Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Fundamentals > Ch 40: Fluid and electrolytes > Flashcards

Ch 40: Fluid and electrolytes Flashcards

1
Q

fluid and electrolytes are involved in almost every what

What is the # 1 indicator of fluid retention

A

Fluid and electrolytes involved in almost every cellular reaction and function

1 indicator of fluid attention = weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most important nutrient in the body

What are the primary functions of water

  • transport (5)
  • facilitate what
  • act as a what for who
  • what is maintained
  • body processes (2)
A

Water = most important nutrient in body

Transport nutrients and waste ,hormones, enzymes, blood

Facilitate cellular metabolism and proper chemical functioning

Act a solvent for (non)electrolytes

Maintain body temperature

Digestion and elimination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Give the body fluid compartments (ICF/ECF)

-give exact locations for ECF

A

ICF(in cells): 70% (2/3) 40%

ECF (outside cell): 30% (1/3) 20%

  • intravascular (plasma) 5%
  • interstitial (tissue and lymph) 10-15%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Variations in fluid Content

healthy person water distribution

What factors determine water distribution (three)

How does fluid Content vary in an infant
-what are they more prone to

What do women and obese people have less of and why
-what is lean tissue rich in

A

Healthy person: 50 to 60% total body weight = water

Factors that determine water distribution:

  • persons age
  • body fat
  • sex

infants have more body fluid and ECF v adult
-infants more prone to fluid volume deficit

Women and those obese have less body water/more body fat
-lean tissue (muscle) is rich in water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is fluid intake primarily regulated by where is it located
-what is it stimulated by

Define dehydration

Define hypovolemia

What is the desirable amount of water / day
what is average amount of water per day

A
  • Fluid intake regulated by thirst mechanism
  • located in the hypothalamus
  • stimulated by dehydration

Dehydration: lost/deprivation of water in body

Hypovolemia: loss of water + loss of electrolytes

Desirable: 1500 to 3500 mL/day
average 2600 mL/ day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the average fluid output per day

What do you want between your I&O’s and what comes about if there’s a deviation

Through losses: give your insensible end sensible losses

A

average fluid output: 2500 to 2900 mL per day

I&Os should be balanced if there’s a deviation there’s a concern about imbalance

Insensible losses: non-measurable through skin and respiration

Sensible losses: miserable: pee, poop, exudate 

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the different sources of water comes from

A

Water sources:

  1. liquid
    • greatest provider
  2. Food
    • Second largest
  3. Metabolism byproducts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Define Electrolytes
Define ions
name for positive and negative ions 

Give the ECF ions
give the ICF ions

What does mill equivalents describe

A

Electrolytes: substance that can break into particles called ions

Ions: Atom or molecule caring electrical charge
(+) cation
(-): anion

What ions are mostly found ECF
-Na, Cl, Ca, bicarb

what ions are mostly found ICF
- K, phosphorus, Mg

mEq describes chemical activity “ Chemical combining power”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are fluid and electrolyte balance is maintained by

What is the shifting(aka what) regulated by (4)

Define solvents
Define solutes

what is almost every organ and system in the body help to

A

Fluid and electrolyte balance are maintained by shifting fluids and solutes between ECF and ICF

Shifting (transport) regulated by:

  • osmosis
  • diffusion
  • active transport
  • capillary filtration

Solvents: fluid that holds substance (H2O)

Salute: substance dissolved in water
((Non) electrolytes)

Almost every organ and system in the body helps maintain fluid homeostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What characters about cell membranes allow solutes to pass through the cell

What is the heaviest relied route for transport

What is the process of osmosis
-Ultimate goal?

Define osmolarity

A

So membranes are semi permeable that allow solutes to pass through cell membrane

Osmosis is the heaviest relied on route for transport

Osmosis: movement of water from an area of less solutes to more solutes
•EQUILIBRIUM

Osmolarity: concentration


How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

For modes transportation of fluid

define osmosis

define diffusion

define active transport
-against what

define capillary filtration
-what does it need

A

Osmosis:
-moving a water from area of ⬇️ solutes to ⬆️ solutes
•EQUILIBRIUM

Diffusion:

  • freely movement of solutes through a solvent
  • ⬆️ to ⬇️ conc until equilibrium

Active transport: NEEDS ENERGY!!!🔋
-movement from ⬇️ solute concentration to ⬆️ solute concentration v concentration gradient

Capillary filtration: fluid through permeable membrane from higher to lower pressure
•NEEDS
-colloid osmotic pressure: pushing force
-hydrostatic static pressure: pulling force


How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Isotonic solution
-what does it have the same concentration of
•give the numerical number

-give Fluid examples 

 hypertonic solution

  • what is the concentration
  • give Fluid examples

Hypotonic solution

  • what is a concentration
  • give fluid examples



A 
Isotonic solution = concentration of plasma
• 275 to 295 mmol per deciliter
-D5W
-NS
-LR

 hypertonic (shrink) solution: greater concentration V plasma

  • 3% NaCl
  • D5NS
  • TPN

Hypotonic (swell) solution: less concentration V plasma
-0. 33% NS
-0.45% NS


How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Give your normal values

Na
K
Ca
Mg
 phosphorus 
Cl
A 
Na : 135 to 145 mEq/ L
K   : 3.5 to 5 mEq/L
Ca : 8 to 10 mg/dL
Mg:  1.3 to 2.3 mEq / L
Cl: 97 to 107 mEq per liter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Sodium

Normal levels

Causes of hypo/hyper natremia

Greatest manifestations hypo/hyper Natremia

Treatments for hypo/hyper natremia

A

Sodium: Na

Normal: 135 to 145 mEq/L

 Hypo natremia:
• causes
    -diuretics( sodium loss or water gain)
• manifestations: 
   -confusion 
   -cerebral edema 
    -seizures
•Treatment:
   -hypertonic oral and IV solutions
   -Salt
Hypernatremia:
•causes
   -fluid deprivation
• manifestations
   -thirst
   -decrease LOC/disoriented
   -SZ
• treatment:
-water intake 
-low sodium 
-diuretics



How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Potassium

Normal levels

Causes of hypo/hyper Kalemia

Greatest manifestations hypo/hyper Kalemia

Treatments for hypo/hyper Kalemia

A

Potassium: K

Normal: 3.5 to 5mEq/L

Hypokalemia
•Causes
-vomiting
-gastric suctioning
•Manifestations
! Cardiac dysrhythmias! 
-*Muscle weakness
-*leg cramps
•Treatment
-Foods high in potassium
-slow IV push
Hyper kalemia
•causes
-Renal failure
•Manifestations
! Cardiac dysrhythmias!
-Muscle weakness/nausea
•Treatment
-Loop diuretics
-Sodium polystyrene sulfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Calcium


Normal levels

Causes of hypo/hyper Calcemia

Greatest manifestations hypo/hyper calcemia

Treatments for hypo/hyper calcemia

A

Calcium: Ca

8 to 10 mg/dL

Hypocalcemia
•Causes
-Inadequate intake
•Manifestations
-Numbness tingling 
-cramps
•Treatment
-Calcium Food/IV 
-Vitamin D supplements
Hypercalcemia:
•Causes
-Hyper parathyroidism
•Manifestations
-lethargy/confusion
-Increased risk for kidney stones
-n/v
•Treatment
-Calcium restriction
-Increase fluids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

 Magnesium

Normal levels

Causes of hypo/hyper Magnesemia

Greatest manifestations hypo/hyper Magnesemia

Treatments for hypo/hyper Magnesemia

A

Magnesium: MG

1.3 to 2.3 mEq per liter

Hypomagnesemia
•Causes
-NG section 
-alcohol
•Manifestations
-Muscle weakness
-HYPERactive DTR
•Treatment
-Foods high in magnesium/IV
Hyper Magnesemia 
•Causes:
-Renal failure
•Manifestations
-Lethargy
-LOSS OF DTR
•Treatment
-Loop diuretics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

If calcium increases what has an inverse relationship

If potassium decreases what else decreases

A

If calcium ⬆️ phosphorous will ⬇️ and vice versa

If potassium ⬇️ chloride ⬇️

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why must your body maintain the acid base balance (3)

What are a few things that can alter the acid balance

 what does acid contain that can be shared or released

What can bases do what is an example of a base 



A

Your body must maintain the acid base balance to sustain

  • health
  • homeostasis
  • life

Conditions like infection and trauma can alter acid base balance

Acid contains hydrogen + they can be liberated or released

Alkali (base) A substance that can accept or trap H+ such as bicarb ions

20
Q

What is a buffer (what does it prevent)
-how does it prevent it

What are buffer systems that help with the acid-base imbalance


A

Buffer:

  • substance that prevents body fluids from becoming overly acidic or alkaline
  • combines with excess acid/base to prevent major pH changes
Buffer system:
* carbonic acid sodium bicarbonate
- phosphate 
-protein
• respiratory/renal mechanism
21
Q

When do acid-base imbalances occur

Metabolic imbalances

-occur as a result of what (disturbance in what level)

How do the lungs and kidneys compensate


A

Acid-base imbalances occur when carbonic acid or bicarb levels become disproportionate

Metabolic imbalance is occur from a disturbance in the bicarb level in the ECF

Lungs and kidneys compensate by excreting or retaining CO2 (Lungs) or bicarb and hydrogen ions (Kidneys)

22
Q

Metabolic acidosis

What causes metabolic acidosis

How does a body respond

What causes metabolic acidosis

How does a body respond

A

Metabolic acidosis

By
-excessive loss of bicarb⬇️ or +in H+

Bodies response
- lungs excrete CO2 by TACHYPNEA 

Metabolic alkalosis

By:
-excessive acid loss

body‘s response
-body retains CO2 with BRAYDYPNEA
• slow and shallow may have periods of apnea

23
Q

Why do respiratory in balances occur and what does it alter

How does a body compensate for respiratory disturbances

A

Respiratory in balances as a result of respiratory disturbances

Respiratory imbalances altar CO2 and carbonic acid in the ECF

Body compensates for respiratory disturbances by

  • lung retaining or eliminating CO2
  • can you try to restore balance with formation or excretion of bicarb
24
Q

What is respiratory acidosis caused by

What is a body‘s response to respiratory acidosis



What is respiratory alkalosis caused by

What is the body‘s response to respiratory alkalosis

A

Respiratory acidosis

Too much CO2 equals a long compensates (increased respiratory rate)

Not enough = body retains CO2

Respiratory alkalosis
Caused by:
-hyperventilation not enough CO2

Body response

  • Bradypnea
  • slower shallow breaths
25
Q

 describe what is lost in fluid volume deficit

What are components of fluid volume deficit

Who is of highest risk for hypovolemia and dehydration

What is third space fluid shift and where does it go
-What is present


A

Influe volume deficit there’s a loss of water and solutes in the same proportion

Components of fluid volume deficit: (2)

  • hypovolemia
  • dehydration

Highest risk for hypovolemia/dehydration

  • children
  • elder
  • sickly

Third spacing fluid shift a.k.a. intracellular dehydration

  • shift of fluids into the transcellular (interstitial compartment)
  • with third spacing Edema is present with dehydration



26
Q

What happens during fluid volume excess

What are the two components of fluid volume excess

What will accumulate in the interstitial space



A

during full volume excess there’s a retention of both sodium and water in the extracellular fluid

Two components of the volume excess:

  • Hypervolemia (intravascular accumulation)
  •  Overhydration

Edema accumulates in the fluids of the interstitial space

27
Q

What are components of the nursing history and physical assessment

A

Assess the skin makes membranes, vital signs, neurological assessment

Assess for symptoms such as:

  • excessive thirst
  • N/V/D,
  • drainage
  • other fluid losses

Get fluid intake and output

Get daily weight

Get your lab studies

  • CBC,
  • serum electrolytes,
  • BUN,
  • creatinine
  • urine pH,
  • specific gravity
  • ABGs



28
Q

When do you want to get patients weights

What are parameters for getting patients weights

How do you know if a patient is retaining water

What is the most accurate way to assess fluid retention

A

Get a patient’s weight in the morning

Must be same time, same clothes, same scale

A patient is retaining water if they gain 2.2 pounds (1 L) in 1 to 2 days

 wait is the most accurate way to assess for Florida attention

29
Q

What questions you wanna ask during the nursing history

Illnesses
Abnormal fluids
Damage ? (3)
Therapies that what

A

Ask the patient if they’ve had questions:

-acute/chronic illnesses
• DM,CHF,renal failure

-abnormal losses of body fluids

-Burns
-trauma
-surgery
- therapies that may just wrecked fluid and electrolyte balance
• chemo, diuretics, steroids

30
Q

What are components of the physical assessment you want to do

A

Assess skin turgor/ tongue turgor

Moisture and oral cavity

Tearing and salvation

Appearance of skin and skin temperature

facial appearance

edema

pulse, respirations,blood pressure

31
Q

what does a ⬆️ BP indicate

what does ⬇️ BP indicate

What may kidney function tell you

Give the normal for the ABGs

A

⬆️ BP: Hypervolemia

⬇️BP: hypovolemia

Kidney function can tell you the origin of electrolyte imbalances

ABG normals:
PH: 7.35 to 7.45
CO2: 45 to 35
HCO3: 22 to 26

32
Q

What are nursing diagnosis is related to imbalances

A

(Fluid, electrolyte, acid base disturbances as the problem)

  • Excess/Deficient fluid volume
  • Risk for deficient fluid volume
  • Ineffective breathing pattern

Fluid and electrolyte disturbances as etiologies:
•Ineffective breathing pattern related to compensatory mechanism by lung hypo ventilation or hyperventilation

•Impaired oral mucous membrane integrity related to fluid volume deficit

•Risk for impaired skin integrity related to deficient flu of volume or excess fluid volume




33
Q

What is the goal for fluid and electrolyte assessments

A

The goal for fluid and electrolyte assessments is to maintain and restore optimum functioning related to fluid, electrolyte and acid base balance
+
Alleviate symptoms and side effects of disease or treatment and prevent complications

34
Q

How do you wanna teach and develop a dietary plan

What do you wanna provide the patient

A

Teach by involving patient and person who prepares the meal on the nutritional plan

Provide the patient with a list of written foods to avoid or include in diet



35
Q

What are nurses responsibility when it comes to IV fluid therapy

What do you do to the iv
Orders
Concerns
Understand what

A

Initiate monitor and discontinue therapy

Evaluate a patient orders before administration

Notified provider of any concerns related to the order

Understand the rationale for using Ivy therapy, types of solution, desire to effect, potential ADR

36
Q

 What are vascular access devices used for

Describe peripheral venous catheters

  • type
  • duration

Describe central venous access device is

  • types
  • duration

How long are implanted porch used for who are they placed by

A 
Vascular access devices available for delivery of solution and medications to vein 

Peripheral venous catheters
-most common to use ! 
-used short term
Central venous access devices
-PICC line 
-Central lines
-peripherally inserted central catheter‘s
-tunneled central venous catheter‘s
-ports (surgical)
• used long-term

Implanted ports used for very long-term placed by surgeon



37
Q

Where does a nurse insert peripheral venous access

What do you consider when inserting a peripheral venous access (site selection)

When do you need to change the IV site

A

Nurse puts pressure venous access (most common) in the safest most appropriate location for patient

Consider for site selection:

  • accessibility of vain
  • condition of vain
  • type of fluid to be infused
  • anticipated duration of infusion

Change IV site every 72 hours and get a new catheter

38
Q

IV therapy complications

Infiltration
Extravasation
Phlebitis
Thrombophlebitis
Infection
Systematic complications
-fluid overload, embolus, sepsis
A

Infiltration
-leakage of fluid into interstitial space because catheter not in vein

Extravasation
-leakage to surrounding tissue by vesicant causing necrosis

Phlebitis
-inflammation of vein (Cord) 
-typically occurs 48 to 72 hours post IV removal

Thrombophlebitis
-clot causing inflammation in vein

Infection

Systematic complications
-fluid overload, embolus, sepsis

39
Q

If Phlebitis ( Cord ) develops what actions do you take as a nurse

A

If phlebitis occurs

  • discontinue IV
  • start new IV
  • apply cold compress
40
Q

What is the most common complication for IV therapy

when dealing with IV and dressing what must you maintain

A

Most common IV complication = infection

When dealing with IV and dressing = sterile

41
Q

What must you always ensure before giving a blood product
 
What is required before starting an IV

A

Ensure typing and cross matching
most importantly Rh factor!!!

Before starting an IV you MUST have doctors orders

42
Q

When initiating transfusions

  • what do you want to get
    -what do you want to ensure (size)
    -how should the tubing be
    -what should be taken before starting the blood transfusion
    -how many nurses must check the blood
    -how do you want to start the transfusion (for how long)
    -how long do you stay with the patient
    
A

initiating Transfusions:
-get informed consent
• witness and put in chart

  • ensure large vein with a needle at 18 to 20 gauge
  • tubing should be primed with NS
  • get baseline before starting blood pressure for comparison
  • two nurses must check the blood
  • Start a transfusion slow (for 15 minutes) stay with a patient for 15 minutes



43
Q

What is the maximum infusion time

A

Max infusion time: 4 hours and throw the rest away

44
Q

Reactions

When will the most severe blood reactions happen

Give signs and symptoms of a blood reaction

What do you do if suspected blood reaction

A

Most of your blood reactions will happen within the first 15 minutes

Signs and symptoms of a blood reaction:

  • itching/hives
  • fever chills
  • lower back pain
  • dyspnea
If suspected blood reaction: 
#1STOP Blood
-remove old tubing
-put new tubing with NS
-check vitals 
-tell doc

45
Q

 When is the only time you can slow blood

Give signs and symptoms of fluid overload

A

You can only slow blood if fluid overload

S&s

  • dyspnea
  • Dry cough 
46
Q

 What can you use to evaluate and Readjust your plan interventions

What are ways to evaluate if your pt has improved related to fluid and electrolyte balance

A

Use nursing care plan to evaluate and readjust your plan and interventions

Ways to evaluate if your patient has improved related to fluid and electrolyte balance:
-is your patient’s urine output equal to their intake

  • are there abnormal sources of food loss
  • Are the signs and symptoms of the initial condition absent or improved
  • is a patient now able to practice self-care behaviors maintain fluid and electrolyte as well as acid base balance



47
Q

Describe what is happening during the acid base reaction

Metabolic alkalosis
metabolic acidosis
respiratory alkalosis
respiratory acidosis

A

Metabolic alkalosis  ➡️ kidneys keep hydrogen excrete bicarb
metabolic acidosis ➡️Kidneys excrete hydrogen keep bicarb
respiratory alkalosis ➡️Retain CO2 slow breathing
respiratory acidosis➡️ Release CO2 fast breathing

Fundamentals (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions