Fluid and Electrolyte Flashcards
1
Q
Extracellular fluid
A
- fluid outside the cells ( intravascular/ interstitial )
- 1/3 total body water
2
Q
Intracellular
A
fluid in the cells
- 2/3 total body water
3
Q
infants
A
- have high daily fluid requirement w/little reserve
- have higher metabolic rates, body surface area, and immature kidneys which means they lose water through breathing, skin, and doesnt conserve water
4
Q
Minimum urine output for kids
A
1-2 ml/kg/per hour
5
Q
What is Extracellular fluid volume deficit (ECFD)
A
- dehydration
- CAUSES : vomiting, diarrhea, NG suctioning, burns, phototherapy leads to electrolyte imbalances
- TX: ondansterone, oral rehydration therapy, strict I/O, education
- NURSING: ** monitor weight loss= MAJOR INDICATOR OF DEHYDRATION ***
6
Q
Mild s/sx of dehydration
A
- restless, thirsty
7
Q
moderate s/sx for dehydration
A
- irritable, thirsty
- VS change ( increased RR + HR, decreased BP )
- dry mucus membranes, minimal tears
- decreased urine output
- delayed capp refill (3-5 sec)
- sunken fontanels
8
Q
Severe s/sx of dehydration
A
- Lethargic ( tiredness, decreased energy, and metal alertness )
- Increased VS changes ( decreased BP= 40% loss of fluid volume )
- Parched, no tears, dry mucus membranes, no urine output
- Capp refill >5 sec
- cool, pale
9
Q
Extracellular fluid volume excess (ECFE)
A
- Overhydration caused by fluid + sodium retention
- CAUSES: heart failure, kidney failure, tumors, excessive IVF admin
- S/SX: weight gain (0.5 kg in 24 hours), generalized edema, bounding, pulses, resp. distress
- TX: depends on cause, diuretics ( watch k+), heart function ( digoxin, beta blocker ), fluid restriction, sodium restriction
10
Q
Hypernatremia
A
- High serum sodium level (>145 )
- Causes: diarrhea, vomiting, ** POOR FEEDING W/ NORMAL DIURESIS **, limited water intake, diabetes insipidus, concentrated baby formula
- S/SX: increase thirst, restlessness, confusion, lethargy, seizures, coma, death, ** ELEVATED URINE SPECIFIC GRAVITY **
- TX: hypotonic IVF -0.45 NS ( moves water into cells ), education (4-6 wet diapers), strict I/O, monitor neuro status + VS
11
Q
Hyponatremia
A
- Low serum sodium (<135)
- CAUSES : excessive water intake, dilute formula, exercise
- S/SX: headache, weakness, lethargy, confusion, seizure, coma, death
- TX: fluid restriction, strict I/O, hypertonic IVF ( moves water out of the cell ), assess neuro status, education, monitor serum sodium, urine specific gravity
12
Q
Hyperkalemia
A
- High serum potassium > 5.5 ( affects muscle function, heart arrhythmias )
- CAUSES: renal insufficiency, increased IV or dietary K +, weakness, lethargy , abd. pain, cramps, cell death ( releases k+ )
- TX: drive k+ back into cells ( K+ follows glucose, kayexelate, monitor K+ (3.5-5.5), monitor heart ( listen at apical )
- NURSING: be sure child is urinating before adding K+ to any IVF
13
Q
Hypokalemia
A
- Low serum potassium <3.5
- CAUSE: vomiting, diarrhea, bulimia, NG suctioning, diuretics
- S/Sx: weakness, dysrrhythimias, constipation
- TX: K+ replacement, monitor serum K+, monitor VS- heart monitor, K+ give IV slow- never give IV push
14
Q
Respiratory ACIDOSIS
A
- increased CO2 = decreased pH
( CO2 + water = carbonic acid ) - CAUSE: anything that interferes w/ CO2 excretion
- NURSING INTERVENTION: encourage deep, breathing, and assit with respiration
15
Q
Respiratory ALKOLOSIS
A
- decreased CO2 = increased pH
( not enough CO2) - CAUSE: hyperventilation
- S/SX: paresthesia, dizzy, cramps
