fluid and electrolyte Flashcards
hypotonic solution
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
Hypertonic solution
higher solute concentration
water is pulled from cells, causing crenation (shrinking)
10% dextrose in water
isotonic solution
plasma solute concentration (same osmolarity as plasma)
0.9% sodium chloride, NS, lactated ringers
hypovolemia (fluid volume deficit)
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
hypovolemia defining characteristics
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
hypovolemia interventions and assessments
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
hypervolemia (fluid volume excess)
sodium and water retention
excessive sodium intake
defining characteristics of hypervolemia
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
hypervolemia interventions and assessments
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
acid base balance
blood chemical buffers
respiratory system
kidneys
blood chemical buffers
constantly regulates hydrogen
body’s first line of defense
respiratory system (acid base)
controls carbon dioxide levels within minutes of a change in pH
second line of defense
kidneys (acid base)
excrete or retain bicarbonate
third line of defense
compensations (complete vs partial)
involves opposites
complete: pH is in normal range
partial: pH remains outside the normal range
ABG normal values
pH: 7.35-7.45
pCO2: 33-45 mmHg
HCo3-: 22.26 (or 28) mEq/L