Final - 3 Fluid & Electrolytes Flashcards
normal calcium level
8.5 - 10.5
Hypocalcemia s/s
Polly The Cow Did Terribly (she didn’t make enough)
- parasthesias
- twitching/tetany
- diarrhea
- trousseou’s
Hypercalcemia s/s
Dairy Cows Can Wait (we have too much)
- diminished reflexes
- constipation
- confusion
- weakness muscle
normal Magnesium level
1.5-2.5
hypomagnesia s/s
The Tape Can Substitute
- tetany
- trousseu’s
- chvostek’s
- sensation changes
hypermagnesia s/s
Real Fridges Have Magnets
- resp. distress/depression
- flushing
- hypotension
- muscle weakness/decreased DTR
are calcium and magnesium correlated with one another, or are their s/s flip-flopped
similar
hyper = hyper
hypo = hypo
are phosphorous and calcium correlated with one another or are their s/s flip-flopped
flip-flopped
hyper = hypo
hypo = hyper
*minus the GI dysfunction
hypophosphatemia s/s
diminished reflexes, confusion, weakness
hyperphsophatemia s/s
tetany, chvostek’s, trousseau’s
Do you have increased BP with fluid volume overload of deficit
overload
Do you have low BP with fluid volume overload of deficit
deficit
Do you have weak, rapid pulse with fluid volume overload of deficit
deficit
Do you have bounding pulse with fluid volume overload of deficit
overload
Do you have flattened neck veins with fluid volume overload of deficit
deficit
Do you have distended neck veins with fluid volume overload of deficit
overload
Do you have nausea/vomiting with fluid volume overload of deficit
deficit
Do you have oliguria with fluid volume overload of deficit
overload
Do you have confusion with fluid volume overload of deficit
deficit
Do you have lethargy with fluid volume overload of deficit
deficit
Do you have fatigue with fluid volume overload of deficit
overload
Do you have dyspnea with fluid volume overload of deficit
overload
Do you have HA with fluid volume overload of deficit
deficit
Do you have edema with fluid volume overload of deficit
overload
Do you have dizziness with fluid volume overload of deficit
deficit
Do you have muscle cramps/weakness twitching-convulsions with fluid volume overload of deficit
deficit
Potassium regulates cardiac rhythm - an increase or decrease in K+ has a direct effect on _____ rhythm and _____ results
cardiac
EKG
high or low K+ s/s
Bananas Have Potassium
- bradycardia
- hypotension
- PVCs, dysrhythmias
hypokalemia s/s
Low Potassium Causes Cramps
- limp
- polyuria
- constipation
- leg cramps
Hyperkalemia s/s
Increased Potassium Offers Death
- irritability
- parasthesias
- oliguria
- diarrhea
high or low Na+ s/s
SALT
- seizures
- abdominal distress (cramping, n/v)
- low pressure
- tachycardia
hyponatremia s/s
LOW
- low temp.
- orientation (confused)
- weak/lethargy
hypernatremia s/s
DASH
- dehydrated (thirsty, dry mouth)
- agitated/twitchy
- swollen (fluid retention)
- hot/flushed (fever)
normal K+ levels
3.5 - 5.5
normal Na+ levels
135-145
hypertonic solutions
3% NS
5% NS
hypotonic solutions
0.45% NS
Isotonic solutions
0.9% NS
LR
Colloid Solutions
Dextran 40 in NS
Albumin
which solution do you use for burns
LR
Chronic Renal Failure causes _____
anemia
oliguria for pediatric pt’s is urine output less than _____
1 ml/kg/hr
Adults minimum urine output should be _____
30 ml/kg/hr
MAP =
(1 systolic + 2 diastolics)/3
<65
T/F: MAP is a tad bit more accurate than BP for your vasodilator meds
T
Renin-angiotensis system is produced in _____
liver
Aldosterone triggers reabsorption of _____ and is produced by _____
Na+
Kidneys
most accurate indicator of fluid loss or gain in acutely ill pt
weight
1 kg wt gain is equal to _____ mL of retained fluid
1000
1 lb wt gain is equal to _____ mL retained fluid
450
normal specific gravity
1.010 - 10.25
normal creatinine
0.5 - 1.5
normal BUN
7-20
normal BUN-to-creatinine ratio
10:3
biopsies are contraindicated in…
morbid obese pt’s
a reversible syndrome that results in decreased GFR and oliguria. Criterion is >50 increase in serum creatinine
acute renal injury
a progressive, irreversible deterioration of renal function that results in acotemia (an excess of urea and other nitrogenous wastes in the blood as a result of kidney insufficiency; compare to uremia)
chronic renal injury
main difference between acute and chronic renal injjry
acute: reversible
chronic: irreversible
- Before you get to the kidneys
- Due to Hypoperfusion (hypovolemia, hypotension, decreased cardiac output & heart failure).
- Labs: Oliguria, elevated BUN, normal creatinine.
prerenal
- Actual kidneys damaged
- Actual damage to kidney tissue occurs.
- Acute Tubular Necrosis (ATN) occurs.
intrarenal
- What happens after the kidneys (ex. prostate)
- Due to obstruction distal to kidney including obstructed arteries or veins. (Kidney stones are NOT common cause but can increase risk.)
postrenal
permanent -_____% reduction in GFR is normal
3%
phases of ARI
- initiation
- oliguria (<400/24 hrs)
- diuresis
- recovery
**most common cause of death in acute renal failure
hyperkalemia
nutritional information for the child with kidney disease
- low Na+, K+, P, sugar, fluids
drug that helps you get rid of K+ for hyperkalemis & acidosis
kayexalate causes extreme diarrhea, so the K+ is pooped out
hemodialysis is recommended when _____ of nephrons are no longer working
80%
how long is hemodialysis tx
typically 3x/wk for 2-4 hrs in an outpatient setting
common s/s hemodialysis
- hypotension
- n/v
- anemia
_____ agents must be held on dialysis days to avoid hypotension
antihypertensives
big difference between hemodialysis & peritoneal dialysis
you can have more protein with PD
