Fluid and Electrolyte Imbalances and Blood Therapy Flashcards
What is homeostasis?
State of equilibrium in the body which is naturally maintained by adaptive responses. Body fluids are Ian important part in keeping the balance
What is the % of the body weight in an adult that is water?
60%
What is hypovolemia?
deficient fluid volume in the body
What are some causes and potential complication of hypovolemia?
Causes: abnormal loss of normal body fluids (diarrhea, vomiting, etc), inadequate intake, diuretics
Potential Complication: hypovolemic shock
What data would you find during an assessment for someone who has a fluid volume deficit?
- 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)
What are some interventions for someone who has fluid volume deficit?
- monitor vitals, I&O, daily weight, electrolyte levels
- Iv solution of lactated ringers or 0.9 NaCl
- administer antidiarrheals, antiemetics as needed
What would the nurse check with a patient that has a fluid volume deficit? Why?
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
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
What is hypervolemia?
fluid volume excess
What are some causes and potential complications of hypervolemia?
Causes: excessive intake of fluids, abnormal retention of fluids(HF)
Potential Complications: Pulmonary edema, ascites
What data would you find during an assessment for someone who has a fluid volume excess?
- pitting edema, distended neck veins
- increase in respirations, pulse, BP, weight
- crackles, cough, dyspnea
What are some interventions for someone who has fluid volume excess?
- 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
What is the range of sodium? Purpose?
135-145 mmol/L
Purpose: Fluid balance
What is the range of potassium? Purpose?
3.5-5 mmol/L
Purpose: Heart function
What is hyponatremia? What are the signs and symptoms?
sodium deficit.
- CNS deterioration (confusion, N&V, seizures, coma), rapid thready pulse
- irritability, fatigue, headache
What is hypernatremia? What are the signs and symptoms?
sodium excess
- thirst, oliguria, fatigue, flushed skin, CNS deterioration( lethargy, agitation, seizures, coma)
What is hypokalemia? What are the signs and symptoms?
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
What is hyperkalemia? What are the signs and symptoms?
potassium excess
- cramping leg pain, weak or paralyzed skeletal muscles, abdominal cramping or diarrhea
- irregular pulse, Brady cardia, respiratory distress
What is the range of calcium? Purpose?
2.25-2.75 mmol/L
Purpose: muscle contractions
What is the range of magnesium? Purpose?
0.65-1.05 mmol/L
Purpose: nerve function
What is hypocalcemia? What are the signs and symptoms?
calcium deficit
- tetany(spasms), muscle twitching, parenthesis digits
- chvosteks sign (facial twitching)
- trousseaus signs (carpal spasms with BP cuff inflation)
What is hypercalcemia? What are the signs and symptoms?
calcium excess
- thirst, increased interstitial fluid, depressed tendon reflexes, decreased memory, confusion, personality changes, anorexia
- flank pain, bone pain
What is hypomagnesemia? What are the signs and symptoms?
magnesium deficit
- hyperactive DTR, tremors, seizures, dysrhythmias
- chvosteks sign (facial twitching)
- trousseaus signs (carpal spasms with BP cuff inflation)
What is hypermagnesemia? What are the signs and symptoms?
magnesium excess
-confusion, coma, loss of DTR, depression of neuromuscular function
- warm flushed skin, lethargy, double vision, Brady cardia, respiratory/cardiac arrest, decreased BP
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
C
What are some causes of metabolic alkalosis?
severe vomiting, GI suctioning, diuretics
What are some causes of respiratory acidosis?
decreased respiratory stimuli(drug overdose), COPD, pneumonia, atelectasis, CHF(chronic heart failure), asthma
What are some causes of respiratory alkalosis?
hyperventilation, anxiety
What are some causes of metabolic acidosis?
impaired kidney function, renal failure, starvation, diarrhea, DKA
What are the two purposes of IV fluids?
- maintenance
- when oral intake is not adequate - replacement
What are some examples of isotonic IV fluids?
- 0.9% NaCl
-Lactated ringers - D5W
What are some examples of hypotonic IV fluids?
0.45% NaCl
What are some examples of hypertonic IV fluids?
D5/0.45% NaCl
D5/0.9% NaCl
What are the purpose of plasma expanders?
Stay in vascular space and increase osmotic pressure
What are some examples of plasma expanders?
colloids (protein solutions)
- Packed RBC
- Albumin (RPN DONT do)
- Plasma
When should vitals be taken during blood work?
baseline, 15 min, 1 hr, after transfusion
What rate do you start blood at?
50ml/hr or 75ml/hr
What is the recommended IV gauge size for blood?
18-20
What is the average urine output? Minimum?
50-60ml
MINIMUM: 30ml
When do you use an isotonic IV solution?
increase fluid volume due to blood loss, surgery, or dehydration
When do you use an hypotonic solution?
to replace electrolytes (as in hyponatremia), to treat hypotonic dehydration, and to treat certain types of shock, vomitting
When do you use an hypertonic solution?
edema,
–> used to pull water out of areas
What is the range for hemoglobin? (male and female)
Male: 140-180
Female: 121-151
What electrolytes become depleted while using diuretics?
potassium
If a pt has fluid imbalances, how often would you need to check on them?
q4h
What is the range for normal pH?
(acidic) 7.35-7.45 (alkalosis)
What is the range for normal PaCO2?
35-45mm Hg
What is the range for normal HCO3?
22-26mEq/L
What is Chvostek’s sign?
face twitching
What is trousseau’s sign?
curling of fingers and wrist while getting BP taken
When receiving blood, what type of IV solution do you give with it?
Isotonic solutions
What do you need to consider before putting someone into trendelenburg position?
head injury patients can’t be in this position
