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NUR 122 > Fluid And Electrolyte > Flashcards

Fluid And Electrolyte Flashcards

0
Q

What is second spacing?

A

Excess accumulation of interstitial fluid; edema

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1
Q

What is “first spacing”?

A

Normal distribution of fluid both intra and extra cellular

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2
Q

What is third spacing?

A

Occurs when fluid accumulates in areas that normally do not have fluid or only a small amount

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3
Q

What is an isotonic fluid imbalance?

A

When water and electrolytes are lost in equal proportions but osmolality remains unchanged

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4
Q

What adverse conditions can third spacing produce?

A

Hypovolemia

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5
Q

What is an osmolar fluid imbalance?

A

Losses or excess of only water that affect the serum concentration

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6
Q

What is osmolarity?

A

Concentration

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7
Q

What is an isotonic fluid volume deficit?

A

Water and electrolytes lost in equal proportions due to excessive fluid loss or 3rd space shifting

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8
Q

What assessment findings should be expected in a patient with hypovolemia?

A

Increased Hct, BUN and urine specific gravity. Tachycardia, hypotension, weak, thready pulse. (If hypovolemia is caused by hemorrhage: Hct and Hgb will decrease)

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9
Q

What is the alternate name for isotonic fluid volume excess?

A

Hypervolemia

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10
Q

How much fluid is lost from the lungs each day?

A

350-400 mL

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11
Q

What are common causes of hypervolemia?

A

Excessive fluid/sodium intake or fluid/sodium retention.

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12
Q

What assessment findings should be expected in a patient in fluid volume excess?

A

Decreased BUN and Hct. Rapid, bounding pulse, tachycardia, hypertension, JVD

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13
Q

What are the two types of IV solutions?

A

Crystalloids and Colloids

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14
Q

What are the three types of crystalloids?

A

Isotonic, hypotonic and hypertonic

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16
Q

What is hypotonic IV solution used for?

A

To shift fluid from the ECF to ICF

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17
Q

What is intravascular fluid?

A

Plasma (the fluid inside blood vessels)

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18
Q

What are examples of third spacing?

A

acites and pulmonary edema

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19
Q

A change in fluid status (whether excess or deficit) with unchanged osmalaity is what?

A

Isotonic

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20
Q

A change in fluid status that affects the concentration of serum is?

A

Osmolar

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21
Q

What would be the appropriate nursing intervention for hyponatremia due to excess volume?

A

Place the pt on a fluid restriction

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22
Q

A pt who is vomiting would have which acid-base imbalance?

A

Metabolic Alkalosis

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23
Q

A pt with diarrhea would have which acid-base imbalance?

A

Metabolic Acidosis

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24
Q

What is the normal range for a pt’s pH?

A

7.35 to 7.45

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25
Q

What is the normal range for a pt’s CO2?

A

35 to 45

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26
Q

What is the normal range for a pt’s HCO3?

A

22 to 26

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27
Q

What are the signs of hypercalcemia?

A

lethargy, headache, weakness, muscle flaccidity, heart block, anorexia, nausea, and vomiting

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28
Q

What is the normal range of serum potassium?

A

3.5 to 5.5

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29
Q

What is the normal level of phosphorus in the body?

A

2.4–4.4

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30
Q

DKA is what type of acid-base imbalance?

A

Metabolic Acidosis

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31
Q

When planning care for adult patients, the nurse concludes that which oral intake is adequate to meet the daily fluid needs of a stable patient?

A

2000-3000 mL

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32
Q

What is acites?

A

extended abdomen

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33
Q

What causes acites?

A

Liver failure

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34
Q

What is the first indication of heart failure?

A

Weight gain

35
Q

What is the amount of weight gain that should trigger concern for heart failure?

A

2 lbs in 24 hours or 5 lbs in a week

36
Q

What type of IV fluid should be administered for a hypertonic fluid volume deficit?

A

Hypotonic fluid

37
Q

What are the cations?

A

Sodium, Potassium, Calcium and Magnesium

38
Q

What is most sodium found?

A

in the ECF –> extra cellular fluid

39
Q

What is the normal range for sodium levels?

A

135-145

40
Q

What are the bodies anions?

A

Bicarbonate, Chloride and Phosphate

41
Q

What is diffusion?

A

movement of molecules from an area of high concentration to one of low concentration

42
Q

What is osmosis?

A

water moving, usually through a membrane, from low concentration to high concentration

43
Q

What is normal plasma osmolality?

A

275-295

44
Q

A pt with decreased pH and increased CO2 has what?

A

Respiratory acidosis

45
Q

Primary signs of respiratory acidosis is what?

A

Lethargy and confusion

46
Q

A pt with increased serum pH and decreased CO2 has?

A

Respiratory alkalosis

47
Q

A pt with respiratory alkalosis will probably be doing what?

A

Hyperventilating

48
Q

Decreased pH and decreased HCO3 means what?

A

Metabolic acidosis

49
Q

What is the treatment for metabolic acidosis?

A

Give IV HCO3, regulate fluid and electrolytes, administer insulin for high blood sugar

50
Q

Increased pH and increased HCO3 means?

A

Metabolic alkalosis

51
Q

How should metabolic alkalosis be treated?

A

Administer sodium chloride and treat potassium

52
Q

What system controls carbon dioxide?

A

cO2/carbon dioxide

53
Q

What body system controls bicarbonate levels?

A

The renal system

54
Q

An ABG shows pH and one other value are abnormal. The ABG is?

A

Uncompensated

55
Q

All ABG values are abnormal. The pt is in?

A

Partial compensation

56
Q

pH is normal, but Co2 and HCO3 are abnormal. Pt is in?

A

Compensation

57
Q

Normal range for serum Magnesium is?

A

1.5-2.5

58
Q

Normal range for serum Sodium is?

A

135-145

59
Q

Serum Calcium range is normally?

A

8.6-10.2

60
Q

What is the acceptable range of urine specific gravity?

A

1.010-1.025

61
Q

Why should a patient with an NG tube not be allowed to drink water?

A

It will increase the loss of electrolytes

62
Q

A short QT interval and a high peaked T wave indicates what?

A

Hyperkalemia

63
Q

What is the primary ECF cation?

A

Sodium

64
Q

What are the 2 roles of sodium?

A

Muscle contraction and fluid balance

65
Q

What is the main cause of hyponatremia?

A

Loss of sodium-rich fluid or excessive water gain

66
Q

What 3 conditions cause excessive water gain?

A

HF, liver disease, excessive intake (PO or IV)

67
Q

What are signs/symtoms of hyponatremia?

A

apprehension, confusion, postural hypotension and tachycardia

68
Q

What can hyponatremia lead to?

A

convulsions, coma even death

69
Q

What is the most common cause of hypernatremia?

A

Excessive water loss

70
Q

Signs/symptoms of hypernatremia?

A

thirst, dry mucous membranes, peripheral/pulmonary edema

71
Q

What is a patient with hypernatremia at risk for?

A

Seizures

72
Q

What is the role of Potassium?

A

nerve impulse conduction; aids in muscle contractions

73
Q

What causes hypokalemia?

A

vomiting, diarrhea, diuretics, uncontrolled diabetes, corticosteriod use or taking digoxin

74
Q

Signs of hypokalemia?

A

Weakness, N/V/C, postural hypotension, EKG changes, shallow respirations, decreased deep tendon reflexes

75
Q

Drugs that can cause hypokalemia?

A

Corticosteriods, laxatives, Lasix and Insulin

76
Q

What EKG changes will hypokalemia cause?

A

Flattened T waves and depressed ST segment

77
Q

What rate should Potassium NEVER exceed?

A

20 mEq/hour or IV push

78
Q

What is the dosing of Potassium?

A

40-80 mEq/day in equally divided doses

79
Q

What are nursing interventions for hyperkalemia?

A
  • monitor for EKG changes
  • give Calcium Gluconate
  • monitor muscle tone
  • give Kayexelate
  • insulin and D5W to move potassium into cells
80
Q

What is Chvostek’s sign?

A

When the facial nerve is tapped, the lip and cheek twitch

81
Q

What is the sign of hypomagnesium?

A

All body system become hypersensitive

82
Q

How often should the serum mag levels be checked, when caring for a pt with hypomagmesium?

A

After every 16mEq

83
Q

Diabetes?

A

Metabolic acidosis

NUR 122 (9 decks)

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