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Clinical Reasoning > Chapter 3 - Fluid & Electrolyte Imbalance > Flashcards

Chapter 3 - Fluid & Electrolyte Imbalance Flashcards

1
Q

What is epidemiology?

A

Study of distribution and determinants of disease, injury and other health related outcomes.

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2
Q

Which cancer has the highest incidence in men and women?

A

Colorectal cancer

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3
Q

What is colorectal cancer?

A

A malignant tumour that starts in the bowel wall.

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4
Q

Aetiology of colorectal cancer…

A

Hereditary and environmental factors.

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5
Q

Name a prophylactic anticoagulant

A

Enoxaparin sodium

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6
Q

Name a phrophylactic antibiotic

A

Metronidazole IV

Cephalothin IV

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7
Q

What is a partial colectomy

A

Removal of a section of the large bowel

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8
Q

PCA - stands for

A

Patient controlled analgesia

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9
Q

IVT stands for -

A

Intravenous therapy

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10
Q

Fluid challenge:

A

Administration of a large amount of IV fluids over a short period of time under close monitoring to evaluate patients response

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11
Q

Bellovac:

A

Vacuum drain

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12
Q

IDC stands for:

A

Indwelling catheter

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13
Q

Stoma:

A

An opening into the body from the outside created by a surgeon

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14
Q

BGL:

A

Blood glucose level

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15
Q

When a persons glomerular filtration rate drops:

A

The juxtaglomerular cells in the kidney respond by secreting renin

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16
Q

Antidiuretic hormone is secreted:

A

By the posterior pituitary gland in response to increased serum osmolality

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17
Q

Oliguria:

A

Is defined as less than 30mL per hour of urine excretion and, left untreated, may lead to AKI

18
Q

When assessing a patients fluid status, which observations are most important?

A

Urine output, blood pressure, weight

19
Q

Insensible fluid loss occurs through all of the following except:

  • Skin
  • Lungs
  • Kidneys
  • Gastrointestinal tract
A

Kidneys

20
Q

Extracellular fluid loss refers to fluid loss from the interstitial fluid compartment and/or:

A

Intracellular compartment

21
Q

In assessing a patient with dehydration, you would expect the urine output to be:

A

Increased with elevated specific gravity

22
Q

A third-space fluid shift may occur as a result of all of the following except:

  • Hypoalbuminaemia
  • An allergic reaction
  • Hypertension
  • Hypovolemia
A

Hypoalbuminaemia

23
Q

Which of the following are considered “normal parameters”?

  • Temp 37
  • Pulse 112
  • RR 22
  • BP 90/50
A

Temp & Resp rate

24
Q

Normal oxygen saturation would be:

A

95-100%

25
Q

With an IDC insitu, for a grown man (Mr Barrett) normal urine output would be at least:

A

41mL per hour (35-40mL) adequate

26
Q

A normal BGL would be:

A

4-8mmol/L

27
Q

Cues most relevant for fluid status…

A

Blood pressure
Pulse
Conditions of oral mucosa
Urine output

28
Q

Ascertainmemt bias and ageism example:

A

“Just what we need today, another one with dementia”!

29
Q

Pathophysiology-

A

Explains the process within the body that results in functional changes in the body from a disease

30
Q

When the inflammatory stage of wound resolves (24-48 hours post-operatively), what are the possible consequences for your patients ‘fluid status’?

A
  1. Plasma from the interstitial compartment typically returns to the circulating blood volume.
  2. Significant increases in blood volume add to likelihood of hypervolaemia.
  3. The third-space fluid shift resolves, resulting in increased blood volume.
31
Q

Type 2 diabetes can influence fluid balance…

A
  • Diabetes can cause impaired renal function

- hyperglycaemia results in increased serum osmolarity, resulting in excessive diuresis..

32
Q

Confusion in the post-operative person can result from the following.

A 
Constipation 
UTI
Pain
Delirium
Dementia
Fluid imbalance 
Electrolyte imbalance 
Infection 
Hypoxia
33
Q

Fluid shifts can contribute to tachypnoea because:

A

Fluid shifts in the alveolar spaces can impact on oxygenation levels.

34
Q

Alternated sodium (Na+) levels…

A

Decreased sodium concentration can be a consequence of over-hydration.

35
Q

Older people are at risk of fluid imbalance because they have an increased likelihood of all of the following:

A

Impaired renal function
Chronic dehydration
Malnutrition
Decreased cardiac function

36
Q

What are normal levels of serum sodium?

A

135-145mmol/L

37
Q

What are normal levels of serum potassium?

A

3.8-4.9mmol/L

38
Q

Hyponatraemia can cause:

A 
Confusion 
Headaches 
Nausea and vomiting 
Abdominal cramps 
Muscle weakness
39
Q

Some signs and symptoms of hyponatraemia:

A

Confusion
Headache
Nausea and vomiting

40
Q

Hypokalaemia can cause:

A 
Irregular pulse 
Arrhythmias 
Cardiac arrest 
Decreased bowel sounds 
Cramps 
Polyuria 
Muscle weakness
41
Q

CKD risk factors

A 
Diabetes 
High BP
Age over 60
Smoking 
Obesity 
Family hx 
Aboriginal 
Established cardiovascular disease

Clinical Reasoning (5 decks)

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