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Pharm II > Chapter 29-Fluids & Electrolytes > Flashcards

Chapter 29-Fluids & Electrolytes Flashcards

1
Q

Body water is composed of these three fluids?

A 
Intracellular fluid (ICF), 
interstitial fluid (ISF), 
plasma volume (PV)
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2
Q

Where is intra-vascular fluid found?

A

Inside the blood vessels

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3
Q

Where is extravascular fluid found?

A

Outside the blood vessels

  • Lymph
  • Cerebrospinal fluid
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4
Q

Where is interstitial fluid located?

A

In the space between cells, tissues, and organs

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5
Q

What does extravascular volume consist of?

A

Plasma and interstitial fluid

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6
Q

What does extracellular volume consist of?

A

Interstitial fluid and intracellular fluid

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7
Q

The adult body is _____% water

A

60%

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8
Q

What fraction of total body water is extracellular fluid?

A

ECF=1/3

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9
Q

What fraction of total body water is intracellular fluid?

A

ICF=2/3

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10
Q

Of the total extracellular fluid contained in total body water, what fraction is plasma volume?

A

PV=1/3

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11
Q

Of the total extracellular fluid contained in total body water, what fraction is interstitial fluid?

A

ISF=2/3

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12
Q

Plasma proteins exert constant osmotic pressure called colloid oncotic pressure (COP). Normal COP is _____ mm Hg

A

24 mm Hg

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13
Q

Interstitial fluid exerts hydrostatic pressure (HP). Normal hydrostatic pressure is _____ mm Hg

A

17 mm Hg

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14
Q

These are solutions containing fluids and electrolytes that are normally found in the body. They do not contain proteins and there is no risk for viral transmission, anaphylaxis, or alteration in coagulation profile

A

Crystalloids

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15
Q

These are used as maintenance fluids to compensate for insensible fluid losses, to replace fluids, to manage specific fluid and electrolyte disturbances, and promote urinary flow

A

Crystalloids

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16
Q 
Normal saline (0.9% sodium chloride),
Half normal saline (0.45% sodium chloride),
Hypertonic saline (3% sodium chloride),
Lactated ringer's,
D5W

What kind of fluid are these classified as?

A

Crystalloids

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17
Q

What indications call for the use of Crystalloids?

A

Acute liver failure, acute nephrosis, adult respiratory distress syndrome, burns, cardiopulmonary bypass, hypoproteinemia, renal dialysis, reduction of the risk for DVT

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18
Q

What are the adverse affects of crystalloids?

A

May cause edema, especially peripheral are pulmonary; they dilute plasma proteins, reducing COP; effects may be short-lived; for prolonged infusions may worsen alkalosis or acidosis

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19
Q

These fluids contain protein substances, increase colloid osmotic pressure, move fluid from interstitial compartment to plasma compartment (when plasma protein levels are low)

A

Colloids

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20
Q

What are the adverse affects of colloids?

A

May cause altered coagulation, resulting in bleeding.

They have no clotting factors or oxygen carrying capacity. Rarely, dextran therapy causes anaphylaxis or renal failure

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21
Q

What is the only class of fluids that are able to carry oxygen?

A

Blood products

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22
Q

This class of fluids carries oxygen, increases tissue oxygenation, increases plasma volume, pull fluid from extravascular space into intravascular space (plasma expanders), and is the most expensive and least available because they require human donors.

A

Blood products

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23
Q

What blood products are used in the management of acute bleeding?

A

Cryoprecipitate and plasma protein factors (PPF)

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24
Q

What blood product is used to increase clotting factor levels in patients with demonstrated deficiency?

A

Fresh frozen plasma (FFP)

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25
Q

What blood product is used to increase oxygen-carrying capacity in patients with anemia, substantial hemoglobin deficits, and those who have lost up to 25% of their total blood volume

A

Packed red blood cells (PRBCs)

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26
Q

Which blood product is most beneficial in cases of extreme blood loss (greater than 25%)?

A

Whole blood

Whole blood contains plasma proteins which help draw fluid back into blood vessels from the surrounding tissue

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27
Q

The patient was taken to the trauma unit after a motorcycle accident. It is estimated that he has lost 30% of his blood volume is in hypovolemic shock. The nurse anticipates a transfusion with which product?

A

Whole blood

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28
Q

What are the adverse affects of blood product infusion?

A

Incompatibility with recipients immune system, crossmatch testing, transfusion reaction, anaphylaxis, transmission of pathogens to recipient (hepatitis, HIV)

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29
Q

What are the principal extracellular fluid electrolytes?

A

Sodium (Na+) & chloride (Cl-)

30
Q

What is the principal intracellular fluid electrolyte?

A

Potassium (K+)

31
Q

What are the other significant electrolytes?

A

Calcium, magnesium, phosphorus

32
Q

What is the normal range for potassium outside of cells

A

3.5 - 5 mEq/L

33
Q

What foods contain potassium?

A

Bananas, oranges, apricots, date, raisins, broccoli, green beans, potatoes, tomatoes, meats, fish, wheat bread, lagumes

34
Q

Excess dietary potassium is excreted via the _____?

A

Kidneys

35
Q

Hyperkalemia is evident with lab values greater than _____ mEQ/L

A

5.5

36
Q

What are some causes for hyperkalemia?

A

Potassium supplements, ACE inhibitors, renal failure, excessive loss from cells, potassium sparing diuretics, burns, trauma, metabolic acidosis, infections

37
Q

Hypokalemia where presents for deficiency with lab values less than _____ mEq/L

A

3.5

38
Q

What are indications for excessive potassium loss?

A

Alkalosis, corticosteroids, diarrhea, ketoacidosis, laxative misuse, hyperaldosteronism, increased secretion of mineralocorticoids, Burns, Thiazide/thiazide-like diuretics, vomiting, malabsorption

39
Q

A deficit of _____, in the presence of Digoxin therapy, can cause toxicity, resulting in serious ventricular dysrhythmias

A

Potassium

40
Q

_____ is responsible for muscle contraction, transmission of nerve impulses, regulation of heartbeat, maintenance of acid-base balance, isotonicity

A

Potassium

41
Q

What condition does a nurse identify as a late manifestation of hypokalemia?

A

Palpitations

42
Q

What are some primary conditions a nurse identifies as early manifestations of hypokalemia?

A

Muscle weakness, hypotension, lethargy

43
Q

Which conditions require the administration of potassium?

A

Potassium deficiency, irregular heartbeats, management of tackydysrhythmias that can occur after cardiac surgery

44
Q

What are the adverse affects of oral potassium?

A

Diarrhea, nausea, vomiting, G.I. bleeding, ulceration

45
Q

What are the adverse affects of IV administration of potassium?

A

Pain at injection site, phlebitis

46
Q

What are the facts of excessive administration of potassium?

A

Hyperkalemia, toxic effects

47
Q

What are the manifestations of hyperkalemia?

A

Muscle weakness, Paris, paralysis, cardiac rhythm irregularities (leading to possible ventricular fibrillation and cardiac arrest)

48
Q

What is the treatment for severe hyperkalemia?

A

Are you sodium bicarbonate, calcium gluconate or calcium chloride, dextrose with insulin;
Sodium polystyrene sulfonate (Kayexalate) or hemodialysis to remove excess potassium

49
Q

A patient is hypokalemic and will be receiving intravenous potassium. The patient is not on a heart monitor. How should the nurse administer the potassium replacement?

A

No more than 10 mEq/hr

If patient is on cardiac monitor a rate of 20 mEq/hr may be used

50
Q

What is the most abundant positively charged electrolyte outside cells?

A

Sodium

51
Q

What is the normal concentration of sodium outside of the cells?

A

135-145 mEq/L

52
Q

Which foods are sodium rich?

A

Salt, fish, meats, foods flavored or preserved with salt.

53
Q

What are the symptoms of hyponatremia?

A

Lethargy, stomach cramps, hypotension, vomiting, diarrhea, seizures

54
Q

What are the causes of hyponatremia?

A

Excessive perspiration, prolonged diarrhea or vomiting, renal disorders, alkalosis, increased secretions of medical record records, burns, corticosteroid use, crash diets, malabsorption

55
Q

What are the symptoms of hyper natremia?

A

Water retention; hypertension; red, flushed skin; dry sticky mucous membranes; increased thirst; elevated temperature; decreased urine output

56
Q

What are the causes of hypernatremia?

A

Poor renal excretion stemming from kidney malfunction; inadequate water consumption; dehydration

57
Q

What functions does sodium control?

A

Water distribution, what an electrolyte balance, of moderate pressure of body fluids, participation in acid-base balance

58
Q

What are the functions are controlled by Potassium?

A

Muscle contraction, transmission of nerve impulses, regulation of heartbeat, maintenance of acid-base balance, isotonicity

59
Q

How is mild hyponatremia treated?

A

Oral sodium chloride and/or fluid restriction

60
Q

How is severe hyponatremia treated?

A

Intervenous normal saline or lactated ringers

61
Q

Adverse affects of oral administration of sodium?

A

Nausea, vomiting, cramps

62
Q

What are the adverse affects of IV administration of sodium?

A

Venous phlebitis

63
Q

What assessment should be done before giving potassium?

A

ECG

64
Q

Potassium should never be given via ______

A

IV bolus

65
Q

How are oral forms of potassium given?

A

Diluted in water or fruit juice to minimize G.I. distress or irritation.

Monitor for complaints of nausea, vomiting, G.I. Pain, or G.I. bleeding

66
Q

Polystyrene sulfonate (Kayexalate) should never be given with _____, _____, or _____

A

Sorbitol, laxatives, antacids

67
Q

Which solution should the nurse administered with packed red blood cells?

A

Normal saline, 0.9% sodium chloride

68
Q

Albumin and dextran fall within which fluid category?

A

Colloids

69
Q

This fluid category is commonly known as maintenance fluids

A

Crystalloids

70
Q

Total protein levels in the body should range between ___ to ___ g/dL.

A

5.4-7.4 g/dL

If the level falls below 5.3, fluid shifts out of blood vessels and into tissues

Pharm II (8 decks)

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