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Foundation > Fluid and electrolytes > Flashcards

Fluid and electrolytes Flashcards

1
Q

Magnesium

a) lab rate
b) Where is most abundant?
c) Modifies what?

A

a) 1.3-2.1 mEq/L
b) Second most abundant ICF

c) Modifies nerve impulse transmission
Skeletal muscle response

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2
Q

Osmosis

A

Water move from low solute to high solute

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3
Q

Isotonic solution IV?

A
  • *Increase fluid volume**
  • due to blood loss, surgery, or dehydration

0.9% Sodium shloride
(normal saline)
Lactated ringers
Dextrose 5%(D5W)

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4
Q

Hypertonic solution IV?

A

Severe hyponatremia and cerebral edema (for cell under hypotonic condition)

Anything higher than 0.9% NACL

3% NACL
10% Dextrose
50% Dextrose

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5
Q

Hypotonic solution IV?

A
  • *Cell is dehydrated and fluids need to be put back intracellularly**
  • *Cell is shrink=hydration**

Anything less than 0.9% NACL

  1. 45% NACL(1/2 noramal saline)
  2. 25% NACL
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6
Q

Flush IV site every ???? hours when not in use

A

8-12 hr

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7
Q

Chang IV site usually every ??? hours

A

72 hr

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8
Q

IV solution overload

Clinical sing?

(Fluid overload)

A

Distended neck veins
Increased BP
Tachycardia
Shortness of breath
Crackles in the lungs
Edema

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9
Q

IV solution overload

Treatment

(Fluid overload)

A

Raise the head of the bed
Check vital sing(O2 as well)

Ajust the rate after correcting fluid overload
Administer diuretics (water pills)
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10
Q

Diuretics?

A

Water pills
Help rid your body of salt (sodium) and water

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11
Q

Cellulitis?

A

Serious bacterial skin infection

Pain
Warmth
Edema
Fever

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12
Q

Cellulitis treatment

A

Discontinue and remove IV
Elevate the extremity
Apply warm compresses 3 to 4 time/day

Administer antibiotics, analgesics

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13
Q

Catheter embolus?

A

Missing catheter tip on removal

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14
Q

Catheter embolus

Treatment

A

Place a tourniquet(band) high on the extremity to limit venous flow
Prepare for removal under X ray or surgery

Save the catheter after removal to determine the cause

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15
Q

DO NOT use vein in the antecubital fossa.

Why?

A

Because it will limit the mobility of the pt’s arm

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16
Q

Fluid volume deficit?

A

Hypovolemia
Isotonic dehydration

A lack of both water and electrolytes
Causing a decrease in circulating blood volume

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17
Q

Cause of dehydration?

A

Prolonged fever
Diabetic ketoacidosis
Hyperventilation(low CO2)

Excessive hypertonic IV fluid

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18
Q

Hypovolemia

A

When the amount of fluid in the intravascular system is too low

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19
Q

Causes of hypovolemia?

A

Vomiting, diarrhea
Renal disfunction
Burns
Hemorrhage
Altered intake
-nausea
-anorexia
-NPO

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20
Q

Hypovolemia

Assessment

A

Hypotension
Tachycardia

Every lab values increase!!
Oliguria
Rapid weight loss
syncope

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21
Q

Oliguria

A

Urine output below normal 30-50mL

less than 30mL emergency condition!!

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22
Q

Hypovolemia

Interventions

A

Oral rehydration
Isotonic water 0.9% NS

Oral hygiene Q2
Frequent skin assessment (turgor)

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23
Q

Hypervolemia

Causes?

A

Chronic kidney failure
High sodium foods
Enteral tube feeding
Excess isotonic IV fluid

SIADH

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24
Q

Hypervolemia

Assessment

A

Hypertension
Tachycardia

Decreased all lab values!!

Chest X-ray fluid in lung

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25
Q

Hypervolemia

interventions

A

Observe breath sounds
Auscultate breath sounds(edema)
Dyspnea

Elevate HOB

devises to reduce pressure

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26
Q

Syncope

A

A temporary loss of consciousness usually related to insufficient blood flow to the brain

27
Q

Polydipsia?

A

Excess thirst

28
Q

Hyponatremia

Expecting finds (Heat to toe)

A

Confusion
Orthostatic hypotension

Nausea, vomiting
abdominal cramps

Weight gain, Edema
Muscle spasms けいれん

29
Q

Hyponatremia

Expecting finds (Heat to toe)

A

Confusion
Seizures
Coma
Orthostatic hypotension

Nausea, vomiting
abdominal cramps

Weight gain, Edema
Muscle spasms けいれん

Decease serum osmolality

30
Q

Hyponatremia

Causse

A

Heart and renal failure
Vomiting
Burns
Hyperglycemia
Medication s such as antidiabetics, diuretics

31
Q

Hyponatremia

Interventions

A

Restrict fluid intake
Seizure precautions
Administer isotonic I.V. fluids

Monitor pt’s conciseness

32
Q

Arterial Blood Gases (ABGs)
Normal rang

a) pH
b) pCO2
c) HCO3
d) PO2
e) SaO2

A

a) 7.35-7.45
b) 35-45 mmHg
c) 22-26 mEq/L

d) 80-100 mmHg
e) (95-100%)

33
Q

Mean Arterial Pressure (MAP)

Definition

What is the normal range

A

Pressure necessary to adequately perfuse organs
normal range is 70-100

34
Q

How to calculate MAP

A
35
Q

Map caculation

a) 120/60?
b) 140/80?

A

MAP = (SBP + 2DBP) ÷ 3

a) (120 +120) /3= 80 MAP
b) (140+160)/3= 100 MAP

36
Q

A high MAP means?

A

A lot of pressure in the arteries

Eventually lead to blood clots or damage to the heart muscle

37
Q

What is a low MAP?

A

Blood may not be reach to the major organs

Without blood and nutrients, the tissue of these organs begins to die

38
Q

Use of Incentive Spirometry

a) Use a_______ method
b) Put mouth on mouthpiece and make?

c) Inhale or exhale? slowly and deeply

d) When the pt cannot c any more
remove the mouthpiece.
Hold breathe for how long?
then slowly inheal or exheale?

Repeat and when finish make cough
Set up position

Prevent pnemonia

A

a) teach-back method
b) seal
c) Inhale

d) 3 sec
Slowly exhale

39
Q

Hypoventilation?

A

Too shallow or too slow to meet the needs of the body
Low O2, more CO2

COPD

40
Q

Hyperventilation?

A

Rapid or deep breathing
Usually caused by anxiety or panic

Diabetic ketoacidosis
Respiratory alkalosis

41
Q

Hyperventilation

Intervention?

A

Monitor RR, depth, breath sounds
Monitor Level of Consciousness
Monitor SpO2, ABG

Assessment – possible anxiety and cause

Assess need for & provide supplemental O2 as ordered

42
Q

Hypoventilation

Intervention?

A

Monitor RR, depth, breath sounds
Monitor LOC
Monitor SpO2, ABG
Assess need for and provide supplemental O2 as ordered

43
Q

Hypo and hyper/ventilation

Nursing DX

A

Problem-focused vs. risk focused nursing dx:
Ineffective airway clearance
Ineffective breathing pattern
Impaired gas exchange
Activity intolerance
Fatigue
Acute confusion
Risk for aspiration
Risk for infection
Risk for falls

44
Q

Non-productive cough meaning?

A

Dry cough

Exposure to smoke or dust
Viral illnesses
Irritation of the airway
Allergies
Medication
Asthma

45
Q

Mobilizing secretions

A
46
Q
A

Frequent repositioning
Deep breathing and coughing

47
Q

Hypernatremia
Causes

A 
Water loss
Inadequate water intake
Excessive sodium intake
Diabetes Insipidus (DI)

Cell shrink

48
Q

HyPERnatremia
S/S

A

Thirst
Dry sticky mucous membranes
Restlessness
disorientation
Muscle weakness and irritability

49
Q

HyPERnatremia
Nursing Intervention

A

Maintain urine output of 0.5 to 1.5 mL/kg/hr
Maintain normal blood pressure
Provide low sodium, no salt added diet
Seizure precautions

Administer hypotonic and non-sodium containing isotonic fluids
D5W at first

50
Q

arouse

A

awaken (someone) from sleep

51
Q

Potassium

a) range
b) Ragulate what?
c) Can affect what rate

A

a) 3.5 - 5.0 mEq/L

b) Cell excitability
Nerve impulse conduction

c) Cardiac rate rythem

52
Q

HyPOkalemia

Excessive K+ output
Why?

A

(<3.5 mEq/L)

GI losses from diarrhea
Prolonged gastric suctioning
Prolonged vomiting

53
Q

HyPOkalemia
S/S

A

Confuse
Depression

Cardiac arrest

Fatigue
Muscle weakness

54
Q

HyPOkalemia
Intervention

A

Assess the patient’s diet for a lack of potassium
Encourage intake of high-potassium foods

IV must given very slowly

55
Q

HyPERkalemia
Causes

A

Why excessive K+ intake?

Oral supplements
Salt substitutes

(>5.0 mEq/L)

56
Q

HyPERkalemia
S/S

A

Arrhythmias HR mess up
Decreased strength of contraction
Cardiac arrest

Nausea, vomiting diarrhea
Decreased bowel sounds
Abdominal distention

57
Q

HyPERkalemia
Intervention

A

Apply and monitor ECG
Restrict K+ intake

Administer oral meds for K+ excertion

58
Q

Calcium

Function

A

Muscles must have Ca+ to contract

Calcination shifts into bone

8.5- 10.2 mg/dL

(including heart)

59
Q

HyPOcalcemia

Excessive losses why?

A

Chronic diarrhea
Shit into bone

Acute pancreatitis
Vitamin D deficiency

60
Q
A
61
Q
A

Hypocalcemia

62
Q
A
63
Q
A
64
Q
A

Foundation (12 decks)

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