Chap 32- Altered Fluid & Electrolytes; Water, F&E Imbalances

Question 1

Older Adult Effects on F & E

Answer 1

-Decreased kidney function/ affects filtration
-Increase use of diuretics
-Increased body fat
-Fluid restriction in evening bc they dont want to go to bathroom @ night
-Decreased thirst response

Question 2

Examples of whats calculated in FLuid Intake:

Answer 2

Water, Tea, Juices, IV fluids

Question 3

Examples of whats calculated in FLuid Output:

Answer 3

Vomiting
Diarrhea
Diaphoresis
Diuretics
Stress
Chronic Illness
Liver, Hear, Kidney Failure

Question 4

a class of drugs that increase urine production and help the body get rid of excess salt and fluid

Answer 4

Diuretic

Question 5

How does a diuretic work?

Answer 5

it increases the amount of water and salt excreted through urine by the kidneys

Question 6

Risk of diuretics; what combats it?

Answer 6

Can cause you to lose too much potassium leading to dysarthymia
- Potassium sparing diuretics cause you to lose fluids EXCEPT Potassium

Question 7

Loss of fluid through difficult-to-measure means such as respiration stool, sweat

Answer 7

insensible fluid loss; accounts for 600 mL daily

Question 8

Fluid deficit may result in

Answer 8

SHOCK !!!

Question 9

Vascular and Interstitial compartments are influenced by which fluids?

Answer 9

ECF (deficit in ECF is most critical)

Question 10

Loss of ECF contains ______

Answer 10

Sodium
Chloride
BiCarb
Water

Question 11

Terms that describe loss of fluids
interchangeable

Answer 11

Hyopvolemia
Isotonic dehydration
Saline Deficit

Question 12

An ECF volume balance problem where fluid leaves vascular spaces and inappropriately accumulates in interstitial spaces

Answer 12

third spacing ; can happen due to decreased plasma proteins (they are necessary to keep fluid IN the vessels

Question 13

Cause of third spacing

Answer 13

R side heart failure
Cirrhosis of liver
Burns

Question 14

first S&S of third spacing

Answer 14

Decreased urine output (fluid is not where it should be, in order for it to be excreted)

Question 15

S& S of ECF Deficit

Answer 15

Orthostatic Hypotension
Increased Pulse
Decreased Urine Output (more concentrated, no volume to put out)
Dehydration, tented skin turgor, dry skin/mouth

I

Question 16

Treatment for ECF Deficit

Answer 16

Forced Fluids orally
IV Replacement
Safety (dehydration syx pose risk for saftey)

Question 17

S&S of Excess ECF

Answer 17

• Edema
  -Rapid weight gain
• Increased BP
  -Bounding Pulse
  -Neck Vein Distention
  -Dyspnea

Question 18

Treatment of of Excess ECF

Answer 18

Low Sodium Diet
Diuretics

Question 19

-Natremia’s

Answer 19

Water imbalances/ ICF deficit

Question 20

when there is a decrease in water intake, an increase in water loss, or an excess intake of solute

Answer 20

-Decrease in water intake
-Increase in water loss
-Excess intake of solute

Question 21

a condition where there is too much sodium blood, relative to the amount of water in the body

Answer 21

hypernatremia; due to excess sodium

Question 22

As NA increases, water is drawn from _____ resulting in____ leading to ______

Answer 22

ICF; cell shrinkage; aeb changes in cognition

Question 23

S&S of Hypernatremia

Answer 23

confusion
agitation
seizures
death possibly
oliguria- low urine output
decrease thirst

Question 24

Treatment of Hypernatremia

Answer 24

Gradually lower Na w/ D5 water as it replaces water, not Na

Question 25

a condition where the level of sodium in the blood is too low, which can cause water to move into cells and make them swell

Answer 25

Hyponatremia; sodium deficit; can be acute or chronic

Question 26

Causes of hyponatremia

Answer 26

Dilution- drinking lots of water leading to dilution of solute (Sodium)
or
Dehydration- getting rid of electrolytes through excretion, diarrhea, excess sweat, etc

Question 27

S&S of hyponatremia

Answer 27

lethargy
irritability
confusion
personality changes
seizures
coma
death

Question 28

Treatment for hyponatremia

Answer 28

Free water restriction
Sodium Pills/ Sodium Replacement

Question 29

How to monitor for fluid & electrolyte imbalances?

Answer 29

Compare Daily body weights
Monitor changes in LOC

Question 30

Which change in LOC presents as imbalance becomes more severe?

Answer 30

Confusion

Question 31

Manifestations of F&E imbalance

Answer 31

Dehydration
Edema
Skin Tenting
Muscle Spasms
Constipation
Change in Vital Signs
Tingling Sensations

Question 32

Normal Urine Output …

Answer 32

1500 mL in 24 hrs
*highly dependent on what you take in *

Question 33

Should wound drainage be calculated in “Output”? Y or N

Answer 33

Yes