Exam 2: Fluids/Electrolytes Flashcards
Where is extracellular fluid (ECF) located in the body?
interstitial and intravascular and transcellular (CSF)
What is the kidneys role in maintaining fluid balance?
Excretes excess water from body
Manages fluid homeostasis
What is the effect of sodium on fluid balance?
Water follows sodium
Most abundant electrolyte in body fluid. Will determine if you have fluid volume excess or deficient
S/S of HYPERnatremia
> 145
Mental status changes - agitation
Thirst
Dry, flushed skin w/low grade fever
Dry mucous membranes
^ BP w/ edema
Decreased UOP
S/S of HYPOnatremia
< 135
Mental status changes - stupor/coma
Hypotension (orthostatic) + reflex tachycardia
Nausea/Vomiting/Diarrhea
Convulsions
Hyporeflexia
Weak/limp
S/S of HYPERkalemia
> 5.0
Dysrhythmias (Peaked T waves, widened QRS complex, PR interval prolongation)
Respiratory distress
Decreased cardiac contractility
Anxiety
Weakness
Muscle cramps
Hyporeflexia
S/S of HYPOkalemia
< 3.5
Cardiac dysrhythmias (PVC, VT, VT) (U waves, flat or inverted T waves, ST segment depression)
Weakness & Fatigue - irritability
Thready pulse
Decreased muscle tone
Alkalosis (increases H+ secretion in the distal nephron)
S/S of HYPERmagnesemia
> 1.9
Hypoactive reflexes
Flushing
Prolonged PR interval on ECG
decreased RR, HR, BP
S/S of HYPOmagnesemia
< 1.5
Tremors
Hyperreflexia
Confusion
Dysrhythmias & tachycardia
Prolonged QT interval
S/S of HYPERcalcemia
> 10.5
Lethargy
Constipation
Muscle weakness
Confusion or Altered Mental Status
Dysrhythmias (Shortened ST segment & Heart Block)
Bone pain (shift from bones -> ECF)
Kidney stones
S/S of HYPOcalcemia
< 8.4
Numbness of fingers/toes/mouth
Tremors/seizures
Dysrhythmias (Prolonged ST segment)
Chvostek’s (face) and Trousseau’s (carpopedal w/BP) signs
What are some safety precautions when replacing electrolytes?
Fix fluid problem first before electrolyte
Need to be on a pump
Cardiac monitor, if needed
Evaluate lab values as you replace
What is the physiological effect of isotonic, hypotonic, and hypertonic fluids when introduced into the venous circulation?
Isotonic - stay in the vein, increase preload, increase bp, hydrate cells that are dehydrated
Hypotonic
Fluid shift out of the bloodstream to the area of higher concentration in the interstitial and intracellular spaces (hydrate cells)
Hypertonic
albumin
Fluid shift from the interstitial/intracellular space into the intravascular space
What are some examples of isotonic, hypotonic, and hypertonic fluids?
isotonic - normal saline (0.9% sodium chloride), lactated Ringer’s solution, 5% dextrose in water (D5W), and Ringer’s solution
hypotonic - 0.45% Normal Saline (0.45% NaCl)
hypertonic - 3% Normal Saline
What are the causes of fluid volume excess and fluid volume deficit?
Fluid volume deficit
ECF deficit can occur due to inadequate intake and/or abnormal losses, third spacing
Signs/symptoms: weight loss, thirst orthostatic/postural changes, hypotension, decreased urine output
Fluid Volume Excess
Due to cardiac, renal and liver disease
Hydrostatic pressure forces fluid into interstitial space
Edema is visible after a significant increase in ECF volume
