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Nursing Theory IV A- Cindy'S Class > Fluid and Electrolyte Imbalances and Blood Therapy > Flashcards

Fluid and Electrolyte Imbalances and Blood Therapy Flashcards

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1
Q

What is homeostasis?

A

State of equilibrium in the body which is naturally maintained by adaptive responses. Body fluids are Ian important part in keeping the balance

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2
Q

What is the % of the body weight in an adult that is water?

A

60%

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3
Q

What is hypovolemia?

A

deficient fluid volume in the body

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4
Q

What are some causes and potential complication of hypovolemia?

A

Causes: abnormal loss of normal body fluids (diarrhea, vomiting, etc), inadequate intake, diuretics
Potential Complication: hypovolemic shock

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5
Q

What data would you find during an assessment for someone who has a fluid volume deficit?

A
  • heart range changes FIRST in vitals
  • thirst, decrease weight, dry mucous membranes, increased pulse, postural hypotension, concentrated urine, confusion, dizziness
  • elevated BUN and serum creatinine, increased hematocrit, changers in electrolytes (sodium and potassium)
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6
Q

What are some interventions for someone who has fluid volume deficit?

A
  • monitor vitals, I&O, daily weight, electrolyte levels
  • Iv solution of lactated ringers or 0.9 NaCl
  • administer antidiarrheals, antiemetics as needed
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7
Q

What would the nurse check with a patient that has a fluid volume deficit? Why?

A

neurological function
–> LOC, PEERRLA, voluntary movements of extremities, muscle strength, reflexes
WHY?
–> Causes an imbalance in the body and doesn’t provide the brain with the water and electrolytes that are needed

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8
Q

When monitoring a client with prolonged vomiting for fluid volume deficit, what does the nurse recognize about fluid shifts that occur as a result on vomiting?
A: Fluid moves from the cells into the interstitial space and the blood vessels
B: Fluid moves from the vascular system causing cellular swelling and rupture
C: An overload of extracellular fluid occurs with a significant increase in intracellular fluid volume
D. Excretion of large amounts of interstitial fluid occurs with depletion of extracellular fluids

A

A

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9
Q

What is hypervolemia?

A

fluid volume excess

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10
Q

What are some causes and potential complications of hypervolemia?

A

Causes: excessive intake of fluids, abnormal retention of fluids(HF)
Potential Complications: Pulmonary edema, ascites

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11
Q

What data would you find during an assessment for someone who has a fluid volume excess?

A
  • pitting edema, distended neck veins
  • increase in respirations, pulse, BP, weight
  • crackles, cough, dyspnea
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12
Q

What are some interventions for someone who has fluid volume excess?

A
  • monitor vitals, I&O, daily weight electrolytes
  • diuretics
  • restrict fluids, sodium, and potassium
  • put pt in semi-fowler
    client with renal failure has an increase risk for FVE
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13
Q

What is the range of sodium? Purpose?

A

135-145 mmol/L
Purpose: Fluid balance

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14
Q

What is the range of potassium? Purpose?

A

3.5-5 mmol/L
Purpose: Heart function

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15
Q

What is hyponatremia? What are the signs and symptoms?

A

sodium deficit.
- CNS deterioration (confusion, N&V, seizures, coma), rapid thready pulse
- irritability, fatigue, headache

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16
Q

What is hypernatremia? What are the signs and symptoms?

A

sodium excess
- thirst, oliguria, fatigue, flushed skin, CNS deterioration( lethargy, agitation, seizures, coma)

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17
Q

What is hypokalemia? What are the signs and symptoms?

A

potassium deficit
- potentially LIFE THREATENING
- ECG changes: bradycardia, skeletal muscle weakness(legs, teeth), weakness of respiratory muscles, decrease gastrointestinal motility, impaired regulation of arteriolar blood flow

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18
Q

What is hyperkalemia? What are the signs and symptoms?

A

potassium excess
- cramping leg pain, weak or paralyzed skeletal muscles, abdominal cramping or diarrhea
- irregular pulse, Brady cardia, respiratory distress

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19
Q

What is the range of calcium? Purpose?

A

2.25-2.75 mmol/L
Purpose: muscle contractions

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20
Q

What is the range of magnesium? Purpose?

A

0.65-1.05 mmol/L
Purpose: nerve function

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21
Q

What is hypocalcemia? What are the signs and symptoms?

A

calcium deficit
- tetany(spasms), muscle twitching, parenthesis digits
- chvosteks sign (facial twitching)
- trousseaus signs (carpal spasms with BP cuff inflation)

22
Q

What is hypercalcemia? What are the signs and symptoms?

A

calcium excess
- thirst, increased interstitial fluid, depressed tendon reflexes, decreased memory, confusion, personality changes, anorexia
- flank pain, bone pain

23
Q

What is hypomagnesemia? What are the signs and symptoms?

A

magnesium deficit
- hyperactive DTR, tremors, seizures, dysrhythmias
- chvosteks sign (facial twitching)
- trousseaus signs (carpal spasms with BP cuff inflation)

24
Q

What is hypermagnesemia? What are the signs and symptoms?

A

magnesium excess
-confusion, coma, loss of DTR, depression of neuromuscular function
- warm flushed skin, lethargy, double vision, Brady cardia, respiratory/cardiac arrest, decreased BP

25
Q

A client is taking a hydrochlorothiazide for treatment of HTN. What symptoms should the nurse teach the client to report?
A: Anxiety and muscle twitching
B: Abdominal cramping and diarrhea
C: fatigue and muscle weakness
D: confusion and personality changes

A

C

26
Q

What are some causes of metabolic alkalosis?

A

severe vomiting, GI suctioning, diuretics

27
Q

What are some causes of respiratory acidosis?

A

decreased respiratory stimuli(drug overdose), COPD, pneumonia, atelectasis, CHF(chronic heart failure), asthma

28
Q

What are some causes of respiratory alkalosis?

A

hyperventilation, anxiety

29
Q

What are some causes of metabolic acidosis?

A

impaired kidney function, renal failure, starvation, diarrhea, DKA

30
Q

What are the two purposes of IV fluids?

A
  1. maintenance
    - when oral intake is not adequate
  2. replacement
31
Q

What are some examples of isotonic IV fluids?

A
  • 0.9% NaCl
    -Lactated ringers
  • D5W
32
Q

What are some examples of hypotonic IV fluids?

A

0.45% NaCl

33
Q

What are some examples of hypertonic IV fluids?

A

D5/0.45% NaCl
D5/0.9% NaCl

34
Q

What are the purpose of plasma expanders?

A

Stay in vascular space and increase osmotic pressure

35
Q

What are some examples of plasma expanders?

A

colloids (protein solutions)
- Packed RBC
- Albumin (RPN DONT do)
- Plasma

36
Q

When should vitals be taken during blood work?

A

baseline, 15 min, 1 hr, after transfusion

37
Q

What rate do you start blood at?

A

50ml/hr or 75ml/hr

38
Q

What is the recommended IV gauge size for blood?

A

18-20

39
Q

What is the average urine output? Minimum?

A

50-60ml
MINIMUM: 30ml

40
Q

When do you use an isotonic IV solution?

A

increase fluid volume due to blood loss, surgery, or dehydration

41
Q

When do you use an hypotonic solution?

A

to replace electrolytes (as in hyponatremia), to treat hypotonic dehydration, and to treat certain types of shock, vomitting

42
Q

When do you use an hypertonic solution?

A

edema,

–> used to pull water out of areas

43
Q

What is the range for hemoglobin? (male and female)

A

Male: 140-180
Female: 121-151

44
Q

What electrolytes become depleted while using diuretics?

A

potassium

45
Q

If a pt has fluid imbalances, how often would you need to check on them?

A

q4h

46
Q

What is the range for normal pH?

A

(acidic) 7.35-7.45 (alkalosis)

47
Q

What is the range for normal PaCO2?

A

35-45mm Hg

48
Q

What is the range for normal HCO3?

A

22-26mEq/L

49
Q

What is Chvostek’s sign?

A

face twitching

50
Q

What is trousseau’s sign?

A

curling of fingers and wrist while getting BP taken

51
Q

When receiving blood, what type of IV solution do you give with it?

A

Isotonic solutions

52
Q

What do you need to consider before putting someone into trendelenburg position?

A

head injury patients can’t be in this position

Nursing Theory IV A- Cindy'S Class (17 decks)

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