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Medsurg Exam 1 > Fluid and Electrolyte Imbalance > Flashcards

Fluid and Electrolyte Imbalance Flashcards

1
Q

the maintanence of equillibrium

A

homeostasis

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2
Q

what can affect homeostasis

A

fluid and electrolytes
energy and nutrition
immune response

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3
Q

natural tendency of a substance to move from area of higher concentration to lower concentration

A

diffusion

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4
Q

how much fluid filtered in kidneys

A

180L of plasma per day

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5
Q

energy must be expended for movement on concentration gradient

A

active transport

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6
Q

exerted by fluid at equillibrium at any given point within the fluid, due to force of gravity

A

hydrostatic pressure

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7
Q

movement of water caused by concentration gradient

A

osmosis

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8
Q

number of dissolved particles contained in a unit of fluid

A

osmolality

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9
Q

movement of isotonic fluids

A

water and solute equal
no fluid shift

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10
Q

movement of hypotonic fluid

A

watery, diluted liquid
fluid rushes inside the cell
big like a hippo

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11
Q

movement of hypertonic fluids

A

solute rich, concentrated liquid
water passes through membrane escaping cell - shrinks

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12
Q

factors affecting water regulation

A

-hypothalamic-pituitary
-renal
-adrenal cortical
-cardiac
-GI
-Age

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13
Q

signs of edema

A

-accumulation of fluid in interstitial space
-hydrostatic pressure rises
-low plasma oncotic pressure
-increased interstitial oncotic pressure

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14
Q

hypovolemia vs dehydration

A

hypo - loss of ECF volume exceeds intake of fluid
dehydration - loss of water alone

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15
Q

leads to hypovolemia

A

-inadequate intake
-elderly
-V/D
-GI suctioning
-fever
-sweating
-burns
-surgery
-DI
-hemorrhage

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16
Q

clinical manifestations of hypovolemia

A

weight loss
decreased skin turgor
oliguria
high urine specific gravity
postural hypotension
weak, rapid HR
flattened neck veins
clammy skin
dry oral mucous
delayed capillary refill
thirst

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17
Q

management of hypovolemia

A

consider usual maintenance requirements
oral or IV hydration
isotonic solutions
assess I&O, weight, VS, CVP, LOC, breath sounds, skin color

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18
Q

hypovolemia nursing diagnosis

A

fluid imbalance
impaired cardiac output
acute confusion
risk for seizures
potential: hypovolemic shock/multisystem organ failure

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19
Q

isotonic expansion of the ECF caused by abnormal retention of water and sodium

A

hypervolemia

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20
Q

clinical manifestations of hypervolemia

A

edema
distended neck veins
crackles, dyspnea
tachycardia, bounding pulse
increased BP, weight, urine output,
SOB
wheezing
AMS
seizures
S3

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21
Q

management of hypervolemia

A
  • directed at the cause
  • DC sodium containing fluids
  • diuretics and restrict fluid
  • pericentisis
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22
Q

hypervolemia (ECF volume excess) nursing diagnosis

A

-fluid imbalance
-impaired gas exchange
-impaired tissue integrity
-activity intolerance
-disturbed body image
-potential; pulmonary edema, ascites

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23
Q

sodium normal range

A

135-145

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24
Q

main cation of ECF

A

sodium

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25
Q

purpose of sodium in the body

A

controlling water distribution throughout the body because it does not easily cross intracellular membrane
acid base balance
muscle contraction
transmission of nerve impulses

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26
Q

how is sodium regulated

A

ADH
thirst
RAAS

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27
Q

clinical manifestations of hypernatremia

A

restlessness, AMS
thirst
edema
hypotension
incr. body temp
incr. DTR
weakness
disorientation
delusions
hallucinations

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28
Q

what does a pt with hypernatremia look like

A

flushed skin
edema
dry and swollen tongue
sticky mucous membranes

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29
Q

management for hypernatremia

A

oral hydration
hypotonic electrolyte solution
isontonic nonsaline solution (D5W)

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30
Q

hypernatremia nursing diagnosis

A

electrolyte imbalance
fluid imbalance
risk for injury
risk for seizures

31
Q

manifestations of hyponatremia

A

HA
irritability
loss of focus
seizures
coma
confusion
death

32
Q

nursing diagnosis for hyponatremia

A

-electrolyte imbalance
-acute confusion
-risk for injury
-risk for seizures

33
Q

main cation of the ICF

A

potassium

34
Q

impacts of potassium

A

neuromuscular function
cardiac rythyms
acid base balance
cellular growth

35
Q

hyperkalemia is often caused by:

A

iatrogenic (treatment induced)

36
Q

clinical manifestations of hyperkalemia

A

cardiac effects!!!
muscular weakness
paralysis of resp and speech muscles
nausea
colic
diarrhea
metabolic acidosis
confusion

37
Q

nursing diagnosis of hyperkalemia

A

electrolyte imbalance
activity intolerance
impaired cardiac output
risk for dysrhythmias

38
Q

management of hyperkalemia

A

restrict dietary potassium
cardiac monitoring!!
insulin and dextrose - help cellular exchange
calcium gluconate

39
Q

risk factors for hypokalemia

A

diuretics
diarrhea
vomiting
gastric suction
recent ileostomy
intestinal drains
villous adenoma
decreased intake
low mag levels which stimulate renin and aldosterone = K excretion
DKA

40
Q

clinical manifestations of hypokalemia

A

resp arrest
impaired insulin secretion - insulin pulls K into cell
fatigue
anorexia
nausea
vomiting
muscle weakness
leg cramps
decreased bowel motility
paresthesias
arrhythmias

41
Q

nursing diagnosis of hypokalemia

A

electrolyte imbalance
activity intolerance
impaired cardiac output
risk for dysrhythmias

42
Q

management of hypokalemia

A

cardiac monitoring!!
assessment of underlying cause
replace K with IV KCL
IV management
ECG monitoring

43
Q

normal calcium range

A

8.5-10.5

44
Q

major roles of calcium

A

bones and teeth
blood clotting
transmission of nerve impulses
cardiac and muscle contractions

45
Q

calcium is regulated by:

A

absorbed from food
excreted by feces and urine
serum controlled by PTH and calcitonin

46
Q

risk factors for hypercalcemia

A

malignancy
hyperparathyroidism

47
Q

clinical manifestations of hypercalcemia

A

reduced neuromuscular excitability
muscle weakness
incoordination
anorexia
constipation
hypertension
elevated QT interval
nausea
vomiting
hallucination
seizures
dysrhythmias

48
Q

nursing diagnosis of hypercalcemia

A

electrolyte imbalance
acute confusion
impaired physical mobility
risk for dysrhythmias

49
Q

management of hypercalcemia

A

decreasing serum calcium
treat underlying cause
thiazides
IV fluids
0.9% sodium chloride solution
bisphosphonates - reduce breakdown of bone
fall risk
seizure precautions
heart monitoring

50
Q

risk factors for hypocalcemia

A

pancreatitis
alcoholism
malnutrition
alkalosis
blood transfusions
taking aluminum-containing antacids, aminoglycosides, anticonvulsants, corticosteroids, loop diuretics

51
Q

clinical manifestations for hypocalcemia

A

usually asymptomatic
tetany
convulsions
tingling
spasms
pain
dysphagia
Trousseau sign or Chvostek’s sign

52
Q

management of hypocalcemia

A

neuro exam
seizure precaution
airway status
ECG monitoring
IV calcium

53
Q

normal magnesium range

A

1.3-2.1

54
Q

magnesium’s roles in the body:

A

activator for many intracellular enzyme systems
carb and protein metabolism
produces sedative effect
produce vasodilation
decreased total peripheral resistance

55
Q

magnesium is regulated by:

A

eliminated by kidneys
GI system

56
Q

risk factors for hypermagnesemia

A

kidney failure
lithium intoxication
adrenocortical insufficiency
addisons
hypothermia
excess use of antacids or laxatives
opioids
anticholinergics
lithium intoxication

57
Q

clinical manifestations of hypermagnesemia

A

depress CNS
hypotension
N/V
urinary retention
paralysis and coma
weakness
soft tissue calcifications
facial flushing
lethargy
difficulty speaking
drowsiness
depressed respirations
increased potassium and calcium

58
Q

nursing diagnosis of hypermagnesemia

A

eletrolyte imbalance
impaired physical mobility
risk for dysrhythmias

59
Q

management of hypermagnesemia

A

avoid admin in pts with kidney failure
discontinue mag salts
cardiac monitoring
monitor DTR
emergencies: ventilator and IV calcium gluconate
loop diuretics
lactated ringers

60
Q

risk factors for hypomagnesemia

A

insufficient food intake
diabetes
pancreatitis
nasogastric suctioning
diarrhea
fistulas
IBD
alcoholism
sepsis
burns
hypothermia

61
Q

clinical manifestations of hypomagnesemia

A

hyperexcitability
dysrhythmias
muscle cramps
tremors
tetany
tonic clonic or focal seizures
laryngeal stridor
postive chvostek and trousseau signs
marked alterations in mood

62
Q

management of hypomagnesemia

A

diet
oral or gluconate mag
mag sulfate IV
seizure precautions
swallow eval

63
Q

IV additives for replacing electrolytes

A

KCL
CaCL2
MgSo4
HCO3

64
Q

Large molecules that increase oncotic pressure and pull fluid into the blood vessels.

A

colloids

65
Q

colloids that restore blood volume

A

albumin
FFP - clotting factors
blood

66
Q

access devices

A

peripheral venous access
midline catheter
central venous access

67
Q

nursing management when preparing for administration

A

review lab orders
gather supplies
choose site
clean catheter hub
flush for patency
start infusion per order
monitor pump, IV site, and pt

68
Q

nursing management when preparing for administration

A

review lab orders
gather supplies
choose site
clean catheter hub
flush for patency
start infusion per order
monitor pump, IV site, and pt

69
Q

potential local complications for IV therapy

A

Phlebitis
Infiltration
Thrombophlebitis
Hematoma
Catheter clotting

70
Q

potential systemic complications

A

Fluid overload
Air embolism
Infection
Reaction

71
Q

isotonic fluids

A

0.9% NS
LR
D5 25% NS

72
Q

hypertonic fluids

A

shrinks cell size
D5LR
D5 1/2
D10W

73
Q

Hypotonic fluids

A

enlarge cells
0.45% NS
D5W

Medsurg Exam 1 (4 decks)

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