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_NS 124 > Ch. 10 Fluids & Electrolytes > Flashcards

Ch. 10 Fluids & Electrolytes Flashcards

1
Q

The three spaces in the body where fluid is found

A

1 – intracellular
2 – extracellular
3 - trans cellular - “3rd space”

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2
Q

Where is MOST water in the body found (which space)

A

Intracellular space

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3
Q

Outcome of too much intracellular water

A

+ Pulmonary edema
+ heart failure

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4
Q

Outcome of too little water in the intracellular space

A

+ Low blood pressure
+ shock / hypovolemic shock

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5
Q

Where is extracellular water/body fluid located – two spaces

A

+ Intravascular
+ interstitial

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6
Q

Examples of trans cellular “third space syndrome”

A

+ Lymphatic edema
+ pleural effusion
+ ascites (peritoneal area)
+ synovial effusion - swelling, bleeding
+ pericarditis
+ hydrocephalus
+ glaucoma
+ hematuria
+ SBO, IBS

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7
Q

Area where least amount of body fluid/water is found

A

Transcellular space.

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8
Q

Normal range for sodium - Na

A

135-145mEq/L

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9
Q

Normal range for K - potassium

A

3.5-5

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10
Q

Normal range for chloride - Cl

A

95-105

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11
Q

Normal range for calcium - Ca

A

9-11

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12
Q

Types of IV fluids (crystalloid)

A

+ Normal saline – isotonic
+ lactated ringer – isotonic
+ D5W - 5% dextrose

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13
Q

Purpose of giving normal saline - IV

A

+ Hydration
+ electrolyte imbalance

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14
Q

Purpose for giving lactated ringers

A

+ pts. w/low blood volume & low blood pressure
+ replace water and electrolytes

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15
Q

Purpose for D5W IV

A

+ Replace water
+ replace carbohydrates

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16
Q

What determines amount of IV fluids (3 things)

A

+ Rate of metabolism
+ weight
+ body surface area

17
Q

Two types of fluid loss in the body

A

+ Normal loss — urine, respiration, sweat, feces, normal electrolyte losses,
+ pathological loss — vomiting, diarrhea, third-spacing

18
Q

Isotonic vs. hypotonic vs. hypertonic

A

+ ISOTONIC: has equal fluid/salts (solutes) as blood ➡️ cell stays same size
+ HYPOTONIC: has LOWER salt (solutes) to fluid ratio than blood ➡️ cell SWELLS
+ HYPERTONIC: has HIGHER salts (solutes) to fluid ratio than blood ➡️ cell SHRINKS

19
Q

Difference between acidosis and alkalosis

A

+ Acidosis is low pH in body
+ alkalosis is high pH in body

20
Q

Difference between metabolic and respiratory acidosis/alkalosis

A

+ MEtabolic acidosis/alkalosis: both pH & CO2 are in saME direction - high or low - ⬆️⬆️, ⬇️⬇️
+ REspiratory acidosis/alkalosis: pH & CO2 are in REverse directions ⬆️⬇️

21
Q

What is hypovolemia?

A

Volume depletion of liquid portion of blood – plasma

22
Q

What causes hypovolemia?

A

Loss of body fluids & electrolytes occurs more rapidly than fluid intake = Fluid Volume Deficit (FVD)
+ Vomiting
+ diarrhea
+ blood loss
+ third-space shifts
+ gastric suctioning
+ excessive sweating
+ burns, ascities

23
Q

Physical assessment for hypovolemia

A

+ Orthostatic hypotension
+ tachycardia
+ organ dysfunction
+ thirst, dry oral mucosa
+ skin turgor
+ cold extremities
+ change in LOC
+ palor
+ GERI PT: altered mental status, poor perfusion of hands/feet veins, *skin turgor not good assessment for them

24
Q

Labs to test for hypovolemia

A

+ Urinary output
+ urine specific gravity
+ oliguria (< 300ml/daily urine) — should be ~30ml/kg/hr
+ lactic acid
+ Na & K levels can be HYPO or HYPER!!
+ BUN/Cr > 20:1 — SHOULD be 10:1 — ***BUN alone NOT optimal gauge of kidney fnct! (TEST QUEST!!)
+ hematocrit
+ ⬇️ central venous pressure

25
Q

Treatment for hypovolemia

A

+ fluid resuscitation: LS, NS — **NOT D5 due to sugar!!!
+ IV bolus may be given in some situations
+ blood trans. for active bleeding — NS ONLY solution given with blood

26
Q

***What is the only solution that can be given with blood?

A

Normal Saline IV – NS

27
Q

What is hypervolemia?

A

Fluid volume excess – SVE
+ Abnormal retention of water and sodium —expansion of extracellular fluid

28
Q

Physical assessment for hypervolemia

A

+ Acute weight gain
+ peripheral edema, ascites
+ DJ V – distended jugular veins
+ Crackles, shortness of breath, elevated respiratory rate, cough
+ high blood pressure, bounding pulse
+ ⬆️ urine output
+ ⬆️ CVP - central venous pressure

29
Q

Labs to test for hypervolemia

A

+ Decreased, hemoglobin, and hematocrit
+ Decreased serum and urine osmolality
+ decreased urine sodium in specific gravity
+ serum sodium concentration is usually normal 

30
Q

Treatment for hypervolemia

A

+ Treat the causes
+ diuretics – loop, thiazide, potassium, sparing
+ fluid and Na restrictions

31
Q

Nursing considerations for hypo and hypervolemia

A

+ Monitor daily bodyweight
+ monitor fluid volume
+ acute loss of 0.5 kg/1.1lb = fluid loss of approximately 500 mL

_NS 124 (4 decks)

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