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Med-Surg Exam 2 > Fluid and Electrolytes > Flashcards

Fluid and Electrolytes Flashcards

1
Q

what is osmolality defined as?

A

is determined by the number of dissolved particles (sodium, urea, & glucose) per kilogram of water or solvent (sodium being the largest contributor).

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2
Q

what is osmolarity defined as?l

A

is the number of osmoles of solute in a liter of solution.

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3
Q

what is normal serum osmolality?

A

270-300 mOsm/L

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4
Q

what does aldosterone release promote?

A

-sodium reabsorption and potassium excretion
-(water follows Na) decreased water loss

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5
Q

what does ADH promote?

A

water reabsorption

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6
Q

what is an example of hypotonic fluids?

A

-1/2 NS or 0.45NS, 0.45% Na Cl
-D5W

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7
Q

when should hypotonic fluids be cautioned? why in these patients?

A

Beware of administration of Hypotonic fluids to patients with Intra Cellular Fluid Volume Excess (ICFVE).
-Cerebral edema may result.

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8
Q

what is an example of isotonic fluids?

A

-NS, 0.9% Na Cl
-LR

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9
Q

what are some examples of hypertonic fluids?

A

-D51/2NS
-D5NS
-D5LR
-3% NS
-D10
-D50

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9
Q

what are some s/s of dehydration?

A

-thirst
-dry membranes
-lethargy, confusion
-hypotension
-tachycardia
-low-grade temp
-weight loss
-decreased UO
-metabolic acidosis
-hypoxia (viscous RBC)

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9
Q

what are some causes of dehydration?

A

-vomiting/diarrhea
-low Na or no Na intake
-diabetes insipidus
-no H2O intake or fluid loss
-diuretics
-constipation medication

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10
Q

what are the lab values expected for those with dehydration?

A

-concentrated
-increased solutes

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11
Q

what are some interventions for dehydration?

A

-encourage fluids
-IV fluids: LR, D5NS, 0.9% NS
-supplemental O2 (hypoxia)
-monitor I & O
-monitor daily weights
-monitor BP

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12
Q

what are some s/s of hypervolemia?

A

-edema
-Pulmonary edema: crackles
-JVD
-lethargy, confusion
-alterations in NA
-hypertension
-tachycardia
-hypoxia, low Hgb
-weight gain
-decreased UO

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13
Q

what are the causes of hypervolemia?

A

-CHF
-too much fluid (PO or IV)
-renal injury or disease

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14
Q

what are the expected lab values of hypervolemia?

A

-diluted
-decreased solutes, increased fluids

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15
Q

what are some interventions for hypervolemia?

A

-diuretics
-Na and H2O restrictions
-monitor daily weights
-monitor I & O
-assess IV fluids (rate? stop?)
-monitor BP

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16
Q

what is the power of 3 CBC?

A
  1. RBC= 5
  2. Hgb= 15
  3. Hct= 45
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17
Q

what is the normal range for Mg? what is the memory key?

A

-1.8-2.6
-M for muscle

18
Q

what is the normal range for Phos?

A

2.5-4.5

19
Q

what is the normal range for K? what is the memory key?

A

-3.5-5
-K for Kardiac

20
Q

what is the normal range for Ca? what is the memory key?

A

-9-10.5
-Ca for calm

21
Q

what is the normal range for CL?

A

95-108

22
Q

what is the normal range for Na? what is the memory key?

A

-135-145
-N for neuro

23
Q

what is addisons disease? how is it treated?

A

an adrenal gland disorder where the patient lacks appropriate cortisol and aldosterone to maintain body function. (this can be treated/activated with corticosteroids)

24
Q

what are some causes of hyponatremia?

A

-diarrhea
-vomiting
-burns
-sweating
-GI suctioning

25
Q

s/s of hyponatremia

A

-neuro! lethargy, headache, confusion, seizures, coma
-N/V, muscular weakness, diminished reflexes

26
Q

how do we treat hyponatremia?

A

-assessments (neuro)
-IV NS or D5NS
-increase Na in diet
-daily weights
-admin steroids

27
Q

what are some causes of hypernatremia?

A

-severe N/V
-steroids or Cushing syndrome
-stress (cortisol release)

28
Q

what is Cushing syndrome?

A

promotes Na retention and K excretion because of additional release of aldosterone and cortisol)

29
Q

what are the s/s of hypernatremia?

A

-thirst
-s/s of dehydration
-orthostatic hypotention
-N/V & anorexia

30
Q

how do we treat hypernatremia?

A

-Na free IV fluids
-daily weight
-Na restrictions

31
Q

causes of hyperkalemia?

A

-Oral K supplements: too much intake
-K sparing diuretics (spironolactone), ACE inhibitors, NSAIDS
-↓ renal function
-Metabolic acidosis
-Addison’s disease

32
Q

what are some s/s of hyperkalemia?

A

-abd cramping
-EKG changes (peaked T-wave)
-bradycardia
-muscle weakness
-oliguria

33
Q

how do we treat hyperkalemia?

A

meds:
-ca gluconate
-furosemide
-Polystyrene sulfonate (Kayexalate)
-insulin + D50
-hold K-containing meds
monitor EKG
Dialysis

34
Q

what are some causes of hypokalemia?

A

-Malnutrition,
-Vomiting, diarrhea,
-K-wasting diuretic: furosemide
-Metabolic Alkalosis
-Steroid use/Cushing syndrome - increased secretion of cortisol and aldosterone

35
Q

what are some s/s of hypokalemia?

A

-early: weakness, leg cramping
-dysrhythmias
-irregular HR

36
Q

how do we treat hypokalemia?

A

-IV KCL
-monitor EKG
-monitor for dig toxicity (low K enhances the action of dig)
-oral K replacement in rich foods

37
Q

when Ca levels are high _____ levels are low.

A

Phos

38
Q

what are some causes of hypercalcemia?

A

-hyperparathyroidism
-↓ serum phosphorus
-some cancers
-steroid therapy-Steroids promote Ca loss from the bone
-medications

39
Q

hypercalcemia s/s?

A

*↓ neuromuscular excitability →
↓ GI motility (constipation & diminished bowel sounds), lethargy, depression – progressing to stupor and coma
*Calcium containing kidney stones (#1 cause of kidney stones)
*Pathologic fractures
*AV heart blocks

40
Q

how do we treat hypercalcemia?

A

-calcitonin
-biophosphonates
-loop diuretics
-fluids
-safety: weakness, neuro checks

41
Q

what are some causes of hypocalcemia?

A

*Parathyroid or thyroid surgery; Hypoparathyroidism
*↓ Ca consumption & Vitamin D deficiency
*Abuse of antacids & laxatives
*Diarrhea & diuretics
*CKD, ESRD
*↓ albumin (liver disease, alcoholism)
*Prolonged NG suction leads to Metabolic Alkalosis. Alkalosis ↑ Ca binding to albumin, which ↓ Ca
*Magnesium imbalances

42
Q

s/s of hypocalcemia?

A

CNS excitability leads to the following:
*Irritability; numbness and tingling around the mouth, hands, and feet;
*Tetany of the face and extremities
oChvostek’s sign: facial tap causes cheek tetany.
*Hyperactive deep tendon reflexes
*Abd distention/cramps

43
Q

how do we treat hypocalcemia?

A

*Medications: V Calcium Gluconate or Calcium chloride
oCorrection of magnesium deficiency; Vit D therapy
*Monitor Ca level following thyroid and parathyroid surgery

44
Q

what is the major cause of hypophosphatemia?

A
  • increased renal excretion (kidney injury or renal disease)
45
Q

what is one major cause of hypermagnesemia?

A

-Rare, but usually caused by renal injury/renal disease or excessive intake of magnesium containing antacids/laxatives

Med-Surg Exam 2 (4 decks)

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