and 0.9% isotonic saline
if there is a rapid rise in sodium level there is risk of developing ____
neurological damage due to demyelination
if there is fluid overload, and the pt has hyponatremia, you want to _____ water intake
restrict
mon I and O and VS and LOC if the pt has
hyponatremia
for hyponatremia, call ___ for E and F replacement
nephrology
for oxygen management, you want to call respiratory services if the pt has
hyponatremia
if the pt with hyponatremia has muscle weakness, mon ____ status
respiratory
encourage cheese, milk and condiments if the pt has
hyponatremia
if______________ is severe, you give hypertonic oral and IV fluids
hyponatremia
this is elevated K levels
Hyperkalemia
the most common cause of ____ is renal failure
Hyperkalemia
this is common with massive cell destruction like tumor lysis and burn or crash injury
Hyperkalemia
this is common with rapid transfusion of blood and infections like catabolic states
Hyperkalemia
there is cardiac conduction disturbances with
Hyperkalemia
there is cramping leg pain and weakness of skeletal muscle ass with
Hyperkalemia
___% of K is within the cells
98
you want to mon the ECG of _____ pts to detect fatal dysrhymias and mon the therapy effects
Hyperkalemia
if there are cardiac dysrhythmia with Hyperkalemia you want to give them ____
IV Ca gluconate
this is the result of K leaving the cells
Hyperkalemia
the result of inadequate kidney excretion is
Hyperkalemia
there is an increased risk of cardiac arrest with
Hyperkalemia
there is a slow irregular pulse and hypotension with
Hyperkalemia
there is restlessness and irritability with
Hyperkalemia
there is flaccid paralysis and paresthesia with
Hyperkalemia
there is premature ventricular contractions and ventricular fibrillation with
Hyperkalemia
there is peaked T waves and diarrhea with
Hyperkalemia
there is increased GI motility and hyperactive bowel sounds with
Hyperkalemia
there is bilateral ascending flaccid muscle weakness and cardiac dysrhythmias with
Hyperkalemia
you want to keep in mind serving size and teach the consequences for
Hyperkalemia
restrict K rich foods if a pt has
Hyperkalemia
avoid salt substitutes if a pt has ____
Hyperkalemia
avoid metformin bc it can increase risk of _____ and avoid diuretics
Hyperkalemia
with ____, call nephrology if dialysis is needed
Hyperkalemia
with ___, cardiology can be consulted for dysrhythmias
Hyperkalemia
with ___, nutritional services can be consulted for food choices
Hyperkalemia
the ECG for imbalance will show this: peaked T waves, widened PR and QRS and you may see dysrhythmias and asystole
Hyperkalemia
do dialysis if ___ levels are high
K
give IV fluids with dextrose and regular insulin to promote the moving of K from ECF to ICF with what imbalance
Hyperkalemia
mon cardiac rhythm and maintain IV access for
Hyperkalemia
give Na polystyrene sulfonate if you have
Hyperkalemia
with Hyperkalemia , the nursing priority is to prevent ____
falls
with Hyperkalemia , assess muscle ____
weakness
observe GI manifestation like nausea and intestinal coli for
Hyperkalemia
mon for signs of hypokalemia while giving K ____ level meds
reducing
give Na bicarb to reverse ___
acidosis
dont give ___ blood to ppl with impaired kidney function
aged
avoid legumes, citrus, and whole grains if you have
Hyperkalemia
avoid lean meat, milk and eggs if you have
Hyperkalemia
avoid cocoa and cola if you have
Hyperkalemia
give apples, cranberries, and grapes to someone that has
Hyperkalemia
give canned peaches, and cranberry/grape juice if pt has
Hyperkalemia
give lettuce, cabbage, and cucumbers if pt has
Hyperkalemia
give green peppers, sweet onions and green peas if pt has
Hyperkalemia
give green beans if a pt has
Hyperkalemia
leach veggies to ___ K content
decrease
give refined grains to a ____ pt
Hyperkalemia
give tea, coffee and ginger ale to a ____ pt
Hyperkalemia
give root bear, applesauce, and angel food cake to A ___ PT
Hyperkalemia
give butter, margarine, and hard candy to a ____ pt
Hyperkalemia
give sugar and honey to a ___ pt
Hyperkalemia
Clients who have ____ kidney function and are taking potassium-conserving diuretics should not receive potassium replacement or salt substitutes
impaired
to increase K excretion, you want to give diuretics(furosmeide) and Na polystyrene sulfonate and Ca gluconate, and ____
albuterol
this is low K levels
hypokalemia
ppl at risk for hypokalemia are having ______ K output and not increased K input
increased
diarrhea, aldosterone excess, and K wasting diuretics ____ K output
increases
cortisol excess ___K output
increases
ppl at high risk for hypokalemia are ______ and _____
chronically low K intake; rapid shifts of K from ECF into cells
kidney and GI tract losses are the most common causes of
hypokalemia
you find bilateral ascending flaccid muscle weakness and ab distension with
hypokalemia
constipation and postural hypotension are findings of
hypokalemia
polyuria and cardiac dysrhythmias are findings of
hypokalemia
the level is below 3.5
hypokalemia
shallow respirations are findings of
hypokalemia
treat this by giving K Cl supplements and increasing dietary K
hypokalemia
the EG for hypokalemia will have: inverted/flat T waves, ST depression, and ___ U wave
elevated
this is bc of no K in the blood and it moving all to the cells
hypokalemia
you see decreased BP, thready weak pulse and orthostatic hypotension with
hypokalemia
there is an altered mental status and anxiety with
hypokalemia
there is lethargy that turns into acute confusion and coma with
hypokalemia
there is an prolonged PR interval with
hypokalemia
there is hyperactive bowel sounds and nausea with
hypokalemia
there is vomiting and constipation with
hypokalemia
there is ab distention and paralytic ileus with
hypokalemia
there is weakness, and DTR are reduced with
hypokalemia
you see bradycardia and blocks with
hypokalemia
you see ventricular tachycardia and anorexia with
hypokalemia
avoid use of diuretics and laxatives in excess with
hypokalemia
administer ___ replacement and don’t give K+ IM or SC
K
mon and maintain adequate urine output and observe breathe with
hypokalemia
mon cardiac rhythm and mon digoxin pts (increased toxicity) with
hypokalemia
mon LOC and maintain safety with
hypokalemia
mon bowel sounds and ab distension and O2(GT95%) with
hypokalemia
assess hand grasps for weakness and DTR and implement fall precautions with
hypokalemia
encourage broccolli and avocados with
hypokalemia
give dairy and dried fruit with
hypokalemia
give canteloupe and bananas with
hypokalemia
give juices, melons and lean meats for
hypokalemia
give milk, whole grains, and citrus for
hypokalemia
give salt substitutes and K meds for
hypokalemia
never give an IV __ with ____
bolus; hypokalemia
assess for phlebitis when on IV ___
K
the rate of K is never more than 10 Meq/hour with no more than 1 MeQ of K per ___ mL of solution
10
contact _____ for electrolyte and fluid management
nephrology
contact ____ for O2 management
respiratory services
contact ____ for dysrhythmias
cardiology
_____ ___ can be contacted for food choices
nutritional services
potatoes and spinach are high in ___
K
