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Fundamentals (Nurs 113) > Fluid and Electrolytes > Flashcards

Fluid and Electrolytes Flashcards

1
Q

What is the major fluid in the body?

A

Water

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2
Q

How much body weight is water?

A

50-60%

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3
Q

What is the most important nutrient to sustain life?

A

Water

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4
Q

What is fluid intake and fluid loss in a patient like?

A

It is equal

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5
Q

Intracellular fluid

A

-Fluid that is in the cells
-70% of water in the body

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6
Q

Extracellular fluid

A

-Fluid that is outside of the cells
-Approximately 30% of water in the body

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7
Q

Where does potassium stays the most?

A

Intracellular fluid

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8
Q

What are electrolytes?

A

substances that are capable of breaking into particles called ions

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9
Q

What are the major electrolyte in the ECF

A

sodium
chloride
calcium
bicarbonate

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10
Q

What are the major electrolytes in the ICF

A

potassium
phosphorus
magnesium

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11
Q

What foods are low in fluid

A

Cereal
Dried fruits

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12
Q

Waft are some things to keep in mind for fluid intake and output

A

-Fluid intake and output should be the same
-Always record I&O

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13
Q

How can we measure I&O for incontinent patients?

A

-Measure the diapers
- Measure urine from pure wick

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14
Q

What is sensible measurable

A

Urine
Stool
Wound

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15
Q

Insensible

A

Not measurable
Respiration
Vapor
Chicken etc

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16
Q

Sodium normal range

A

135-145

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17
Q

Potassium normal range

A

3.5-5.0

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18
Q

Calcium normal range

A

8.9-10.5

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19
Q

Normal range for magnesium

A

1.3-2.3

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20
Q

Chloride normal range

A

97-107

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21
Q

What causes fluid volume deficit: hypovolemia

A

Anything that causes us to lose fluids
Vomiting
Diarrhea
Taking lasix
Not drinking enough fluids
Bleeding
Burns
Sweating without replacing fluids
Nasogastric suction
Fever

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22
Q

What might cause a patient to have issues with intake leading to hypovolemia

A

Nausea
Impaired swallowing
Confusion
NPO
patient loses sense of taste

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23
Q

What are the S/S for hypovolemia

A

Dizziness
Confusion
Nausea
Vomiting
Fatigue
Seizures
Cool and clammy skin
Thirst
Dry mucous membrane
Decreased skin turgor
Tachycardia
Decreased urine output

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24
Q

Who is at risk for hypovolemia

A

Children
Older adults
Patients who are ill

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25
Q

Interventions for hypovolemia

A

Patient to intake fluids
Monitor patient weight
Safety precaution because the patient will be dehydrated

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26
Q

Hypervolemia causes

A
  • when there is an increase in the intake of sodium in dehydrates the cells causing the water to move out of the cell causing edema
  • too fluid fluid intake
  • malfunction of the kidney: when the kidney is unable to excrete the excess fluid
  • heart failure: accumulation of fluid in the lungs
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27
Q

Hypervolemia S/S

A

Bounding pulse
Edema
High blood pressure
Crackles
Distended neck vein
Weight gain
Wet cough
Skin is cool to touch
Dyspnea

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28
Q

What is a sign of Hypervolemia

A

Distend neck vein

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29
Q

Who is at risk for Hypervolemia

A

Patients with heart failure
Kidney disease
Certain meds

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30
Q

Interventions for Hypervolemia

A

Restrict sodium intake
Observe respiratory
Monitor for SOB
Check for edema
Monitor I&O
Administer diuretics
Monitor patient weight
Place patient in a semi Fowler position

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31
Q

What position do you put patients with Hypervolemia in

A

Semi fowlers

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32
Q

Hypernatremia

A

Sodium level higher than 145

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33
Q

Hypernatremia causes: anything that causes you to lose water

A

Dehydration or water deprivation
Heat stroke
Excess fluid loss
Too much sodium intake
Diarrhea
Vomiting
Burns
Patient is unable to communicate that they are thirsty
Sodium retention: kidney failure or Cushing disease

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34
Q

Hypernatremia S/S
FRIED

A

Fatigue
Restlessness
Increased flexes
Extreme thirst
Decreased urine and dry mouth

Seizures
Delusion
Hallucination
Disorientation

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35
Q

Interventions for Hypernatremia

A

Monitor the patients level of consciousness
Provide oral care
Monitor I&O
Low sodium diet
Encourage I oral fluid

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36
Q

Hyponatremia

A

Sodium level less than 135

37
Q

Hyponatremia causes

A

Too much water intake
Congestive heart failure: dilute the sodium
Low salt due
NPO status
Kidney disease
Sodium wasting

38
Q

What are examples of sodium wasting for Hyponatremia

A

Vomiting
Diarrhea
Sweating
Diuretics usage

39
Q

Hyponatremia S/S

SALT LOSS

A

Seizures
Abdominal cramps
Lethargic
Tendon reflex diminished
Loss of urine and appetite
Orthostatic hypotension
Shallow respiration
Spasm of muscle

Muscle cramps
Weakness
Dry skin

40
Q

What are the severe signs of Hyponatremia

A

Lethargy
Muscle twitching
Hyperflexia
Seizure
Coma

41
Q

Intervention for Hyponatremia

ADD SALT

A

Monitor I&O
Vitals and level of consciousness
Monitor respiratory status if muscle weakness is present
Encourage intake of high sodium foods
Restrict water intake

Administer iv saline solution
Diuretic
Daily weight check
Safety
Airway precautions
Limit water intake
Teach high salt diet

42
Q

What foods are source of sodium

A

Milk
Cheese
Processed meat
Canned foods

43
Q

Hypokalemia

A

Potassium less than 3.5

44
Q

With potassium everything is

A

Slow and low

45
Q

Hypokalemia common causes: anything that causes you to lose electrolytes

Remember we “DITCH”potassium

A

Drugs: laxative or diuretic
Inadequate consumption of potassium
Too much water intake
Cushing syndrome
Heavy fluid loss: vomit, diarrhea, suction, sweat, wound drainage

Alkalosis

46
Q

Hypokalemia S/S

A

Everything is slow and low
Decrease HR
Muscle weakness
Leg cramps
Fatigue
Parenthesis
Dysthymia
Weak irregular pulse
Respiratory distress
Decrease muscle tone
Hypoactive reflex

47
Q

Bradycardia is for
Tachycardia is for

A

Bradycardia is for Hypokalemia
Tachycardia is for hyperkalemia

48
Q

Interventions for Hypokalemia

A

Treat the underlying cause
Potassium intake
Potassium administration
Monitor for slow respiration
Monitor cardiac rhythm

49
Q

What foods are high in potassium

A

Banana
Avocado
Leafy greens
Tomato
Strawberry
Mushroom
Fish

50
Q

Hyperkalemia

A

Potassium higher than 5.0

51
Q

Common causes of hyperkalemia

A

Excess potassium intake
Renal failure
Hyperaldosteeroism
Medications

52
Q

What drugs might cause hyperkalemia

A

Potassium chloride
Heparin
Ace inhibitors
Potassium sparing diuretics

53
Q

S/S Hyperkalemia

A

Tachycardia
Muscle weakness: the heart is working too much
Paralysis
Paresthesia

54
Q

Interventions for hyperkalemia

A

ECG monitoring
Decrease potassium intake
Monitor serum potassium

55
Q

Hypocalcemia

A

Less than 8.9

56
Q

Common causes of Hypokalemia

A

Not enough calcium intake
Impaired calcium uptake
Excessive calcium loss
Low vitamin d
Low parathyroid hormone
Wound drainage
Kidney disease

57
Q

S/S of hypocalcemia

A

Positive Chvostek
Numbness and tingling
Muscle spasms
Positive trousseau signs
Tetany or muscle twitching
Muscle cramps,os
Hyperactive reflex

58
Q

What is trousseau

A

Hand and finger spasm

59
Q

Interventions for Hypocalcemia

A

administer calcium
Vitamin d supplements
Seizure precautions
Safety precaution
High diet calcium

60
Q

What foods are high in calcium

A

Milk
Yoghurt
Cheese
Spinach
Collard Greens
Almonds

61
Q

Hypercalcemia

A

Higher than 10.5

62
Q

Common cause of hypercalcemia

A

Hyperthyroidism : too much calcium released in blood
Cancer
Increased calcium intake

63
Q

Signs and symptoms of hypercalcemia

A

Muscle pain
Bone pain
Nausea
Vomiting
Excessive urination
Thirst
Slurred speech
Lethargy
Thirst

64
Q

Intervention for hypercalcemia

A

Restrict calcium intake
Increase fluid intake to dilute the calcium
Monitor from cal, injures
Assess for abdominal or flank pain
Strain urine for kidney stone

65
Q

Hypomagnesia

A

Less than 1.3

66
Q

Common cause of hypomagnesmia

A

Nasogastric suction
Diarrhea
Sepsis
Burns
Chronic alcoholism
Vomiting

67
Q

Signs and symptoms for hypomagnesemia
Remember that the muscle will be experiencing excitement which causes ?

A

Muscle weakness
Tremors
Tetany
Seisures
Cardiac arrhythmia
Change in mental
Respiratory paralysis
Hyperactive deep tendon reflex

68
Q

Interventions for hypomagnesmia

A

Disscontinue medication that might be causing losing magnesium
Magnesium administration
Encourage foods high in magnesium

69
Q

What foods are high in magnesium

A

Whole grain
Dark vegetables

70
Q

What is the precaution when giving oral magnesium

A

It can cause diarrhea further increasing magnesium depletion

71
Q

Hypermagnesemia

A

Greater than 2.1

72
Q

Common causes of hypermagnesemia

A

Renal failure
Excessive intake of magnesium

73
Q

Signs and symptoms of hypermagnesemia
Everything is lethargic

A

Nausea
Vomiting
Weakness
Flushing
Lethargic
Hypoactive reflex
Respiratory depression
Coma
Cardiac arrest

74
Q

Interventions for hypermagnesemia

A

Perform focused assessment of level of consciousness and reflex
Administer loop diuretics and magnesium iv free if kidney function adequate
Administer calcium glucinate
Withhold foods high in magnesium

75
Q

What nursing assessment questions should you be asking

A

Acute and chronic illness
Any abnormal loss of body fluids
Burns
Trauma
Surgery
Treatment may disrupt fluid and electrolytes balance

76
Q

Physical assessment should include

A

Skin
Muscous membrane
Vital signs
Neuro exam
Look for relative signs and symptoms

77
Q

What are so,e relative signs and symptoms of fluid and electrolytes altercation

A

Nausea
Vomiting
Diarrhea
Wounds

78
Q

Daily weights

A

Weighing the patient at the same time each day with them wearing the same clothes

79
Q

what laboratory studies can you complete

A

CBC
Serum electrolyte
Blood urea nitrogen
Creatinine

80
Q

What is a normal specific gravity

A

1.005 to 1.030

81
Q

What increased urine specific gravity occur with

A

Dehydration
Vomiting
Diarrhea
Heart failure

82
Q

Decreased urine specific gravity indicates

A

Renal damage

83
Q

What would be some planned outcome for a patient with altercation in fluid and electrolytes

A
  • patient will maintain fluid balance between fluid intake and fluid output
  • patient will maintain a urine specific gravity of 1.005-1.030
84
Q

Implementations

A

Dietary change
Change of fluid intake
Medication administration
Iv therapy
Blood and blood products replacement
Patient and family/ caregiver teaching

85
Q

What can you teach the patient

A

The importance of accurately recording all of input and output
Provide instructions and explanations to help patient keep the measurements of when care instructions and for how the patient can keep measurements accurate
Use the patient plan of care to communicate to other nursing personal the need to measure fluid intake and output

86
Q

Nursing care

A

Place a sign in the room the door to measure intake and output
Measure do not estimate
Record I&O for each 8 hour shift

87
Q

What counts as patients fluid intake

A

All foods and fluid at room temperature
Use the faculty designation if specific volume for common food containers
All parental fluid
Sips of water
Subcutaneous fluid
Gastrointestinal fluid
Iv flush

88
Q

Are sips of water included

A

Yes

89
Q

Fluid output include

A

Urine
Diarrhea
Drainage from fistula, wounds and ulcers
Drainage from other
Heavy perspiration should be noted
Hyperventilation
Urine or liquid feces in diapers.
Vomiting on clothes or bed
Wound drainage saturated dressings

Fundamentals (Nurs 113) (11 decks)

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