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Med Surg 1 > fluid and electrolyte balance > Flashcards

fluid and electrolyte balance Flashcards

1
Q

older adult considerations: skin

A
  • decrease elasticity and turgor
  • unreliable indicator of fluid status
  • catheter might not stay in
  • tent over sternum or forehead
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2
Q

older adult considerations: renal

A
  • decrease glomerular filtration
  • retain fluid, waste product, medications
  • unable to concentrate
  • increased water loss
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3
Q

older adult considerations: muscular

A
  • decrease muscle mass
  • holds a lot of water
  • increased risk for dehydration d/t decreased total body water content
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4
Q

older adult considerations: neurologic

A
  • decreased thirst refelx

- decreased intake, increased risk for dehydration

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5
Q

older adult considerations: endocrine

A
  • adrenal glands begin to atrophy

- poor regulation of na/k

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6
Q

intracellular

A

within cell

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7
Q

extracellular

A

plasma- blood

interstitial- space between

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8
Q

normal fluid intake

A

2300ml

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9
Q

fluid loss routes

A

urine, feces, emesis, drainage

insensible- perspiration, lungs

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10
Q

fluid loss output

A

obligatory: 400-600ml a day
prefer 30ml/hr—> 720ml/day

insensible: 500-1000ml/day

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11
Q

hypervolemia

A

results from too much fluid in body or dilution of electrolytes and rbcs

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12
Q

hypovolemia

A

not enough fluid in body, especially in the intravascular area

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13
Q

fluid deficit causes: inadequate fluid intake

A
  • poor PO intake
  • NPO- nothing by mouth
  • dysphagia
  • unconsciousness
  • inadequate IVF replacement
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14
Q

fluid deficit causes: excessive fluid or sodium losses

A
  • gastrointestinal losses
  • excessive diaphoresis
  • prolonged hyperventilation
  • hemorrhage
  • diabetes insipidus
  • burns
  • open wounds
  • excessive use of diuretics
  • fluid shifts: ascites, effusions
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15
Q

fluid deficit signs and symptoms

A
  • thirst
  • rapid weak pulse
  • low bp
  • dry skin and mucous membranes
  • skin tenting
  • increased temp
  • decreased urine output: increase concentration/ specific gravity
  • increase BUN
  • increase HCT
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16
Q

fluid deficit interventions

A

MONITOR DAILY WEIGHT 1L=2.2LBS

  • monitor intake and output
  • treat underlying cause
  • increase fluid intake: PO IV
  • use caution with elderly pt
17
Q

isotonic
what it does?
type of solutions

A

same concentration no fluid shift

  • equal pressure inside and outside cell
  • “stay where I put it”
  • expands volume
  • dilute meds
  • fluid resuscitation
  • .9 nacl
  • lactated ringers
18
Q

hypotonic

A

lower concentration- fluid shift out of vessel into cell

  • less salt or more water than normal body fluids
  • water leaves blood and into cells
  • “goes out of vessel”

1/2 normal saline
D5W dextrose 5% water

could lead to vascular fluid depletion and cardiovascular collapse

19
Q

hypertonic

A
  • higher concentration- fluid shifts into vessel from cell s
  • either more salt or less water than our own fluids
  • water is removed pulled from cells and pulled into vascular
  • can result in vascular overload and dehydration
  • enters the vessel

used for na replacement
- volume replacement

D 1/2 NS
D5LR

20
Q

fluid excess causes: excessive sodium or water intake

A
  • high sodium diet
  • psychogenic polydipsia
  • hypertonic fluid admin
  • free water
  • enteral feedings
21
Q

fluid excess causes: inadequate sodium or water elimination

A

inadequate sodium or water elimination

  • organ failure:renal liver heart
  • endocrine disorders: hyperaldosteronism, cushings syndrome, syndrome of inappropriate antidiuretic
22
Q

fluid excess s/s

A
  • bounding pulse
  • elevated blood pressure
  • respiratory changes
  • weight gain
  • edema
  • increased urine output
  • diluted/ decrease specific gravity
  • decrease BUN decease NA
23
Q

fluid excess interventions

A
  • monitor dailey weight
  • place in fowleys positon
  • admin oxygen
  • admin diuretics
  • monitor I&O
  • restrict fluid and sodium
24
Q

sodium

A

135-145

25
Q

potassium

A

3.5-5.0

26
Q

calcium

A

9.0-10.5

27
Q

magnesium

A

1.8-2.6`

28
Q

interventions for hyponatremia

A
  • daily weight
  • monitor LOC
  • I&O
  • fluid restriction
  • increase PO intake

medical:

  • IVF- hypovolemic
  • diuretics- hypervolemic
29
Q

hypernatremia interventions

A
  • monitor VS
  • daily weights
  • monitor LOC
  • I&O
  • encourage fluids

medical

  • loop diuretics: lasix
  • NA free IVFs: D5W
30
Q

hypokalemia interventions

A
  • cardiac monitor
  • D/C loop osmotic diuretics
  • frequent iv assessment
  • monitor renal function
  • decrease dietary intake

medical

  • PO admin
  • IV admin: always dilute, never IVP, monitor for phlebitis
31
Q

hyperkalemia interventions

A
  • cardiac monitor
  • d/c k+
  • increased fluid intake
  • dietary restriction

medical:

  • admin loop/ osmotic diuretics
  • kayexalate
  • dialysis
  • insulin: moves k + out of blood into cells
  • calcium gluconate: counteracts myocardial effect of increase k+ levels
32
Q

hypocalcemia interventions

A
  • encourage PO intake
  • monitor for neuromuscular changes
  • trousseaus sign
  • chvostek sign
  • fall prevention

medical

  • oral Ca with it D
  • calcium gluconate
33
Q

hypercalcemia interventions

A
  • cardiac monitor
  • D/C thiazide diuretics
  • D/C calcium supplements
  • pathologcal fracture

medical

  • loop diuretics
  • IVF .9% NS
  • calcitonin: decrease movement out of bones
  • dialysis
34
Q

hypomagnesemia interventions

A
  • cardiac monitor
  • monitor I&O

medical

  • d/c diuretics
  • IV mag sulfate
35
Q

hypermagnesium

A
  • increase fluid intake
  • d/c mg supplements

medical
- diuretics
- calcium gluconate
dialisys

Med Surg 1 (25 decks)

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