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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
purpose of sodium in the body
controlling water distribution throughout the body because it does not easily cross intracellular membrane acid base balance muscle contraction transmission of nerve impulses
26
how is sodium regulated
ADH thirst RAAS
27
clinical manifestations of hypernatremia
restlessness, AMS thirst edema hypotension incr. body temp incr. DTR weakness disorientation delusions hallucinations
28
what does a pt with hypernatremia look like
flushed skin edema dry and swollen tongue sticky mucous membranes
29
management for hypernatremia
oral hydration hypotonic electrolyte solution isontonic nonsaline solution (D5W)
30
hypernatremia nursing diagnosis
electrolyte imbalance fluid imbalance risk for injury risk for seizures
31
manifestations of hyponatremia
HA irritability loss of focus seizures coma confusion death
32
nursing diagnosis for hyponatremia
-electrolyte imbalance -acute confusion -risk for injury -risk for seizures
33
main cation of the ICF
potassium
34
impacts of potassium
neuromuscular function cardiac rythyms acid base balance cellular growth
35
hyperkalemia is often caused by:
iatrogenic (treatment induced)
36
clinical manifestations of hyperkalemia
cardiac effects!!! muscular weakness paralysis of resp and speech muscles nausea colic diarrhea metabolic acidosis confusion
37
nursing diagnosis of hyperkalemia
electrolyte imbalance activity intolerance impaired cardiac output risk for dysrhythmias
38
management of hyperkalemia
restrict dietary potassium cardiac monitoring!! insulin and dextrose - help cellular exchange calcium gluconate
39
risk factors for hypokalemia
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
clinical manifestations of hypokalemia
resp arrest impaired insulin secretion - insulin pulls K into cell fatigue anorexia nausea vomiting muscle weakness leg cramps decreased bowel motility paresthesias arrhythmias
41
nursing diagnosis of hypokalemia
electrolyte imbalance activity intolerance impaired cardiac output risk for dysrhythmias
42
management of hypokalemia
cardiac monitoring!! assessment of underlying cause replace K with IV KCL IV management ECG monitoring
43
normal calcium range
8.5-10.5
44
major roles of calcium
bones and teeth blood clotting transmission of nerve impulses cardiac and muscle contractions
45
calcium is regulated by:
absorbed from food excreted by feces and urine serum controlled by PTH and calcitonin
46
risk factors for hypercalcemia
malignancy hyperparathyroidism
47
clinical manifestations of hypercalcemia
reduced neuromuscular excitability muscle weakness incoordination anorexia constipation hypertension elevated QT interval nausea vomiting hallucination seizures dysrhythmias
48
nursing diagnosis of hypercalcemia
electrolyte imbalance acute confusion impaired physical mobility risk for dysrhythmias
49
management of hypercalcemia
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
risk factors for hypocalcemia
pancreatitis alcoholism malnutrition alkalosis blood transfusions taking aluminum-containing antacids, aminoglycosides, anticonvulsants, corticosteroids, loop diuretics
51
clinical manifestations for hypocalcemia
usually asymptomatic tetany convulsions tingling spasms pain dysphagia Trousseau sign or Chvostek's sign
52
management of hypocalcemia
neuro exam seizure precaution airway status ECG monitoring IV calcium
53
normal magnesium range
1.3-2.1
54
magnesium's roles in the body:
activator for many intracellular enzyme systems carb and protein metabolism produces sedative effect produce vasodilation decreased total peripheral resistance
55
magnesium is regulated by:
eliminated by kidneys GI system
56
risk factors for hypermagnesemia
kidney failure lithium intoxication adrenocortical insufficiency addisons hypothermia excess use of antacids or laxatives opioids anticholinergics lithium intoxication
57
clinical manifestations of hypermagnesemia
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
nursing diagnosis of hypermagnesemia
eletrolyte imbalance impaired physical mobility risk for dysrhythmias
59
management of hypermagnesemia
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
risk factors for hypomagnesemia
insufficient food intake diabetes pancreatitis nasogastric suctioning diarrhea fistulas IBD alcoholism sepsis burns hypothermia
61
clinical manifestations of hypomagnesemia
hyperexcitability dysrhythmias muscle cramps tremors tetany tonic clonic or focal seizures laryngeal stridor postive chvostek and trousseau signs marked alterations in mood
62
management of hypomagnesemia
diet oral or gluconate mag mag sulfate IV seizure precautions swallow eval
63
IV additives for replacing electrolytes
KCL CaCL2 MgSo4 HCO3
64
Large molecules that increase oncotic pressure and pull fluid into the blood vessels.
colloids
65
colloids that restore blood volume
albumin FFP - clotting factors blood
66
access devices
peripheral venous access midline catheter central venous access
67
nursing management when preparing for administration
review lab orders gather supplies choose site clean catheter hub flush for patency start infusion per order monitor pump, IV site, and pt
68
nursing management when preparing for administration
review lab orders gather supplies choose site clean catheter hub flush for patency start infusion per order monitor pump, IV site, and pt
69
potential local complications for IV therapy
Phlebitis Infiltration Thrombophlebitis Hematoma Catheter clotting
70
potential systemic complications
Fluid overload Air embolism Infection Reaction
71
isotonic fluids
0.9% NS LR D5 25% NS
72
hypertonic fluids
shrinks cell size D5LR D5 1/2 D10W
73
Hypotonic fluids
enlarge cells 0.45% NS D5W

Medsurg Exam 1 (4 decks)

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