EXAM 2: F&E Flashcards
How much of body weight is water?
50-60%
How much of the body is the ICF compartment and how much of the body is ECF?
70%; 30%
What variations determine body fluid needs in the body?
- age
- body fat
- biological sex
What is meant by sensible?
urination + defication
What is meant by insensible?
sweat
What are the cations?
- Sodium
- Potassium
- Calcium
- Hydrogen
- Magnesium
What are the anions?
- Chloride
- Bicarbonate
- Phosphate
What are non-electrolytes?
- Urea
- Glucose
How does gases enter or leave a cell?
by diffusion
How does water enter or leave a cell?
by osmosis
How does glucose, amino acids and salts enter or leave a cell?
by active transport
What two processes are passive, requiring no ATP?
osmosis and diffusion
This regulation requires energy and ATP against a concentration gradient:
active transport
This regulation passes through a permeable membrane from a higher to lower pressure gradient:
capillary filtration
What is a buffer?
solutions that contain a weak acid and conjugate base
What is the main organ utilized in a buffer?
the kidneys
What organ systems regulate hydrogen ions?
the respiratory and renal systems
What is hypovolemia (dehydration)?
when you have less blood running through the veins; loss of water and solutes in ECF
Who is at risk for experiencing hypovolemia?
- children
- elderly
- ill
What is the different levels of severity for hypovolemia?
- Pronounced 5%
- Severe 8%
- Life-threatening 15%
What is third space shift?
fluid is stuck in the ECF so its not running through the veins but is collecting in the transcellular space (they are dehydrated but have fluid built up)
What is hypervolemia?
Intravascular compartments and interstitial spaces have a overload of blood
What is perinsitis?
a local anesthetic to get fluid out
What is 0+ edema classified as?
non-pitting edema that is 0mm
What is 1+ edema classified as?
mild pitting edema that is 2mm and disappears rapidly
What is 2+ edema classified as?
moderate pitting edema that is 4mm and disappears in 10-15 seconds
What is 3+ edema classified as?
moderately severe edema that is 6mm and a depression that last more than 1 minute
What is 4+ edema classified as?
severe pitting edema that is 8mm and the depression last more than 2 minutes
What should be the first attempt to regain F&E balance?
the diet (try changing diet before giving F&E via IV which would be the fastest route if too much has been lost)
What is the cause of hyponatremia?
- Loss of Na or gain of water
- Fluid Swift Extracellular to intracellular causing, swelling
What are the s/sx of hyponatremia?
Confusion hypotension, edema, muscle cramps & weakness, and dry skin
What is considered severe hyponatremia?
Serum sodium less than 115mEq/L
What are the s/sx of severe hyponatremia?
Increased intracranial pressure, lethargy, muscle twitching, focal weakness, hemiparesis and seizures***…death
What is the cause of hypernatremia?
- Excess water loss or excess sodium
- Swift of fluids from the cell causing them to shrink
What are the s/sx of hypernatremia?
- Neurological Impairment
- Children – Permanent brain damage
What are the causes of hypokalemia?
vomiting, suction, alkalosis, diarrhea (laxatives), diuretics
What are the s/sx of hypokalemia?
Muscle weakness, leg cramps, fatigue, parathesias, and dysrhythmias***
What is the cause of hyperkalemia?
Renal failure, hypoaldosteronism, or medications
What are the s/sx of hyperkalemia?
- Poor nerve conduction and muscle contractility
- Skeletal muscle weakness and paralysis
- Dysrhythmias and Cardiac arrest
What is the cause of hypocalcemia?
Decreased intake, poor absorption, excessive loss
What are the s/sx of hypocalcemia?
Numbness and tingling of fingers, mouth, or & feet, and seizures
What is the cause of hypercalcemia?
Cancer and Hyperparathyroidism
What are some s/sx of hypercalcemia?
bone pain, excessive urination, constipation & slurred speech
What is the cause of hypomagnesemia?
alcohol withdrawal, tube feedings & parental nutrition, sepsis, and burns
What are some s/sx of hypomagnesemia?
tetany, hyperactive deep tendon reflexes, & respiratory paralysis
What is the cause of hypermagnesemia?
renal failure
What are the s/sx of hypermagnesemia?
loss of DTRs, resp depression, coma, & cardiac arrest
What is the cause of hypophosphatemia?
Administration of calories, alcohol withdrawal, diabetic ketoacidosis, hyperventilation, insulin release,
What are the s/sx of hypophosphatemia?
Irritability, fatigue, weakness, paresthesias, confusion, seizures, and coma
What is the cause of hyperphosphatemia?
Impaired kidney excretion and Hypoparathyroidism***
What are the s/sx of hyperphosphatemia?
Tetany, anorexia, and tachycardia
What is the cause of hypochloremia?
gastric tube drainage***, metabolic acidosis
What are the s/sx of hypochloremia?
Hyperexcitability of muscles, tetany, hyperactive DTRs, weakness & muscle cramps
What is the cause of hyperchloremia?
Metabolic acidosis, head trauma, increased sweating, excess adrenocortical hormone, and decreased glomerular filtration
What are the s/sx of hyperchloremia?
Tachypnea, weakness, lethargy, diminished cognitive ability, hypertension, decreased cardiac output, dysrhythmias, and coma
What organ is responsible for sodium bicarbonate?
the kidneys
What organ is responsible for carbonic acid?
the lungs
What is the treatment for metabolic acidosis?
sodium bicarbonate
What is the treatment for metabolic alkalosis?
fluid and electrolytes
What condition presents with a higher level of CO2?
COPD
What is the treatment for respiratory acidosis?
a bronchodilator
What is the treatment for respiratory alkalosis?
fluid and electrolytes
What is the cause of respiratory acidosis?
Alveolar Hypoventilation
What is the cause of respiratory alkalosis?
Alveolar Hyperventilation
What should always be taken and monitored in patients with F&E imbalance?
I/O (may not always balance out)
When/how should daily weights be taken?
in the morning at the same time and in the same clothing
Where should the fluid balance be maintained?
at 2,500ml I&O over 3 days
All IV fluid therapy should be done using what technique?
the sterile technique
How should IVs be placed?
- do not place in dominant arm
- choose most distal site as possible
- you can always go up on the arm but never lower on the arm
What are the different types of vascular access devices?
- Peripheral venous catheters
- Midline peripheral catheters
- Central venous catheters
This IV solution will cause the cell to shrink and edema:
hypertonic solution
This IV solution will cause the cell to swell and dehydration?
hypotonic solution
What are the rules when giving blood products?
- two nurse check
> if a home RN, another responsible adult must be present - type and cross check
- vitals signs should be rechecked in 15 minutes after starting the transfusion
- the infusion must start within 30 minutes
- infusion unit must be completed within 4 hours or discarded because after 4 hours the blood will start to clot
An adult IV catheter is what size?
20-24g
An adult rapid infusion catheter is what size?
14-18g
If a patients temperature rises over 100 F(38C) during a blood transfusion, what should you do?
stop the transfusion ASAP
An acute adverse reaction to a blood transfusion can occur within?
24 hours
An delayed adverse reaction to a blood transfusion can occur within?
1 day to several days
What are the different types of parenteral nutritions?
- central parental nutrition (central line)
- peripheral central parenteral nutrition (PICC line)
Who can benefit from parental nutrition?
Patients who:
- have nonfunctional GI tracts
- are comatose
- have high caloric needs
- are on aggressive cancer therapy
- have burns, surgery, sepsis, or multiple fractures
What are some complications of parental nutrition?
- Catheter-related infection
- Electrolyte imbalances
This parental nutrition is expensive ($1k-$1500k/bag) but contains everything the patient needs:
TPN
What are the normal lab values for potassium?
3.5-5.0
What are the normal lab values for magnesium?
1.5-2.5
What are the normal lab values for calcium?
8.5-10.5
What are the normal lab values for phosphorus?
2.5-4.5
What are the normal lab values for chloride?
95-105
What are the ABGs?
pH = 7.35-7.45 pCO2 = 35-45 HCO3 = 22-26 pO2 = 80-100
What is the normal range for Hct? What is the normal range for Hgb?
36%-52%; 12-17
