fluid and electrolyte Flashcards

1
Q

hypotonic solution

A

lower solute concentration
NEVER GIVEN IV
excessive IV infusion of this will cause severe fluid and electrolyte imbalance
0.45% NS, 5% dextrose in water

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2
Q

Hypertonic solution

A

higher solute concentration
water is pulled from cells, causing crenation (shrinking)
10% dextrose in water

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3
Q

isotonic solution

A

plasma solute concentration (same osmolarity as plasma)
0.9% sodium chloride, NS, lactated ringers

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4
Q

hypovolemia (fluid volume deficit)

A

loss of H2O and electrolytes from ECF
confusion, combative, coma
veins become flat in supine position
prolonged capillary refill (above 5 seconds)
concentrated urine, oliguria, dry skin, furrowed tongue, decreased moisture in oral cavity
tachycardia, tachypnea, hypotensive
loss of sensation

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5
Q

hypovolemia defining characteristics

A

extreme thirst, irritable, dizzy, weak, fever, dry skin, dry mucous, increased urine specific gravity and HR, decreased BP, orthostatic hypotension, weak and rapid pulse, increased hematocrit and BUN and serum sodium, decreased hemoglobin

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6
Q

hypovolemia interventions and assessments

A

monitor sodium level, urine specific gravity, osmolarity, virals, I&O, abdominal girth, daily weights
encourage salt free foods
administer IV fluids
replace lost fluids (over 48 hours)
provide skin care
administer oxygen

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7
Q

hypervolemia (fluid volume excess)

A

sodium and water retention
excessive sodium intake

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8
Q

defining characteristics of hypervolemia

A

confusion, disorientated, convulsion, coma
increased BP
decreased BUN, hematocrit, sodium, specific gravity
SOB, tachypnea, dyspnea, weak, crackles/wheezes, pleural effusion, pulmonary edema, bounding pulse, neck,hand vein distention, quick weight gain, peripheral edema, ascites, polyuria

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9
Q

hypervolemia interventions and assessments

A

monitor ABG, resp status, response to diuretics, rate of IV therapy, measure abdominal girth for ascites patient, STRICT I&O and weights
restrict sodium and fluid intake, administer diuretics as prescribes, O2 therapy, elevate HOB

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10
Q

acid base balance

A

blood chemical buffers
respiratory system
kidneys

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11
Q

blood chemical buffers

A

constantly regulates hydrogen
body’s first line of defense

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12
Q

respiratory system (acid base)

A

controls carbon dioxide levels within minutes of a change in pH
second line of defense

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13
Q

kidneys (acid base)

A

excrete or retain bicarbonate
third line of defense

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14
Q

compensations (complete vs partial)

A

involves opposites
complete: pH is in normal range
partial: pH remains outside the normal range

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15
Q

ABG normal values

A

pH: 7.35-7.45
pCO2: 33-45 mmHg
HCo3-: 22.26 (or 28) mEq/L

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16
Q

respiratory acidosis risk factors

A

hypoventilation (COPD, pneumonia, atelectasis)
respiratory depression (barbiturate or sedative overdose, guillian barre)
respiratory arrest

17
Q

resp acidosis clinical manifestations

A

neurological (coma, drowsy, disoriented)
cardiovascular (hypotension, tachycardia)
respitatory (shallow, dyspenea, tachypnea, bradypnea)
muscular (weak, tremors)
GI (n/v/d)
pH below 7.35, paCO2 above 45, HCO3 normal

18
Q

respiratory alkalosis risk factors

A

hyperventilation, anxiety, salicylates, disease states, mechanical over ventilation, hypermetabolic states, acute hypoxia, pulmonary disease, anemia, hypotension

19
Q

respiratory alkalosis clinical manifestations

A

neurologic: hyporeflexia, disoriented, weak, coma
muscular: tetany hyperreflexia
respiratory: hyperventilation, dyspnea, tachypnea
cardiac: syncope, chest pain, EKG changes
diaphoresis
pH above 7.45, paCO2 below 35, HCO3 normal

20
Q

metabolic acidosis risk factors

A

cardiac arrest, aspirin, overdose,
excess production of acids (DKA, lactic acidosis)
inadequate loss of acids (uremia)
excess loss of base (diarrhea)

21
Q

metabolic acidosis clinical manifestations

A

neurologic: hyporeflexia, disoriented, weak, coma
GI: NVD, abdominal pain, dehydration
cardiacL peripheral edema, weak pulse, hypotension
respiratory: hyperventilation
pH is less than 7.35, paCo2 normal, HCO3 less than 22

22
Q

metabolic acidosis nursing interventions

A

treat underlying cause (diarrhea, DKA)
monitor K+ levels neurologic status
provide mechanical ventilation
dialysis as ordered

23
Q

metabolic alkalosis risk factors

A

loss of acids (vomit, excess gastric suctioning)
base or buffer inbalance (K+ deficit, excess NaHCO3 intake)
disease states (cushing, kidney)
multiple transfusions
overcorrection of acidosis

24
Q

metabolic alkalosis clinical manifestations

A

neurologic: confusion, stupor, coma
GI: anorexia, nausea, vomiting
muscular: weakness, tetany, paresthesia, hyperreflexia, tremors, cramps
respiratory, hypoventilation cyanosis
pH above 7.45, PaCO2 above 45, HCO3 above 26

25
Q

potassium important info

A

never give IM or IV push or bolus, it is too rapid an infusion
never given on an empty stomach

26
Q

diuretics

A

furosemide/ lasix
main cause of potassium/ sodium loss

27
Q

dehydration

A

skin sticks together due to decrease in interstitial fluids
elderly turgor= skin has decreased elasticity