Exam 3 - Fluid and Electrolytes Flashcards
-natremia
sodium
-kalemia
potassium
-calcemia
calcium
-magnesemia
magnesium
what is the range for sodium?
136 to 145 mEq
what is the range for potassium?
3.5 to 5.0 mEq
what is the range for calcium?
8.5 to 10.2 mEq
what is the range of magnesium?
1.3 to 2.1 mEq
what should urine output be per hour (at least)?
0.5 mL per kg
what type of fluid is electrolytes found in?
both intra and extracellular
what is the major player for extra cellular fluid?
sodium
what compartment has most fluid?
ICF
what is ECF made up of
interstitial, intravascular and other… including lymph and synovial
what type of movement is osmosis?
pulling of water
what is the major player of ICF?
potassium
to what concentration does osmosis move?
high to low
what does diffusion rate depend on
size of molecule, temperature and concentration of solution
what is filtration or hydrostatic pressure?
pushing action
what direction does the fluid and solutes go on the arterial side of the cap bed?
outward
which is higher, the arterial capillary pressure or the venous?
arterial
what is isotonic osmolality?
fluid in each compartment stays put
what is hypertonic osmolality?
fluid in ICF moves out – cells shrink
what is hypotonic osmolality?
fluid in ECF moves in – cells swell
what does thirst/fluid intake trigger? what regulates thirst and fluid intake?
angiotensin/hypothalamus
what does ADH do?
regulates excretion from the kidneys- wants water reabsorbed
what is the atrial natriuretic system?
counter increase in BP and volume from renin-angiotensin-aldosterone
what is the primary regulator of the electrolytes and body fluids?
kidneys
how do the kidneys play a role in acid base regulation?
excrete hydrogen ion and retain bicarb
what does the renin-angiotensin-aldosterone system do?
retain sodium and water (increase BP)
edema
accumulation of fluid in interstitial spaces
localized edema
organ or site of injury
dependent edema
feet/legs or buttocks
generalized edema
more uniform distribution
what is third spacing?
shifts of fluid from vascular space to unavailable location
how is edema caused by decreased capillary oncotic pressure?
pushed out what it needed and vascular did not want it
how is edema caused by increase capillary hydrostatic pressure?
capillary has too much pressure and venous is also too high
how is edema caused by increased capillary permeability?
too much left the capillary
what is fluid volume deficit?
hypovolemia
the isotonic loss of water and electrolytes
what are some causes of hypovolemia?
excessive sweating
vomitting/diarrhea
high drainage wound
what are some signs and symptoms of hypovolemia?
hyperthermia tachycardia weak pulse dizziness thirst pale
what are nursing interventions for hypovolemia? (8)
assess manifestations weight and VS turgor and mucous membranes BUN and creatine administer fluids (isotonic) frequent mouth care prevent skin breakdown fix underlying cause
what is low pH
acidic
what is high pH
alkalosis
what is a normal pH
7.35 to 7.45
how is a pH balanced?
renal system (slowest) respiratory system (2nd) buffers (quickest)
how much mEq/L should be in each compartment?
154 in ecf and 196 to icf
what is a buffer
neutralizes the excess acid or bases (chemical line of defense)
what is the role of the respiratory system in acid base balance?
eliminate or retain carbon dioxide
what happens when breaths are deep and fast?
co2 leaves and pH rises
what happens when breaths are shallow and slow?
retain co2 and pH lowers
what is the respiratory buffer?
co2
pco2 numbers
35 to 45
how does the renal system work to maintain acid base balance?
regulates through excreting or conserving bicarb or hydrogen ions
what is the renal systems main mechanism function?
kidneys
what is the renal systems player
HCo3
HCO3 numbers
22-26
what is respiratory acidosis
retention of co2
what is the panic level of sodium
110
what is the panic level of potassium
2.5 / 6.6
what is the panic level of chloride
80
what is the manic level of pH
7.2 or 7.6
what is the panic level of paCO2
20/70
what is the panic level of HCO3
10/40
what is the panic level of paO2
40
what is the panic level of saO2
50%
what is fluid volume excess
isotonic gain of water and electrolytes
causes of hypervolemia
chronic stimulus for kidneys to retain
renal function abnorms
age
intake sodium excess
what is distinct difference between over hydrations and FVE
increase in electrolytes and BUN/Creatine
nurisng interventions for FVE (11)
assess manifestations monitor weight and VS assess for edema assess breath sounds monitor I and O monitor lab findings place in fowlers administer diuretics restrict fluid intake restrict sodium implement measures for skin breakdown
what two electrolytes don’t like each other?
potassium and sodium
what are the main target cells for sodium?
nerve and muscle cells and influence water distribution
what does potassium regulate?
cell excitability
what is calcium the major cation for
teeth and bones; muscles must have to contract
what does chloride do?
affects body pH, maintain acid base
what does phosphate do
hydrogen buffer; promotes energy storage
what does bicarb do
regulate acid base balance
lethargy confusion coma headache apprehension seizures
may be what?
hyponatremia
hypernatremia causes
"model" Medications/meals Osmotic diuretics Diabetes insipidus Excessive h20 loss Low H20 intake
hypernatremia signs and symptoms
"FRIED" Fever/flush skin Restless and irritable Increase fluid retention and high BP Edema Decreased urine output/dry mouth
hypokatremia signs
weakness
constipation
hyperkalemia signs (8)
muscle twitches cramps irritability anxiety low BP EKG changes dysrythmias diarrhea
how to check for hypocalcemia
chovestks
trousseau
hypocalcemia
bleeding gums
hypercalcemia
kidney stones lethargy anxiety nausea constipation anorexia
nystagmus confusion alcoholism malnutrition malabsorption tremors
may be
hypomagneisium
nausea vomitting muscle weakness hypotension bradycardia respiratory depression depressed nerve function and MSK fxn
hypermagensium
