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Clients with Health Challenges - N3600 > Electrolyte and fluid balance - things in red > Flashcards

Electrolyte and fluid balance - things in red Flashcards

1
Q

Factors that affect total body water?

A

Age - newborn is 80% TBW
Gender - Women 50%; men 60%
Body fat - Fat tissue essentially water free

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2
Q

A typical adult needs approximately how many mL per day of water?

Therefore, how many 8 oz glasses of fluid intake would a 158.5lb adult need?

A

30-40 mL/day*kg

  1. 5lb / 2.2 = 72.045kg
  2. 045kg * 30 mL/kg*day = 2161.36 mL/day

2161 mL/day * 1oz/30mL = 72.045 oz

72.045oz * 1glass/8oz = 9 glasses

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3
Q

Sodium normal range?

A

135-145 mmol/L

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4
Q

Potassium normal serum range?

A

3.5-5.0 mmol/L

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5
Q

Calcium normal serum range?

A

2.2-2.58 mmol/L

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6
Q

Chloride normal serum range?

A

95-105 mmol/L

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7
Q

Phosphate normal range?

A

0.97-1.45 mmol/L

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8
Q

When measuring fluid input, what are examples of foods that become liquid at room temp?

A

Jello, Popsicles, ice cream, yogurt

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9
Q

What is the minimum urinary output?

A

30 mL/hr or 0.5 mL/hrkg ()

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10
Q

What should the minimum urinary output be for a 150lb adult?

A

150lb / 2.2 lb/kg = 68.18 = 68.2kg

68.2kg * 0.5 mL/kg*hr = 34.1 mL = 34 mL/hr

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11
Q

What are the normal hematocrit levels for males and females?

A

Males - 0.37-0.49

Females - 0.36-0.46

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12
Q

What is the normal serum osmolality value?

A

280-300 mmol/kg

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13
Q

What is the normal urine osmolality value?

A

500-800 mmol/kg

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14
Q

What is the normal urine specific gravity?

A

1.01-1.025

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15
Q

When taking ABGs, it is important to do this?

A

Apply pressure at the puncture site for 5 mins

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16
Q

What are the six measurements of ABGs?

A 
pH
PaO2 (arterial blood)
PaCO2 (arterial plasma)
Bicarb (HCO3-)
Base excess - BE
SaO2 (oxygen saturation)
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17
Q

What are the normal ABG values?

A 
pH = 7.35-7.45
PaCO2 = 35-45
bicarb = 22-26
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18
Q

What is the normal PaO2 at RA in adults under the age of 60?

A

80-100

19
Q

When the blood pH is acidic, how does the respiratory system conpensate?

A

Respiratory rate increases

20
Q

If bicarb caused the acidosis or alkalosis, it is ________
If CO2 caused the acidosis or alkalosis, it is _______
if carbon dioxide and bicarb caused the acidosis or alkalosis, it is _________

A

metabolic
respiratory
combined

21
Q

Differentiated between uncompensated, partially compensated, fully compensated, and corrected

A

Uncompensated - abnormal pH and change in one blood parameter
Partially compensated - all 3 values are off
Fully compensated - pH normal, bicarb and CO2 off
Corrected - all three normal

22
Q

Respiratory acidosis values?

A

pH < 7.35; PaCO2 > 45

23
Q

Respiratory alkalosis values?

A

pH > 7.45; PaCO2 < 35

24
Q

Metabolic acidosis values?

A

pH < 7.35; bicarb < 22

25
Q

Metabolic alkalosis values?

A

pH > 7.45; bicarb > 26

26
Q

ABG results:
pH: 7.26
PaCO2: 42
HCO3-: 17

A

acidosis
metabolic
uncompensated

27
Q

ABG results:
pH: 7.49
PCO2: 30
HCO3-: 23

A

alkalosis
respiratory
uncompensated

28
Q

ABG results
pH: 7.26
PCO2: 52
HCO3-: 34

A

acidosis
combined
partially compensated

29
Q

ABG results:
pH: 7.45
PCO2: 51
HCO3-: 29

A

combined, fully compensated

30
Q

Urine pH
- in metabolic acidosis, urine pH _______
in metabolic alkalosis, the pH _______

A

decreases

increases

31
Q

Hypovolemic shock

What is the difference between absolute and relative fluid loss? Gives examples of each.

A

Absolute - fluid volume loss - i.e. outside of the body
- e.g. external hemorrhage; gross dehydration (vomiting), diabetes insipidus

Relative - fluid volume shift

  • internal hemorrhage
  • increased vascular permeability - e.g. sepsis
32
Q

What is always a part of the treatment for hypovolemic shock?

A

Support breathing - OXYGEN ALWAYS (may require mechanical ventilation)

33
Q

What is a late sign of neurogenic shock?

A

Decreased tissue perfusion leading to decreased cap refill, pallor, cold (LATE)

34
Q

What are the important preventive treatments for anaphylactic shock?

A

Ensure that allergies are PROPERLY DOCUMENTED IN THE CHART - KNOW THEM

35
Q

What are the most important drug treatments for anaphylaxis?

A

Epinephrine

Dimenhydramine

36
Q

Bacteremia/fungemia/viremia/parasitemia - presence of viable bacteria/fungi/virus/parasites in the ______.

A

blood

37
Q

Sepsis = _____ + _____

A

SIRS + infection

38
Q

a general inflammation in organs remote from the initial insult.

A

SIRS - systemic inflammatory respones syndrome

39
Q

severe sepsis + acute circulatory failure (Severe hypotension unexplained by other causes)

A

septic shock

40
Q

Sanchia Bulgin case:
What went wrong? What type of shock?

How could this have been prevented?

A

Nurse didn’t report the low blood pressure to the charge nurse or physician

Most likely hypovolemic shock - relative type - internal hemorrhage was the culprit

  • decrease in BP, tachycardia and tachypnea (Sympathetic compensation are consistent)
  • anxiety and agitation are also consistent

Prevention:

  • stop the blood loss - may include trip to OR
  • restore circulating volume - IV fluids, blood
  • OXYGEN
  • support BP
41
Q

Which of the following would you include in the nursing management of hypovolemic shock?
A -Client/family teaching re: blood product safety
B - Establish a large bore IV
C - Monitor fluid status
D - All of the above

A

A - blood transfusion often a treatment - will need to teach
B - large bolus of fluids is often necessary
C - mainstay of treatment
D - CORRECT ANSWER as a result

42
Q 
Which of the following are common sources of nosocomial infections? 
A - Bloodstream
B - Lungs
C - Urinary tract
D - All the above
A

All of these contains bodily fluids and can thus cause hospital acquired infections
D is correct

43
Q 
Which of the following can increase the client’s risk of developing sepsis? Select all that apply.
A - Prednisone (steroids)
B - MRSA
C - Myocardial infarction
D - Total parenteral nutrition
A

A - corticosteroids reduce inflammation and immune system

D - direct entry to bloodstream

A, D

Clients with Health Challenges - N3600 (22 decks)

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