Fluid And Electrolytes Flashcards
What factors influence fluid content?
Age, muscle mass, fat content, gender (females w/ hormonal changes)
What is the normal lab value for Potassium?
3.5-5.2
What is the movement of fluid from an area of less solute to an area of greater solute? Or more fluid to an are of less fluid
Osmosis
What is the movement of solutes from from an area of higher concentration to an area of lower concentration (to equal itself out)?
Diffusion
What is the energy used to transport proteins thoroughly the body?
Active transport
What is the pressure that water places on the wall of the blood vessel; generated by the heart pumping?
Hydrostatic pressure
True or false: 70% of protein in plasma is Albumin
True
What is the pressure exerted by protein (colloid) in plasma against the capillary wall?
Plasma colloid osmotic pressure
What is the total concentration of solute particles in a solution?
Osmolarity
What is the normal range for serum osmolarity?
275-295
What IV fluid changes from isotonic on the shelf to hypotonic in the body?
D5W
What solution causes cells to swell because the fluid moves into the cell?
Hypotonic
What solution causes cells to shrink because fluid moves out of the cell?
Hypertonic
What solution is under 275 osmolarity?
Hypotonic
What solution has an osmolarity greater than 295?
Hypertonic
What are hypotonic solutions used to treat?
Severe dehydration
What do you treat with hypertonic solutions?
Edema
What is the first regulatory mechanism to kick in?
Thirst
When does the renin angiotensin system kick in?
When there’s not enough fluid in the body. It holds on to water and nacl
Name the hormone: pituitary gland releases vasopressin-renal fluid reabsorption-kidneys conserve water
Anti-diuretic hormone
Name the process: blood volume increase-bp increase-heart stretch-atria releases anp-inhibits aldosterone secretion and na reabsorption (increase urine output)
Atrial Natiuretic Peptide
When will the body be stimulated to secrete ADH?
Dehydration
What role does albumin play in fluid balance?
Fluid magnet
What is the normal value of specific gravity?
1.010-1.025
What is fluid loss you CAN’T measure?
Insensible loss
What is fluid loss you CAN measure?
Sensible loss
What is the normal lab value of Na?
135-145
What is your typical diagnosis when your bun and hct are elevated?
Dehydration
True of false: increased albumin is a sign of dehydration .
True
What dilution would you give for diarrhea, burbs, and hemorrhage?
Isotonic
What solution would you give for watery diarrhea, diabetes insidious, and insufficient ADH?
Hypertonic
What solution would you give for diarrhea, vomiting, ng tubes, diuretics, and fever?
Hypotonic
What fluid imbalance is described as: increased HR, increased thirst, thready pulse, decreased BP, flat neck veins.
Fluid volume deficet
What is the most common area for fluid volume excess?
Interstitial (third space)
What are the most common causes for fluid volume excess?
Hypertonic fluid and renal/heart disease
What fluid imbalance is described as: increased HR, increased BP, bonding pulses, vein distension, increased resp rate, crackles in lungs?
Fluid volume excess
Name the edema: proteins are trapped inside fluid buildup causing discoloration.
Brawny edema
How do you treat refractory edema (unmanageable)?
Aldactone
What is it when increased capillary pressure forces fluid into surrounding tissue?
Hydrostatic pressure
What conditions lead to a decreased colloid osmotic pressure?
Liver disease, malnutrition, protein loss
What conditions will increase capillary permeability?
Tissue damage, burns, distended bowel, sprain
Name the disease: excessive ADH production (pituitary gland), loss of electrolytes but not water, fluid retention but low sodium.
SIADH
Name the disease by signs/symptoms: FVE, crackles, decreased urine output, increased BP, aldosterone secretion suppressed.
SIADH
What are the treatment options for SIADH?
Diuretics, hypertonic Iv, po fluid restrictions, declomycin ( blocks ADH in kidneys)
Name the disease: decreased ADH causes the kidneys to NOT concentrate urine, dehydration, increase na in plasma/increase plasma osmolarity, decrease urine osmolarity.
Diabetes insipidus
What is the difference between central DI and nephrogenic DI?
Central–ADH DEFICIENCY
nephrogenic– ADH is produced but kidneys do not respond
How do you treat central Diabetes Insipidus?
Replacement ADH (vasopressin) low na diet, Diabense
How do you treat nephrogenic DI?
Thiazides diuretics
Why is potassium replacement needed for the postoperative patient?
Aldosterone kicks in and holds on to sodium and potassium is excreted.
Why do patients undergo fluid challenges?
Force the kidneys to work
What solution will a patient receive is their serum osmolarity is elevated?
Hypotonic (pulls water out of vessel into the cell)
What is the best assessment finding to determine fluid balance imbalance?
Daily weight
What are charged particles that help the body use energy?
Electrolyte
What disease is too much water that dilutes the sodium in the body?
Hyponatremia
Who is at most risk for hyponatremia?
Elderly, children, unconscious pt
What is the most obvious sign of hyponatremia?
Neurological disorders
Hypo or hyper- natremia? Confusion, dehydration, increased HR/BP, dry mm, hyperactive bs
Hyponatremia
Name the disease: excessive na, triggers thirst, increase neurological activity (tremors and hyper reflexion)
Hypernatremia
Hyper or hypo-natremia? Fluid volume excess, too much fluid/too much salt.
Hypernatremia
What is the overproduction of aldosterone in the adrenal gland?
Cushings disease
What is the under production of aldosterone in the adrenal gland?
Addison’s disease
Names the disease: S-skin flushed A- agitation L- low grade fever T- thirst
hypernatremia
How do you treat hypernatremia?
1/2 NSS
Where is potassium primarily excreted?
Kidneys
What are the best sources of potassium?
Fruits and vegetables
True or false: potassium helps transport glycogen into the cell.
True
What mental disorder Dan cause hypokalemia?
Anorexia nervosa
Name the disease: flat/inverted t waves, weak/thready pulse, weakness in legs
Hypokalemia
Name the disease: slow HR, decrease BP, tall peaked ‘T’ waves, weakness, hyperactive gi, resp failure
Hyperkalemia
How do u correct hyperkalemia?
Diuretics and D10 w/ insulin
How do you correct cardiac arrhythmia with hyperkalemia ?
10% calcium gluconate
What is the normal lab value for Calcium?
8.5-10.5
What regulates calcium in the body?
Parathyroid
What vitamin is needed to help with absorption of calcium?
Vitamin D
Where do the serum levels of calcium come from primarily?
Gi absorption
True or false: calcium contracts cardiac, smooth, and skeletal muscle. As well as, helps with blood clotting.
TRUE
What form of calcium is calculated in lab values and is pro dominantly used?
Ionized
How does pancreatitis cause hypocalcemia?
Lipase breaks down fat to fatty acid; fatty acid binds to protein
What is steatorrhea?
Fat in feces
Name the disease: tremor, seizure, involuntary muscle spasm, weakness hands/feet (w/Ca)
Hypocalcemia
What is the best treatment for hypocalcemia?
Iv calcium gluconate, w/ d5w
How is hypercalcemia different from other imbalances? (HR)
Increased HR and BP then decreased HR
What is the normal lab value for phosphorus?
2.5-4.5
Where is phosphorus regulated?
Parathyroid
What chronic addicted disease is hypophosphatemia associated with?
Alcoholism
What is the best treatment for hyperphoshatemia?
Increase calcium intake, diuretics
What is the normal lab value for magnesium?
1.5-2.5
Where is magnesium absorbed?
Small intestine
What regulates magnesium?
Kidney and gi
