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Exam 5 > Fluid and Electrolytes > Flashcards

Fluid and Electrolytes Flashcards

1
Q

What does ADH do?

A

Hypothalomus monitors osmolality of body fluid to secrete ADH from the pituitary to regulate kidneys to excrete or retain water.

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2
Q

What does Renin-angiotensin-aldosterone-system (RAAS) do?

A

With decreased blood pressure the kidneys release Renin which secretes Angiotensin 1 then 2 which causes the secretion of Aldosterone from the adrenal cortex. Sodium reabsorption occurs to increase water.

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3
Q

What does atrial natriuretic peptide do?

A

Cardiac atria monitor atrial pressures for an increase thereby causing nephrons to increase sodium excretion. Sodium excretion occurs to decrease water.

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4
Q

What regulates fluid intake?

A

Thirst, located in hypothalamus, based on plasma osmolality

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5
Q

Serum levels of Na

A

135-145

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6
Q

What does sodium do?

A

Regulating ECF volume and distribution
Maintaining blood volume
Transmitting nerve impulses and contracting muscles

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7
Q

Potassium levels?

A

3.5-5.3

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8
Q

What does potassium do?

A

Maintaining ICF osmolality
Transmitting nerve and electrical impulses
Regulating cardiac impule transmisson and muscle contraction
Skeletal and smooth muscle function
Regulating acid-base balance

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9
Q

Calcium levels?

A

8.2-10.2

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10
Q

What does calcium do?

A 
Forming bones and teeth
Transmitting nerve impulses
Regulating muscle contractions
Maintaining cardiac pacemaker 
Blood clotting
Activating enzymes
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11
Q

Magnesium levels?

A

1.6-2.6

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12
Q

What does magnesium do?

A 
Metabolism
Sodium-potassium pump
Relaxing muscle contractions
Transmitting nerve impulses
Regulating cardiac function
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13
Q

What is clinical dehydration?

A

ECV deficit and hypernatremia combined

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14
Q

What is FVD?

A

Equal loss of sodium, chloride, bicarbonate, and water in interstitial or vascular volume

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15
Q

What causes FVD?

A

vomiting, diarrhea, fever, diuretics

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16
Q

S/S of FVD?

A

Weight loss and thirst
Vascular deficit: orthostatic blood pressure changes; weak, rapid pulse; decreased urine output; slow filling peripheral veins, increased BUN and hematocrit
Interstitial deficit: dry mucous membranes; poor skin turgor

17
Q

How do we treat FVD?

A

oral or IV replacement (isotonic)

18
Q

What is FVE?

A

Equal increase of sodium, chloride, bicarbonate, and water in interstitial or vascular volume

19
Q

What causes FVE?

A
20
Q

What causes FVE?

A

excess intake (Na IV fluids or salty foods with water) OR impaired fluid balance regulation (CHF, RF)

21
Q

S/S of FVE?

A

Weight gain, increased blood pressure, bounding pulse, fullness of neck veins, possible increased urine output, pulmonary edema (dyspnea, orthopnea, crackles), decreased BUN and hematocrit

22
Q

Management of FVE?

A

restriction of sodium, restriction of water, administration of diuretics

23
Q

What is hypernatremia?

A

Unequal loss of water relative to solutes or unequal gain of solutes relative to water

Decrease in water intake (NPO) OR water loss (diuresis) OR excess intake of solute (IV fluids)

(Water Deficit or Hyperosmolarity)

24
Q

S/S of hypernatremia?

A

Increased serum Na+ level and Confusion, agitation, convulsions, coma, decreased urine output, increased urine concentration, thirst, dry mucous membranes, death

25
Q

Management of hypernatremia?

A

water orally or IV (D5W)

Excessive rate of correction may lead to seizures, brain damage, death

26
Q

What is hyponatremia?

A

Unequal gain of water relative to solutes or unequal loss of solutes relative to water

Unequal gain of water relative to solutes or unequal loss of solutes relative to water

(Water Excess or Hypoosmolarity)

27
Q

S/S of hyponatremia?

A

Decreased serum sodium and lethargy, irritability, confusion, personality changes, anorexia, nausea, vomiting, weakness, cramps, seizures, coma and death

28
Q

Management of hyponatremia?

A

treat cause, hypertonic 3% saline and diuretics

Excessive correction has been associated with seizures, brain damage, death

29
Q

Levels of hypernatremia? Why?

A

Greater than 145

Decreased water, increased diarrhea, excess intake of sodium

30
Q

What do you find in physical exam with hypernatremia?

A

Confusion
Agitation
Convulsions
Coma

31
Q

Levels of hyponatremia?

A

Less than 135

32
Q

What do we find in physical exam with hyponatremia?

A

Decreased LOC (confusion, lethargy, coma)
Seizures
Muscle cramping

Decreased vomiting, excess water, sweating

33
Q

What are some isotonic solutions?

A

Normal Saline 0.9% NaCl (NSS /PSS)

Lactated Ringer’s (LR)

34
Q

What are some hypotonic solutions? What does it do?

A

0.45 % NaCl (½ NSS or ½ PSS)

Promotes fluid shifts into cells = Cells Swell
Primarily used to expand intracellular volume.

35
Q

What are some hypertonic solutions? What do they do?

A

3% NaCl or 5% NaCl (NSS or PSS)

Dextrose solution greater than 5% (10% or 50% Dextrose solutions)

Promotes fluid shifts out of cells = Cells Shrink
Primarily used to decrease intracellular volume and expand the intravascular space.

36
Q

What are some IV therapy complications?

A

Exam 5 (3 decks)

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