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Med surg2 > Ch 8 Fluid and Electrolyte Management > Flashcards

Ch 8 Fluid and Electrolyte Management Flashcards

1
Q

What are the major Cations?

A

Sodium, Potassium, Magnesium, hydrogen

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2
Q

What are the major anions?

A

Chloride Bicarbonate Phosphate

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3
Q

What does the transcellular portion effect?

A

GI respiratory,urinary,glandular,intraocular,cerebrospinal fluid

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4
Q

Osmosis

A

the movement of water through a semipermeable membrane from a area of high water concentration to an area of lower concentration

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5
Q

Diffusion

A

Moves solutes or particles from an area of higher concentration to area of lower concentration

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6
Q

Fluid intake & output

A

2,500ml

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7
Q

Hypotonic

A

Lower concentration, fluid movement in cells

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8
Q

Hypertonic

A

Higher concentration fluid movement out cells shrink

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9
Q

Oncotic pressure

A

Pulls fluid from interstitial space back into the intravascular space

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10
Q

Osmotic Diuresis

A

Increase urine output

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11
Q

What organ is primary for regulating fluid volume?

A

Kidneys

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12
Q

Fluid and electrolyte balance is maintained by which hormone?

A

ADH

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13
Q

Fluid loss occurs from the lungs through?

A

Vaporization

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14
Q

Increased insensible water losses can be seen in which hypermetabolic states

A

trauma, burns,fever,thyroid crisis, impaired skin integrity

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15
Q

Normal BUN

A

8-21

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16
Q

Increase Bun does what to kidneys?

A

Impaired renal function

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17
Q

Decrease BUN does what?

A

seen in SIADH, liver failure,malnutrition,Dilutes blood volume

18
Q

Creatine Normal levels

A

0.5-1.2

19
Q

Age related changes

A

Decrease in taste smell,thirst, comorbidities,medication,decrease in olfactory function

20
Q

Hypovelemia

A

Cause-excess loss of fluid, fluid shifts(third spacing)-fluid leaves the vasular space
Clinical manifestations- Weight loss, loss of skin turgor, oliguria,thirst,dry mucous membranes
Decrease- hemoglbin,hematocrit
Increase- urine specific gravity,serum osmality,urine osmolality

21
Q

Hypervolemia

A

Causes- Increase water and sodium retention, cirrhosi,heart failure, stress
BUN and hematocrit are low
low albumin hyonatremia
Clinical manifestations-weight gain,edema,tachycardia,increase urine output
complication pulmonary edema

22
Q

Sodium Normal level

A

135-145

23
Q

Hyponatremia

A

Causes-diuretics, diarrhea, hyperglycemia,hyothyroidism,SIADH,adrenal insufficiency
Clinial Manifestations- cerebral edema,neuro decline,lethargy,headache,gait disorder
COmplications- Postural hypotension
Severs seizure coma death

24
Q

Hypernatremia

A

Causes reduced water intake, DI, Hyperglycemia,hypercalcemia,hyperkalemia
Clinical manifestations-neuro changes,hallucinations thirst
limit sodium

25
Q

Chloride Normal range

A

97-107

26
Q

Hypochloremia

A

Causes-Severe vomiting,burns,respiratory acidosis,mtabolic alkalosis, addison disease
Clinical manifestaions-irritablity,hypotension, shallow resp
complication-cardiac hyponatremia, dsyrthmias related to hypokalemia

27
Q

Hyperchloremia

A

Causes-Infusion of high levels of chloride
Clinical maifestations-deep rapid resp,tachypnea, high bp,
medical management- hypotonic iv solutions
complications- decrease cardiac output

28
Q

Potassium Normal range

A

3.5-5.0

29
Q

Hypokalemia

A

less than 3.5
Causes-loss of potassium stores
Medications-laxatives,diuretics,steroids
Clinical manifestations-st depression,cardiac resp arrest,constipation weakness
Medical management-potaaium supplements cardiac monitoring
Complications-muscle weakness decrease gi mobility,cardiac dysrthmias

30
Q

Hyperkalemia

A

more than 5
causes- acute or chronic renal failure
excess intake of foods with high potassium
shift of intracellular potassium to extracellularspace
Clinical manifestations-muscle cramps palpations, paresthesias(tingling) ecg changes
Complications-muscle weakness,cardiac dysrthmias

31
Q

Magneisum normal range

A

1.6-2.2

32
Q

Hypomagnesium

A

causes-malnutrition ,chronic alchol abuse,excessive excretion via renal system
CLinical Manifestation-muscle weakness and cramping
tetany,trousseau,chovestek,tachycardia,vertigo
Medical management-evaluation of potassium and calcium levels\
Complications-seizures, vent fib
Nursing managemnt
no drinking alcohol,falls precaution, cardiac monitor

33
Q

Hypermagnesium

A

more than 2.2
Causes- over replacement of magnesium
renal insuffiency, soft tissue injury
Clinical manifestation-hypotension,asytole,cardiac dysrthmias muscle weakness,increase bleeding
Medical maagement-hydration,loop diuretics
Complications-resp failure stupor,coma hypotension, refractory to vasopressors

34
Q

Calcium normal range

A

8,2-10.2

35
Q

Hypocalcemia

A

less than 8.2
Causes vitamin d Deficiency, malnutition, chronic renal failure, chronic alcohol abuse,hypoparathyrodism
Clinical manifestations-positive trosseau chvostek, prolonged qt interval,muscle spasm
medical management-cardiac monitoring,oral calcium vitamin d
Complication-Refractory hyptension, dsyrthmias

36
Q

Hypercalcemia

A

more than 10.2
Causes hyperparathyroidism, malignancy
Clinical manifestation-bradycardia,hypertension,muscle weakness,thirst,anorexia
Medical management-removal of parathyroid gland,calcitonin,dialysis,hydration 0.9nnacl
complication-T wave changes confusion

37
Q

Phosphorus Normal range

A

2.5-4.5

38
Q

Hypophosphatemia

A

less than 2.5
causes resp alkalosis
decrease absorption of phosphorus
clinical manifestations-tremors,joint stiffness,confusion,paraesthesia
Medical management- oral or iv replacement of phosphorus
Complication-bleeding
decrease function of white blood cells
impaired hepatic function
organ system dysfunction

39
Q

Hyperphosphatemia

A

more than 4.5
causes- renal failure
diabetic keto acidosis, hyperthyroidism or hyperparathyroidism
Clinical manifestations-delirium
prolonged qt interval, positive chvostek trosseau sign
medical management-loop diuretics
dialysis
complicatons
tetany
kidney disease

40
Q

Magnesium foods

A

Nuts fish oatmeal peanut butter halibut

Med surg2 (5 decks)

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