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Med Surg 1 > Fluid And Electrolytes > Flashcards

Fluid And Electrolytes Flashcards

1
Q

A lack of fluid in the body , either from insufficient intake or excessive loss is called…

A

Dehydration

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2
Q

What is isotonic fluid volume deficit?

A

Also called hypovolemia; lack of both water and electrolytes which causes a decrease in circulating blood volume

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3
Q

List some causes of isotonic fluid volume deficit (hypovolemia)

A

Excessive vomiting, diarrhea, diaphoresis, diuretics, third spacing, anorexia, NPO, impaired swallowing

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4
Q

List some causes of dehydration?

A

Hyperventilation, excessive sweating without water treatment, prolonged fever, DKA, decreased water intake, excessive intake of salt or hypertonic IV fluids

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5
Q

What are some expected findings with hypovolemia?

A

Hypothermia, tachycardia, hypotension, hypoxia, dizziness, confusion, thirst, acute weight loss, oliguria, poor skin turgor

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6
Q

Hematocrit is _____ in hypovolemia

A

Increased

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7
Q

BUN is ______ due to hemoconcentration in hypovolemia

A

Increased (greater than 25mg/dL)

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8
Q

Urine specific gravity is _____ than 1.030 with hypovolemia

A

Greater

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9
Q

Blood sodium is ____ with dehydration

A

Greater than 145 mEq/L

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10
Q

Blood osmolality is _____ with dehydration/hypernatremia

A

Greater than 295 mOsm/kg

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11
Q

Hypovolemic shock

A

Occurs with significant loss of body fluid; patients MAP decreases (slows blood flow and perfusion) and the cells are no longer able to carry oxygen to the blood adequately

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12
Q

What should a nurse do for hypovolemic shock?

A

Give oxygen, monitor VS q15 minutes, give colloid and crystalloids as replacements

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13
Q

What are colloids?

A

Whole blood, packed RBCs, plasma, synthetic plasma expanders. Given with hypovolemic shock

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14
Q

What are crystalloids?

A

Lactated ringers, normal saline

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15
Q

Too much fluid in the body from excessive intake or ineffective removal from the body is….

A

Overhydration

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16
Q

Fluid volume excess

A

Hypervolemia; excess of water and electrolytes in the same proportion

Excessive sodium causes excessive water retention

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17
Q

Patients that have fluid overload are at risk for developing ____ and ____

A

Pulmonary edema, congestive heart failure

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18
Q

What are some causes of hypervolemia?

A

Heart failure, kidney disease, cirrhosis, overdose of fluids, prolonged corticosteroid use, severe stress, hyperdosteronism

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19
Q

What are some causes of over-hydration?

A

Water replacement without electrolyte replacement, excessive water intake, SIADH, excessive administration of IV D5W

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20
Q

What can you expect to find in someone that has fluid volume overload?

A

Tachycardia, bounding pulse, HTN, weakness, visual changes, altered LOC, ascites, crackles, peripheral edema, weight gain, distended veins, increased urine output

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21
Q

What would the lab tests look like for Hct, blood osmolarity, urine specific gravity, and BUN?

A

All would be decreased

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22
Q

A weight gain or loss of 1kg in 24 hr is equivalent to __L of fluid

A

1L

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23
Q

Patients with fluid volume overload should get daily weights. When should you notify the provider of a concerning weight gain?

A

1-2 lb gain in 24hrs or 3lb gain in 1 week

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24
Q

Is magnesium, potassium, sodium, calcium, and hydrogen ions cations or anions?

A

Cations (positive)

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25
Q

Sodium normal lab value

A

136-145 mEq/L

26
Q

Chloride normal lab value

A

98-106 mEq/L

27
Q

Calcium normal lab value

A

9.0-10.5 mEq/dL

28
Q

Potassium normal lab value

A

3.5-5 mEq/L

29
Q

Phosphorus normal lab value

A

3.0-4.5 mg/dL

30
Q

Magnesium normal lab value

A

1.3-2.1 mEq/L

31
Q

What is the major electrolyte found in the ECF?

A

Sodium

32
Q

Sodium importance in the body

A

Maintain skeletal muscle contraction, cardiac contraction, and nerve impulse transmission

33
Q

Hyponatremia

A

Net gain of water or loss of sodium-rich fluids that results in sodium levels less than 136 mEq/L

34
Q

Do cells shrink or swell with hyponatremia?

A

The cells will swell

35
Q

What can you expect to find with hyponatremia in the patient?

A

Hypothermia, tachycardia, rapid and threats pulse, hypoTN, HA, confusion, seizures, abd cramping

36
Q

What type of IV fluids would be administered for hyponatremia?

A

Lactated ringers, 0.9% isotonic saline

37
Q

Severe hyponatremia can cause someone to develop…

A

Seizures, coma, or respiratory arrest

38
Q

Hypernatremia

A

Increased sodium causes hypertonicity of the blood. This causes a shift of water out the cells (dehydrated cells)

39
Q

What are some risk factors for developing hypernatremia?

A

Kidney failure, Cushings, aldosteronism, glucocorticosteriods, excessive intake of oral sodium

40
Q

What are some expected findings for hypernatremia in the patient?

A

Thirst, hyperthermia, tachycardia, restlessness, irritability, muscle twitching, dry mucous membranes, nausea

41
Q

What is the major cation in the ICF?

A

Potassium

42
Q

Potassium has an ____ relationship with sodium

A

Inverse

43
Q

What is potassium’s role in the body?

A

Cell metabolism, transmission of nerve impulses, acid-base balance, muscle function (heart, lung)

44
Q

Hypokalemia

A

Blood potassium less than 3.5 mEq/L

45
Q

Risk factors for developing hypokalemia

A

Overuse of diuretics and corticosteroids, cushings, increased aldosterone, laxatives, NPO

46
Q

What can you expect to find with hypokalemia in patients?

A

Decreased BP, weak pulse, AMS, lethargy, flattened T wave, prominent U waves, ST depression, prolonged PR interval, hypoactive bowel sounds, shallow breathing

47
Q

Never give potassium via ___ or ___ due to it causing necrosis of the tissues

A

IM or SQ

48
Q

Foods high in potassium

A

Avocados, broccoli, dairy products, dried fruits, cantaloupe, bananas, lean meats, milk, whole grains

49
Q

2 main complications that can occur from hypokalemia

A

Respiratory failure and cardiac arrest

50
Q

Hyperkalemia

A

Potassium level greater than 5.0 mEq/L

51
Q

What can you expect to find with hyperkalemia in patients?

A

Slow irregular pulse, hypoTN, restlessness, premature ventricular contractions, v-fib, peaked T waves, wide QRS, diarrhea, oliguria

52
Q

What diuretic would you administer for hyperkalemia?

A

Loop diuretic like furosemide to help increase the excretion of potassium from the renal system

53
Q

Sodium polystyrene sulfonate is administered with hyperkalemia because of its ability to…

A

Work in the intestine to excrete excess potassium from the body thru feces

54
Q

What beta-2 agonist would be administered for hyperkalemia?

A

Albuterol

55
Q

Hypocalcemia

A

Total blood calcium less that 9.0 mEq/L

56
Q

Expected findings for hypocalcemia are…

A

Tetany, paresthesia, seizure, charley horse, positive Chvosteks sign (tapping of facial nerve), positive trousseaus sign (hand/finger spasms with sustained BP cuff inflation) prolonged QT interval

57
Q

Foods high in calcium

A

Dairy products, canned salmon, sardines, fresh oysters, dark leafy green vegetables

58
Q

Hypomagnesemia

A

Blood magnesium level less than 1.3 mg/dL

59
Q

Risk factors for developing hypomagnesemia include…

A

Celiac disease, crohns disease, MI, concurrent hypokalemia and hypocalcemia

60
Q

Side effects of hypomagnesemia

A

Increased BP,hyperactive DTRs, positive chvosteks and trousseaus signs, constipation, depressed mood, agitation

61
Q

Foods high is magnesium

A

Dark green vegetables, nuts, whole grains, sea food, peanut buttwr

Med Surg 1 (1 decks)

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