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Pharmacology > Fluid and Electrolyte Balance: Part 3 > Flashcards

Fluid and Electrolyte Balance: Part 3 Flashcards

1
Q

PRBCs

A

Packed red blood cells

Plasma & platelets removed

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2
Q

Can give platelets if patient is experiencing….

A

Disseminated intravascular coagulation

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3
Q

Blood and blood products: maximum rate of infusion

A

4 hours per unit (not in emergencies)

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4
Q

Whole blood

A

Include platelets, fluid, etc

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5
Q

What drug should you give simultaneously with whole blood?

A

Loops to prevent circulatory overload

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6
Q

Sodium

A

Major cation in ECF

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7
Q

Normal plasma sodium level

A

135-145 mEq/L

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8
Q

Sodium plays a major role in…

A

Volume balance and plasma osmolarity

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9
Q

Hyponatremia is caused by..

A

Vomiting, diarrhea, NG suctioning, burns, diabetes insipidus

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10
Q

Treatment of hyponatremia

A

Oral replacement, 0.9% sodium chloride IV

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11
Q

Why is 0.9% sodium chloride given for hyponatremia?

A

Has more sodium than we need even though it is isotonic

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12
Q

Hypernatremia is caused by….

A

Excessive oral intake, hypertonic IV or tube feedings, Cushing’s syndrome

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13
Q

Treatment of hypernatremia

A

Sodium restriction

Hypotonic IV fluids

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14
Q

Potassium is required for…

A

Nerve impulse conduction & electrical excitability of muscles

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15
Q

Potassium is regulated by..

A

The kidneys

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16
Q

Extracellular (blood) K+ normal potassium values

A

4 - 5 mEq/L

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17
Q

Hypokalemia

A

<3.5 mEq/L

18
Q

Hyperkalemia

A

> 5mEq/L

19
Q

Hypokalemia causes

A

Thiazide and loop diuretics, inadequate K+ intake, alkalosis, vomiting diarrhea, laxatives

20
Q

Consequences of hypokalemia

A

Skeletal muscle weakness, cardiac dysrhythmias, intestinal ileus, digoxin toxicity

21
Q

Treatment of hypokalemia

A

K+ replacement PO or IV (NEVER pushed)

22
Q

K+ replacement contraindications

A

Renal insufficiency, use with K+ sparing diuretics

23
Q

Hyperkalemia: >9mEq/L =

A

Cardiac arrest

24
Q

Hyperkalemia causes …

A

Elevated T wave, prolonged PR interval, confusion, anxiety, dyspnea, numbness / tingling hands, feet and lips

25
Q

Hyperkalemia treatment

A

Stop all K + sources, food, meds and lower extracellular K+ levels

26
Q

Ways to decrease extracellular K+ levels

A

Calcium salts (calcium gluconate), insulin & glucose, Na+ bicarb if acidotic, oral or rectal sodium polystryene sulfonate or dialysis

27
Q

Modes of delivery (tube placement)

A

Nasogastric (NG), nasoduodenal, nasojejunal, PEG tube (esophagus, stomach, jejunum)

28
Q

Enteral nutrition

A

Into the GI (Has to have a functioning gut)

29
Q

Parenteral nutrition

A

Bypassing stomach and goes straight into blood

30
Q

Administration schedule options

A

Continuous
Intermittent
Bolus

31
Q

Methods of administration (nutrition)

A

Syringe
Gravity drip
Pump

32
Q

Nutritional components in nutrition therapy

A

Amino acids, carbohydrates, fats, electrolytes, vitamins and trace elements

33
Q

Complications of enteral therapy

A 
Aspiration 
Pneumonitis 
Diarrhea, vomiting 
Insufficient gastric emptying 
GI bleeding 
Hyperglycemia
Electrolyte imbalances 
Fatty acid deficiency
Aspiration pneumonia
34
Q

How to prevent aspiration

A

Sit patient up

35
Q

Parenteral nutrition therapy purpose

A

Conserve and restore lean body mass, promote wound healing

36
Q

Parenteral nutrition therapy routes

A

Peripheral IV short term

Central venous catheter –> 10 days, hypertonic solutions

37
Q

Components of parenteral nutrition therapy

A

Amino acids, dextrose, fats, carbohydrates, electrolytes and trace elements

38
Q

Complications of TPN

A

Fluid overload, dehydration, increased BUN, glucose intolerance, hyperlipidemia allergy, catheter related complication (pneumothorax, phlebitis, thrombosis)

39
Q

TPN

A

Parenteral nutrition therapy

40
Q

What to monitor daily with TPN

A

Daily weight, blood and urine chemistries, I&O

Pharmacology (38 decks)

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