Fluid and Electrolyte

Question 1

Fluid can be intracellular (woth in cell) - 2/3 of total body water

Or

Transcellular… (name 3 types)

Answer 1

CSF, synovial fluid, pleural fluid

Question 2

New borns have the highest percentage of body fluids ___% and are at most risk fir fluid & electrolyte imbalances.

Answer 2

75%

Question 3

Maintenance fluid requirement Infant - Adolescente
Daily

Up to 10Kg….

11 - 20 Kg…..

> 20 KG…..

Answer 3

Up to 10Kg: 100mL × kg

11 - 20 Kg 1000 + 50 mL × each kg > 10

> 20 KG 1500 + 20Ml × ( each kg > 20)

Question 4

What physiological symptoms put baby at risk for fluid imbalance…. (4)

Answer 4

Increased body surface area

Increased metabolic rate

Kidneys are immature

Higher fluid requirement.

Injest & excretion of greater amount of fluid per Kg

Question 5

Normal specific gravity range for infants/ children…

Answer 5

Fluid volume exceess> 1.016 - 1.022 < dehydration

Question 6

Average urine output…

Answer 6

1mL / kg / hr

Question 7

Average number of urination daily

Infant

Adult

Answer 7

Infant 9 - 10

Adult 6 - 8

Question 8

ICP
Mechanical Ventilation
Kidney Disease
SIADH
CHF

Have this fluid requirement….

Answer 8

Decreased input

Question 9

Management of fluid overload…

Answer 9

Limit fluid
Diuretics
VS / Neurological
DAILY WEIGHT
find cause
Electrolyte
SEIZURE PRECAUTIONS

Question 10

Retention of NA

Damaged plasma proteins from starvation/ liver disease

Alterations in membrane permeability, nephrotic syndrome, trauma.

Lead to this problem….

Answer 10

Edema

Question 11

Edema complications…(4)

Answer 11

Peripheral/ Periorbital Edema (Infants)

Ascites fluid in abdominal cavity

Pulmonary edema Fluid in interstitial space of lungs

Cerebral edema- Trauma, infection, vascular overload of hypertonic solution

Question 12

Fever
Tachypnea
V&D
Birns
DI
DKA
Sickle cell
Gastric suction

All have this fluid requirement…

Answer 12

Increased

Question 13

Dehydration

Monitor _____ to access degree…

Answer 13

I&O
Urine Specific Gravity

Daily weight too

Question 14

Severe dehydration adminster _____ IV bolus

May tjen order maintenance rate or 1.5 maintenance rate of Dextrose solution unless Contradicted .

Answer 14

20 mL / Kg NS or LR

Question 15

Mild to moderate dehydration.

Oral rehydration therapy

Fluid given…

Answer 15

Pedialyte

NOTHING ELSE

NO WATER, BROTH, JUICE

Question 16

Isotonic fluids with adequate K, Ch, Dextrose.

IV solutions with K have this warning before use…

Answer 16

Don’t hang until K+ bag until urine output has been established

Question 17

Major ICF electrolyte…

Major ECF electrolyte…

Answer 17

K

Na

Question 18

False increase in K level can happen from this collection method…

Answer 18

Finger prick

Due to squeezing Finger to get more blood, leading to hemolysis

Question 19

135 - 145 range

3.5 - 5 range

Answer 19

135 - 145 Na

3.5 - 5 K

Question 20

Subarachnoid hemorrhage, brain tumor, meningitis, encephalitis, SIADH

Excessive loss of water from diarrhea, vomiting, sweating, burns, heavy respirations

Answer 20

Hyponatremia <135
Subarachnoid hemorrhage, brain tumor, meningitis, encephalitis, SIADH

Hypernatremia >145
Excessive loss of water from diarrhea, vomiting, sweating, burns, heavy respirations

Question 21

Which do you considered seizure precautions

Hypo / Hypernatremia

Answer 21

Hypernatremia >145

Question 22

Why is pH important in rhe body…

Answer 22

Enzymes only function at certain ranges

Question 23

Acidic >7.35 - 7.45<Alkaline

What is the range for infants…<2

Answer 23

Acidic >7.32 - 7.49 < basic

Question 24

Respiration & Co²

Remove Co² type of breathing

Retain Co² type of breathing

Answer 24

Remove Co² type of breathing (Rapid) Kussmaul

Retain Co² type of breathing (Slow) drugged up

Question 25

Renal system & Co² Reabsorption of CO² (Correction of ____) Excretion of CO² (Correction of ____)

Answer 25

Reabsorption of CO² (Correction of acidosis Excretion of CO² (Correction of alkalosis

Question 26

Capillary Blood Gas Measures pH, HCO³ , PCO2 (Correltes well with arterial sample) PaO² levels mot reliable, use...

Answer 26

PO² Pulse oximity

Question 27

CBC with PaO² maybe used instead of ABG T or F

Answer 27

T

Question 28

Do a few ABG with compensation for NCLEX Practice

Answer 28

Less than 6 months til you take the boards

Question 29

Resp Acid base disorders Causes CNS depression Asphyxia Hypoventilation Causes Hyperventilating Respiratory stimulation- drugs,fever,hot temps Gram neg bacteria

Answer 29

Acidosis CNS depression Asphyxia Hypoventilation Alkalosis Causes Hyperventilating Respiratory stimulation- drugs,fever,hot temps Gram neg bacteria

Question 30

SS Paresthesia, light headed, twitching, anxiety, fear Diaphoresis, HA, Tachycardia, confusion, Restlessness, flushed face Respiratory Acidosis Respiratory Alkalosis

Answer 30

Respiratory Alkalosis Paresthesia, light headed, twitching, anxiety, fear Respiratory Acidosis Diaphoresis, HA, Tachycardia, confusion, Restlessness, flushed face

Question 31

Causes Diarrhea - bicarbonate depletion Renal Disease Hepatic disease - excessive production of organic acids Causes Prolonged vomiting/ gastric suctioning- loss of hydrochloric acid Loss of K from diuretics/ steroids Metabolic Alkalosis Metabolic Acidosis

Answer 31

Metabolic Acidosis Diarrhea - bicarbonate depletion Renal Disease Hepatic disease - excessive production of organic acids Metabolic Alkalosis Causes Prolonged vomiting/ gastric suctioning- loss of hydrochloric acid Loss of K from diuretics/ steroids

Question 32

SS Slow shallow breathing, hypertonic nuscles, Restlessness,twitching, confusion, tetany, seizures, coma Rapid deep fruit breathing, fatigue, HA, Lethargy, NV, Ab pain, coma Metabolic acidosis Metabolic alkalosis

Answer 32

Metabolic alkalosis Slow shallow breathing, hypertonic nuscles, Restlessness,twitching, confusion, tetany, seizures, coma Metabolic acidosis Rapid deep fruit breathing, fatigue, HA, Lethargy, NV, Ab pain, coma