Chapter 3 - Fluid & Electrolyte Imbalance Flashcards
What is epidemiology?
Study of distribution and determinants of disease, injury and other health related outcomes.
Which cancer has the highest incidence in men and women?
Colorectal cancer
What is colorectal cancer?
A malignant tumour that starts in the bowel wall.
Aetiology of colorectal cancer…
Hereditary and environmental factors.
Name a prophylactic anticoagulant
Enoxaparin sodium
Name a phrophylactic antibiotic
Metronidazole IV
Cephalothin IV
What is a partial colectomy
Removal of a section of the large bowel
PCA - stands for
Patient controlled analgesia
IVT stands for -
Intravenous therapy
Fluid challenge:
Administration of a large amount of IV fluids over a short period of time under close monitoring to evaluate patients response
Bellovac:
Vacuum drain
IDC stands for:
Indwelling catheter
Stoma:
An opening into the body from the outside created by a surgeon
BGL:
Blood glucose level
When a persons glomerular filtration rate drops:
The juxtaglomerular cells in the kidney respond by secreting renin
Antidiuretic hormone is secreted:
By the posterior pituitary gland in response to increased serum osmolality
Oliguria:
Is defined as less than 30mL per hour of urine excretion and, left untreated, may lead to AKI
When assessing a patients fluid status, which observations are most important?
Urine output, blood pressure, weight
Insensible fluid loss occurs through all of the following except:
- Skin
- Lungs
- Kidneys
- Gastrointestinal tract
Kidneys
Extracellular fluid loss refers to fluid loss from the interstitial fluid compartment and/or:
Intracellular compartment
In assessing a patient with dehydration, you would expect the urine output to be:
Increased with elevated specific gravity
A third-space fluid shift may occur as a result of all of the following except:
- Hypoalbuminaemia
- An allergic reaction
- Hypertension
- Hypovolemia
Hypoalbuminaemia
Which of the following are considered “normal parameters”?
- Temp 37
- Pulse 112
- RR 22
- BP 90/50
Temp & Resp rate
Normal oxygen saturation would be:
95-100%
With an IDC insitu, for a grown man (Mr Barrett) normal urine output would be at least:
41mL per hour (35-40mL) adequate
A normal BGL would be:
4-8mmol/L
Cues most relevant for fluid status…
Blood pressure
Pulse
Conditions of oral mucosa
Urine output
Ascertainmemt bias and ageism example:
“Just what we need today, another one with dementia”!
Pathophysiology-
Explains the process within the body that results in functional changes in the body from a disease
When the inflammatory stage of wound resolves (24-48 hours post-operatively), what are the possible consequences for your patients ‘fluid status’?
- Plasma from the interstitial compartment typically returns to the circulating blood volume.
- Significant increases in blood volume add to likelihood of hypervolaemia.
- The third-space fluid shift resolves, resulting in increased blood volume.
Type 2 diabetes can influence fluid balance…
- Diabetes can cause impaired renal function
- hyperglycaemia results in increased serum osmolarity, resulting in excessive diuresis..
Confusion in the post-operative person can result from the following.
Constipation UTI Pain Delirium Dementia Fluid imbalance Electrolyte imbalance Infection Hypoxia
Fluid shifts can contribute to tachypnoea because:
Fluid shifts in the alveolar spaces can impact on oxygenation levels.
Alternated sodium (Na+) levels…
Decreased sodium concentration can be a consequence of over-hydration.
Older people are at risk of fluid imbalance because they have an increased likelihood of all of the following:
Impaired renal function
Chronic dehydration
Malnutrition
Decreased cardiac function
What are normal levels of serum sodium?
135-145mmol/L
What are normal levels of serum potassium?
3.8-4.9mmol/L
Hyponatraemia can cause:
Confusion Headaches Nausea and vomiting Abdominal cramps Muscle weakness
Some signs and symptoms of hyponatraemia:
Confusion
Headache
Nausea and vomiting
Hypokalaemia can cause:
Irregular pulse Arrhythmias Cardiac arrest Decreased bowel sounds Cramps Polyuria Muscle weakness
CKD risk factors
Diabetes High BP Age over 60 Smoking Obesity Family hx Aboriginal Established cardiovascular disease
