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#4 Flashcards

1
Q

FVD

A

the loss of extracellular fluid from the body > intake

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2
Q

Causes of FVD

A

Abnormal fluid loss
Decreased intake
Third-space fluid shifts

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3
Q

FVD S/S

A 
Acute weight loss
Concentrated urine
Weakness
Confusion
Thirst
Nausea
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4
Q

FVD Labs

A

Increased H+H
Increased BUN + Cr
Decrease Na
Increased SG

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5
Q

FVD Nursing Management

A 
I+O
Daily weight
Vitals
Skin turgor
Mental status
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6
Q

FVD Medical Management

A

Replace fluid PO if possible
Isotonic electrolytes
Hypotonic if normotensive
Rate of admin depends on severity

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7
Q

0.9% Saline

A

Excess Na / Cl
Given w/ blood
Not maintenance

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8
Q

LR

A

Multiple electrolytes

Not w/ CKD or AKI

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9
Q

FVD Complications

A

Hypovolemic Shock - Insufficient blood volume to pumo

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10
Q

Hypovolemic Shock Tx

A

O2
Fluid replacement
Admin vasoconstrictors, coronary vasodilators

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11
Q

FVE

A

hypervolemia, refers to an isotonic expansion of the ECF due to an increase in total body sodium content and an increase in total body water

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12
Q

Causes of FVE

A

Fluid overload
HF, Kidney Failure, Liver Cirrhosis
Excess Na

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13
Q

FVE S/S

A 
Acute weight gain
Distended neck veins
Crackles
Peri edema
SOB
HTN
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14
Q

FVE Labs

A

Decreased BUN
Decreased H+H
Increase Na
CXR

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15
Q

FVE Meds

A

Diuretics or Dialysis

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16
Q

FVE Nursing Management

A 
I & O
Daily weights
Monitor response to medications
Promote adherence to fluid restriction
Avoid sources of excessive sodium
Promote rest
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17
Q

Hydrostatic Pressure

A

exerted on walls of blood vessels

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18
Q

Osmotic Pressure

A

exerted by protein in plasma

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19
Q

Osmosis

A

area of low solute concentration to area of high solute concentration

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20
Q

Diffusion

A

solutes move from area of higher concentration to one of lower concentration

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21
Q

Filtration

A

movement of water, solutes occurs from area of high hydrostatic pressure to area of low hydrostatic pressure

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22
Q

Active Transport

A

Na/K Pump

Maintains gradient of high intra K, extra Na

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23
Q

Sodium

A

Most abundant electrolyte in ECF
Controls H2O distribution through body
135-145mEq/L
Muscle contraction, nerves

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24
Q

Hyponatremia

A

Na deficit <136
Low urine sodium occurs when kidneys retain sodium
High urine sodium is associated with diuretics

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25
Q

Hypernatremia

A

Na excess >145

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26
Q

Hypernatremia S/S

A

a. Edema
b. Warm, flushed skin
c. Oliguria
d. Tachycardia
e. Extreme thirst
f. Orthostatic hypotension

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27
Q

Potassium

A

Major intracellular electrolyte

3.5-50mEq/L

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28
Q

Hypokalemia Cause

A

Medications
Vomiting, diarrhea
Inadequate diet

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29
Q

Hypokalemia S/S

A

a. ECG changes
c. Dilute urine
d. Excessive thirst
e. Fatigue
f. Anorexia

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30
Q

Hypokalemia Nursing Management

A

a. Replace lost potassium
b. Monitor ECG for changes
c. Monitor adequate urine output
d. Monitor level of consciousness
e. Maintain safe environment

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31
Q

Hyperkalemia

A

a. Seldom occurs in patients with normal renal function
b. Increased risk in older population
c. Cardiac arrest is frequently associated

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32
Q

Hyperkalemia Causes

A

a. Decreased renal excretion of potassium
b. Rapid administration of potassium
c. Untreated kidney disease
d. Medications

33
Q

Hyperkalemia S/S

A

a. Slow, irregular pulse
b. Cardiac changes
c. Muscle weakness
d. Anxiety
e. Nausea, vomiting, diarrhea

34
Q

Calcium

A

Regulates muscle contractions and relaxation

8.6-10.2mg/dL

35
Q

Hypocalcemia

A

Patients can have low body calcium level but a normal serum calcium level

36
Q

Causes of Hypocalcemia

A

a. Hypoparathyroidism
b. End stage kidney disease (ESKD)
c. Pancreatitis
d. Renal failure
e. Medications

37
Q

Hypocalcemia S/S

A

a. Tetany
b. Chvostek’s sign
c. Trousseau’s sign
d. Seizures
e. Osteoporosis

38
Q

Hypocalcemia Management

A

a. Life threatening
b. IV of calcium gluconate
c. Seizure precautions
d. Oral calcium and vitamin D supplements
e. Exercises to decrease bone calcium loss
f. Patient teaching related to diet and medications

39
Q

Hypercalcemia Characteristics

A

50% fatal

40
Q

Hypercalcemia Causes

A

a. Malignancies
b. Hyperparathyroidism
c. Bone loss
d. Diuretics

41
Q

Hypercalcemia S/S

A

a. Symptoms are proportioned to the degree of elevation
b. Severe thirst
c. Polyuria
d. Muscle weakness
e. Nausea

42
Q

Hypercalcemia Management

A

a. IV 0.9% sodium chloride
b. IV phosphate
c. Furosemide
d. Calcitonin
e. Increase mobility
f. Encourage fluids
g. Dietary teaching

43
Q

Magnesium

A

Plays a role in carbohydrate and protein metabolism
1.3-2.3
Important in neuromuscular function
Affects the cardiovascular system

44
Q

Hypomagnesemia

A

Associated with hypokalemia and hypocalcemia

45
Q

Hypomagnesemia Causes

A

a. Alcoholism
b. GI losses
c. Malnutrition
d. Medications

46
Q

Hypomagnesemia S/S

A

a. Chvostek and Trousseau signs
b. Hypoactive bowel sounds
c. Depression
d. Constipation
e. Muscle weakness
f. Tremors

47
Q

Hypermagnesemia

A

a. Rare electrolyte abnormality

b. Risk of false positive serum magnesium level

48
Q

Hypermagnesemia Causes

A

a. Kidney injury
b. Untreated DKA
c. Excessive administration of magnesium
d. Extensive soft tissue injury

49
Q

Hypermagnesemia S/S

A

a. Hypotension
b. Muscle weakness
c. Hypoactive reflexes
d. Drowsiness
e. ECG changes
f. Depressed respirations

50
Q

Hypermagnesemia Management

A

a. Avoid administration to patients with kidney injury
b. IV calcium gluconate
c. Hemodialysis
d. Loop diuretics (furosemide), sodium chloride, LR
e. Monitor vital signs
f. Observe deep tendon reflexes (DTR)

51
Q

Phosphorus

A

Essential to function of muscles and RBC

Helps with metabolism of carbohydrates, protein, and fat

52
Q

Hypophosphatemia Lab

A

< 2.5mg/dL

53
Q

Hypophosphatemia Causes

A

a. Alcoholism
b. Pain
c. Major burns
d. Use of diuretics and antacids

54
Q

Hypophosphatemia S/S

A

a. Confusion
b. Muscle weakness
c. Seizures
d. Muscle and bone pain
e. Increased susceptibility to infection

55
Q

Hypophosphatemia Tx

A

a. IV phosphorous replacement
1. limited for patients with phosphorous level less than
1mg/dL; GI tract not functioning
2. tetany from hypocalcemia and calcifications in tissues
b. Oral replacement can be given in less acute situations

56
Q

Hyperphosphatemia

A

Serum > 4.5mg/dL

57
Q

Hyperphosphatemia Causes

A

a. Kidney injury
b. Excess phosphorous
c. Excess vitamin D
d. Hypoparathyroidism
e. Chemotherapy

58
Q

Hyperphosphatemia S/S

A

a. Tetany
b. Tachycardia
c. Anorexia
d. Muscle weakness
e. Soft-tissue calcifications

59
Q

Hyperphosphatemia Medical Management

A

a. Treat underlying disorder
b. Vitamin D preparations
c. Calcium binding antacids
d. Loop diuretics
e. Normal saline IV
f. Dialysis

60
Q

Chloride

A

Major anion of ECF

Produced in stomach

61
Q

Chloride Lab

A

97-107mEq/L

62
Q

Hypochloremia

A

a. GI tube drainage
b. Gastric suctioning
c. Gastric surgery
d. Severe vomiting and diarrhea
e. Excessive sweating
f. Burns

63
Q

Hypochloremia Medical Management

A

a. Replace chloride with either normal saline (0.9% sodium chloride or half-strength saline (o.45% sodium chloride)
b. Diuretics may be discontinued or changed to a different diuretic

64
Q

Hypochloremia Nursing Management

A

a. I & O’s
b. Arterial blood gases
c. Electrolyte levels
d. LOC
e. Changes in muscle strength
f. Vital signs
g. Respiratory assessment

65
Q

Hyperchloremia Causes

A

a. Excess sodium chloride infusions
b. Head injury
c. Hypernatremia
d. Dehydration
e. Severe diarrhea

66
Q

Hyperchloremia Medical Management

A

a. Restore electrolyte and fluid balance
b. Lactated Ringer solution
c. Diuretics
d. Restriction of sodium, chloride, and fluids

67
Q

Metabolic Acidosis Causes

A

Kidney failure, starvation, hypoxia, seizures, dehydration

68
Q

Metabolic Acidosis S/S

A

a. Bradycardia, hypotension
b. Dysrhythmias
c. Confusion, muscle weakness
d. Warm, dry, flushed skin

69
Q

Metabolic Alkalosis

A

Ingestion of antacids, blood transfusions, prolonged vomiting, potassium depletion (thiazide diuretics, laxatives)

70
Q

Metabolic Alkalosis S/S

A

a. Hypotensive, tachycardia
b. Dysrhythmias
c. Numbness, tetany, confusion, convulsion, muscle weakness
d. Ineffective breathing

71
Q

Respiratory Acidosis

A

Results in hypoventilation

Poisons, anesthetics, hemothorax, asthma, pulmonary embolus

72
Q

Respiratory Acidosis S/S

A

a. Tachycardia
b. Dysrhythmias
c. Anxiety, irritability, confusion
d. Shallow, rapid breathing
e. Pale or cyanotic skin

73
Q

Respiratory Alkalosis

A

Results in hyperventilation

Fear, anxiety, shock, early-stage asthma or pneumonia

74
Q

Respiratory Alkalosis S/S

A

a. Tachypnea
b. Tingling, numbness
c. Palpitations, chest pain
d. Rapid, deep respirations

75
Q

ABG Labs

A 
pH 7.35-7.45
PaCO2 35-45 mm Hg
HCO3 22-26 mEq/L
PaO2 80-100 mm Hg
Oxygen saturation > 94%
Base Excess/deficit (+) or (-) 2 mEq/L
76
Q

pH

A

a. If pH less than 7.35, diagnosis is acidosis

b. If pH greater than 7.35, diagnosis is alkalosis

77
Q

CO2 / HCO3

A

c. Less than 35 or greater than 45 PaCO2, respiratory

d. Less than 22 or greater than 26 HCO3, metabolic

78
Q

Third Spacing

A

Movement of blood from intravascular space into interstitial “third space”

130 (6 decks)

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