Electrolytes Flashcards
Function:
Controls fluid osmolality and volume of blood
Stimulates conduction of electrical impulses along nerves
Works with calcium to regulate muscle contraction
Sodium Na+
normal blood range:
135-145 mEq/L
Sodium
Sources for intake:
Salt: Most individuals obtain 90%–94% from packaged, processed foods, including bacon, ham, canned vegetables, soy sauce, steak sauces, other sauces, salad dressings, processed cheeses, sandwich meats, salty snacks such as chips, jerky, pretzels, canned soups, broths
Adding table salt to prepared foods
Sodium
Normal range: 97-107 mEq/L
Chloride CL-
Functions:
Assists sodium in regulating fluid osmolality and volume
Important for acid-base balance Production of gastric HCl
Chloride
Source for intake:
High-sodium-content foods listed above
Lettuce, tomatoes, celery, olives, seaweed
Chloride
Normal blood range:
3.5-5.3
Potassium
Function:
98% in ICF helps regulate fluid balance 2% in ECF is important for neuromuscular functions, especially for the heart’s contractility and rhythm
Potassium
Source for intake:
Dried fruits, tomatoes, potatoes, spinach and other leafy greens, oranges, bananas, cantaloupe, red meat, chicken, fish, nuts, soy products
Potassium
Normal blood range:
1.6-2.2 mg/dL
Magnesium (Mg2+)
Functions:
Assists neuromuscular function; dilation of arteries and arterioles; enzyme function; carbohydrate and protein metabolism
Magnesium
Source for intake:
Leafy green vegetables, whole grains, beans, fish (halibut), almonds, soybeans
Magnesium
Normal range:
8.2-10.2
Calcium
Functions:
Strengthen skeletal bones and teeth Ionized Ca2+: stimulates conduction of electrical impulses via nerves, which controls muscle contraction and relaxation, includes heart muscle Initiates enzyme action Cellular membrane permeability
Calcium
Source of intake:
Dairy products, green vegetables, shellfish, salmon, dried beans
Calcium
Normal range:
2.5-4.5 mg-Dl
Phosphorus
Function:
Vital for all tissues; muscle and red blood cell functions; metabolism of fat, protein, carbohydrates; manufacturing ATP energy source
Phosphorus
Source of intake:
Meats, fish, egg yolks, dairy products, nuts, beans, legumes, whole grains, soft drinks
Phosphorus
what are serum pH?
7.35-7.45
What are normal CO2?
35-45
What are normal HCO3?
22-26
If Ph and CO2 arrows go different direction its?
Respiratory
If ph and CO2 arrows go same direction its?
metabolic
Describe intracellular fluids and where are they found?
Intracellular fuilds are found in 2/3 of body fluids with the cell.
Describe extracellular fluid and where they are found?
Extracellular fluid is 1/3 of body fluid.
Fluid outside of cell in the interstitial space and intravascular space such as the heart and blood vessels.
What is a solvent?
Liquid
What is a solute?
solid
What is a solution?
Dissolves
What are the four functions of water?
- Maintaining temperature
- transporating electrolytes minerals, vitamins and waste products.
- Protecting the brain and spinal cord
- lubricating the joints and digestive tract.
_______________: Water helps to maintain body temperature, whether warm or cold. Because it takes longer for the temperature of liquid to change than it does for solid matter, the body’s water protects from extreme changes. For example, when you step out of a warm house into a blizzard, your body fluids help to preserve heat. When the body is overheating, evaporation of fluid from sweat and from breathing will keep the body cool. However, water can only help the body to preserve heat for a certain length of time. When the body becomes dehydrated after large amounts of sweat are lost and not replenished, water is no longer available to decrease the body’s temperature. Safety: When patients are dehydrated, they can lose the ability to regulate body temperature.
Maintaining water
___________ Water transports electrolytes such as sodium and potassium; an electrolyte is a salt that transmits electrical impulses when it is dissolved in water. Water also transports minerals such as zinc and copper and vitamins such as vitamin C and the B-complex vitamins to all the individual cells throughout the body. Water also transports waste products from the cells to the blood so that they can be eliminated in the urine.
Protecting the brain and spinal cord: Water, as a component of spinal fluid, acts as a cushion for organs such as the brain and spinal cord, protecting these organs from damage from outside forces.
Transporting electrolytes, minerals, vitamins, and waste products:
___________-Water helps to lubricate joints such as the knees and elbows, reducing friction and allowing for smoother movement. It also provides for the smooth passage of food through the digestive tract, from the mouth through the large intestine.
Lubricating the joints and digestive tract
______-when water moves through a semipermeable membrane to equalize concentration of solutes on each side of the membrane.
Osmosis
How does osmosis works in the body?
If a patient is given an IV solution that is more concentrated than plasma, some of the water in the red blood cells will leave the cells and cross the cell membrane to equalize the concentration in the fluid on the outside of the cell. This causes the red blood cell to shrivel, which is called crenation.
_____________-when molecules move from an area of higher concentration to an area of lower concentration to equalize the amount throughout the area or space.
Diffussion
How does diffusion works in the body?
In the lungs, the blood in the capillaries around the air sacs contains higher levels of carbon dioxide and lower levels of oxygen than room air. When you inhale, room air that is higher in oxygen and lower in carbon dioxide is drawn into the air sacs. Oxygen molecules move into the capillaries (higher to lower concentration), and carbon dioxide molecules move out of the capillaries into the air sacs to be exhaled (higher to lower concentration).
_______: when solids are separated from liquids or gases by a barrier that only the liquids and very fine solutes can pass through.
Filtration
How does filtration works in the body?
The liver filters blood to remove dissolved substances such as medications, over-the-counter drugs, alcohol, caffeine, and toxins from the blood.
_______- increase water reabsorption making urine concentrated.
Antidiuretic hormone
______- Blood volume becomes low, blood pressure falls. Regulated fluids and electrolytes.
Aldosterone
________-excessive blood volume, it causes the blood pressure to go up. It causes the production of renin to be suppressed, Now the kidneys will excrete more sodium and therefore more water.
Atrial natriuretic factor.
________- (hypovolemia) results when the patient loses both fluid and the electrolytes contained in that fluid.
Fluid Volume deficit
Whate are the causes of fluid volume deficit?
Hemorrhage and dehydration
Signs and symptoms of fluid volume deficit?
Patient report of little or no fluid intake or urine output
Patient report of frequent vomiting or diarrhea
Flushed, pale, hot, dry skin with nonelastic turgor (nonelastic turgor is a very late sign)
Complaints of thirst or nausea
Dry, cracked tongue and lips
Elevated heart rate
Weak pulse
Fever
Low blood pressure
In newborns, sunken or depressed fontanels
Decreased level of consciousness (severe fluid volume deficit)
Confusion (severe fluid volume deficit)
What are nurisng actions for fluid volime deficit?
Replace fluids orally and by IV as ordered by the health-care provider.
Monitor electrolyte levels closely.
Administer antiemetic medications ordered for nausea or vomiting, or antidiarrheal medication for loose stools.
Monitor vital signs for low blood pressure, elevated pulse rate, and elevated temperature.
Measure and monitor intake and output (I&O) for balance. Normally, the output total should be equal to or within 300 to 500 mL of the total intake. If a patient has a fluid volume deficit, urinary output initially will be less than the intake but should gradually increase as the patient becomes more hydrated. Safety: Persistent urinary output below 30 mL per hour may indicate renal failure.
Assess each patient to be sure that he or she has voided at least every 8 hours and notify the health-care provider if this does not occur.
Administer IV fluids at the rate ordered. Safety: Even though a patient who has fluid volume deficit needs fluids, rapid infusion of IV fluids may cause fluid volume excess, or overload.
________-(hypervolemia) is caused by retention of sodium and water in extracellular fluid
Fluid volume excess
What are the causes of fluid volume excess?
Causes of this include increased intake of dietary sodium; administration of IV fluids containing sodium; or retention of sodium or fluid as a result of medication or kidney, heart, or liver disease.
What arre nursing actions of fliud volume excess?
Carefully monitor I&O for fluid volume excess (intake greater than output).
Administer ordered diuretics and monitor for effectiveness.
Assess daily weights at the same time of the day, preferably before breakfast, using the same scales and with the patient wearing the same type of garment.
Monitor meal trays to ensure there are no extra salt packets or high-sodium foods because the patient will likely be on a low-sodium diet.
If the patient is on a fluid restriction, determine the volume of fluid allowed on each shift and monitor it closely. Post the volume of fluids allowed for each shift above the patient’s bed or on a marker board to serve as a reminder for patient, family, and staff. Collaborate with the dietary service to limit fluids sent on meal trays. Provide patient and family teaching to ensure their understanding and cooperation.
Monitor vital signs for elevated blood pressure, increased pulse rate, bounding pulse, elevated temperature, and pulse oximetry every 4 hours.
Auscultate breath sounds and heart sounds at least every 4 hours.
Check dependent body sites for edema. Dependent sites are those that are hanging down or where blood can pool. When the patient is sitting in a chair, the lower legs, feet and ankles are in a dependent position. When the patient is lying on his or her back in bed, the sacral area is in a dependent position.
Monitor urine output every 2 to 3 hours, or even every hour if inadequate urine excretion is suspected. Administer diuretics as ordered by the health-care provider. Safety: Some diuretics such as furosemide, a loop diuretic, are known to deplete the serum level of potassium, so check those levels often.
KNOWLEDGE CONNECTION
What are signs and symptoms of fluid volume excess?
Increased respiratory rate, shortness of breath with exertion, or labored respirations
Sudden onset of coughing
Jugular vein distention
Increased blood pressure or pulse pressure
Full, bounding pulse
Edema of extremities or dependent areas, such as feet, ankles, lower legs, and sacrum while in bed
Auscultation of crackles or wheezes in the lungs and muffled or distant heart sounds
Weight gain
Increased urine production
Pink or frothy sputum
Decreased oxygen saturation level
Anxiety or fear that is unexplainable by the patient
The normal Ph _________
7.35-7.45
Low ph is ____ and is referred to as ________
7.35
Acidosis
High pH is more than _____and is referred to as ______
7.45
Alkalosis
Which three system regulate balance and what is the fuction of each?
- Bicorbonate/ carbonic acid system: to maintain an acid /base balance
- Repiratory system: lungs control retention and elimination of co2 and acid
3.Renal system: Kidneys control retention and elimation of hydrogen (H), an acid, and sodium bicarbonate (NaHCO3), a base.
How are chemoreceptor impact pH?
Chemorecptor sense or detect changes in blood level of O2 and CO2
What occurs and causes respiratory acidosis?
less than 7.35
co2 greater than 45
HCO3 greater 22
When a patient does not breathe as deeply and frequently as normal, he or she will retain more carbon dioxide than normal. Some conditions that could cause this include opioid pain medications, certain other types of medications, pneumonia, and chronic respiratory diseases such as emphysema and chronic bronchitis. All of these cause hypoventilation, which traps carbon dioxide in the lungs where it converts to carbonic acid. When acid is trapped, the blood pH moves towards acidosis. Because the lungs are unable to regulate pH normally, this is referred to as respiratory acidosis.
What occurs and causes repiratory alkalosis?
When a patient is breathing rapidly and deeply, he or she will “blow off” more carbon dioxide than normal. Some mental states and illnesses that might cause this include fear and anxiety, fever, and overdose of aspirin. All of these cause hyperventilation. Remember that carbon dioxide combined with water makes carbonic acid, so when hyperventilation occurs, more carbonic acid is lost than with normal breathing. When acid is lost, the blood pH moves towards alkalosis. Because the lungs are unable to regulate pH normally, this is referred to as respiratory alkalosis.
What occurs and causes metabolic acidosis?
Metabolic Acidosis
If a patient has a condition that causes an increase in hydrogen ions or a very low level of bicarbonate ions, it will result in metabolic acidosis. Conditions that can cause this include prolonged diarrhea, intestinal disorders, and surgical removal of the colon. Because the intestinal tract contains large amounts of bicarbonate ions, damage to this area leads to loss of bicarbonate, causing the pH to lower. Two other conditions that also cause this situation are lactic acidosis, often the result of shock, and ketoacidosis, the result of uncontrolled diabetes mellitus. Both of these are types of metabolic acidosis. When patients are in kidney failure, their kidneys cannot respond to changes in pH, hydrogen ions are retained, and the pH falls below 7.35.
What occurs and causes metabolic alkalosis?
Metabolic Alkalosis
If a patient has a condition that causes either a marked loss of hydrogen ions or a marked increase of sodium bicarbonate, it will lead to metabolic alkalosis. Some conditions that cause this are severe vomiting and nasogastric suction. Both of these situations cause the patient to lose large amounts of hydrochloric acid from the stomach. Other possible causes of metabolic alkalosis include taking diuretic medications and overuse of antacids or taking sodium bicarbonate for heartburn. Diuretics can cause a loss of potassium in the urine, which stimulates the kidneys to excrete hydrogen ions to save potassium ions, leading to the pH increasing above 7.45. Antacids and sodium bicarbonate are alkaline, and excess amounts lead to alkalosis.
What is the correlation between water percentage and age?
Water accounts for 50% to 70% of the total body total weight. Age effects the precentage of water that comprises total body weight.
what is the sodium/water rule ?
where sodium goes water goes
What is the most improtant factor resulting in water intake?
Thirst
How is thrist stimulated ?
Hypothalamus sends information to stimulae thirst .Increased concentration of the plasma (osolality) results in low fluid levels in the blood.
What happens to water when it enters the bloodstream?
I becomes part of the plasma and is circulated throught the blood vessels until it reaches the capillary beds.
Water intake:
1.5-2 liter
Body composition
more mucle less fat
Hormonal regulation
antidiuretic hormone
aldosterone
atrial atriuertic factor
Normal fluid losses
Insensible fluid loss cannot be measure
normal fluid loss 1-3 L
water is moving
osmosis
molecules are moving
diffusion
liquids and fine solutes are moving
filtration
what is the weight equivalent for one liter of water ?
1 kilogram
Chemical substance that dissolve in water.
releases positive or negative charged ions
must be balanced maintain homeostasis, regulate fluid, maintain acid base balance
elctrolytes
Lungs
Acid base concerns:
not enough CO2,
(more CO2 needs to be retained)
slow RR
Lungs
too much CO2
(excess CO2 needs to be retained)
Increase RR
Kidneys
blood too acidic
Excrete hydrogen, retain HCO3
Kidneys
blood too alkaline
retain hydrogen ,
excrete HCO3
Blood/ buffer
blood too acidic
bicard secreted to lower acidity of blood
blood/buffer
blood too alkaline
carbonic acidic secreted to lower alkalinity of blood
______ is a weak base (it is considered alkaline )
bicarbonate
______- carbonic acid which is a weak acid ( it is considerd acidic)
CO2 plus H2O
