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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
Interventions for hypovolemia
Patient to intake fluids Monitor patient weight Safety precaution because the patient will be dehydrated
26
Hypervolemia causes
- 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
27
Hypervolemia S/S
Bounding pulse Edema High blood pressure Crackles Distended neck vein Weight gain Wet cough Skin is cool to touch Dyspnea
28
What is a sign of Hypervolemia
Distend neck vein
29
Who is at risk for Hypervolemia
Patients with heart failure Kidney disease Certain meds
30
Interventions for Hypervolemia
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
31
What position do you put patients with Hypervolemia in
Semi fowlers
32
Hypernatremia
Sodium level higher than 145
33
Hypernatremia causes: anything that causes you to lose water
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
34
Hypernatremia S/S FRIED
Fatigue Restlessness Increased flexes Extreme thirst Decreased urine and dry mouth Seizures Delusion Hallucination Disorientation
35
Interventions for Hypernatremia
Monitor the patients level of consciousness Provide oral care Monitor I&O Low sodium diet Encourage I oral fluid
36
Hyponatremia
Sodium level less than 135
37
Hyponatremia causes
Too much water intake Congestive heart failure: dilute the sodium Low salt due NPO status Kidney disease Sodium wasting
38
What are examples of sodium wasting for Hyponatremia
Vomiting Diarrhea Sweating Diuretics usage
39
Hyponatremia S/S SALT LOSS
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
What are the severe signs of Hyponatremia
Lethargy Muscle twitching Hyperflexia Seizure Coma
41
Intervention for Hyponatremia ADD SALT
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
What foods are source of sodium
Milk Cheese Processed meat Canned foods
43
Hypokalemia
Potassium less than 3.5
44
With potassium everything is
Slow and low
45
Hypokalemia common causes: anything that causes you to lose electrolytes Remember we “DITCH”potassium
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
Hypokalemia S/S
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
Bradycardia is for Tachycardia is for
Bradycardia is for Hypokalemia Tachycardia is for hyperkalemia
48
Interventions for Hypokalemia
Treat the underlying cause Potassium intake Potassium administration Monitor for slow respiration Monitor cardiac rhythm
49
What foods are high in potassium
Banana Avocado Leafy greens Tomato Strawberry Mushroom Fish
50
Hyperkalemia
Potassium higher than 5.0
51
Common causes of hyperkalemia
Excess potassium intake Renal failure Hyperaldosteeroism Medications
52
What drugs might cause hyperkalemia
Potassium chloride Heparin Ace inhibitors Potassium sparing diuretics
53
S/S Hyperkalemia
Tachycardia Muscle weakness: the heart is working too much Paralysis Paresthesia
54
Interventions for hyperkalemia
ECG monitoring Decrease potassium intake Monitor serum potassium
55
Hypocalcemia
Less than 8.9
56
Common causes of Hypokalemia
Not enough calcium intake Impaired calcium uptake Excessive calcium loss Low vitamin d Low parathyroid hormone Wound drainage Kidney disease
57
S/S of hypocalcemia
Positive Chvostek Numbness and tingling Muscle spasms Positive trousseau signs Tetany or muscle twitching Muscle cramps,os Hyperactive reflex
58
What is trousseau
Hand and finger spasm
59
Interventions for Hypocalcemia
administer calcium Vitamin d supplements Seizure precautions Safety precaution High diet calcium
60
What foods are high in calcium
Milk Yoghurt Cheese Spinach Collard Greens Almonds
61
Hypercalcemia
Higher than 10.5
62
Common cause of hypercalcemia
Hyperthyroidism : too much calcium released in blood Cancer Increased calcium intake
63
Signs and symptoms of hypercalcemia
Muscle pain Bone pain Nausea Vomiting Excessive urination Thirst Slurred speech Lethargy Thirst
64
Intervention for hypercalcemia
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
Hypomagnesia
Less than 1.3
66
Common cause of hypomagnesmia
Nasogastric suction Diarrhea Sepsis Burns Chronic alcoholism Vomiting
67
Signs and symptoms for hypomagnesemia Remember that the muscle will be experiencing excitement which causes ?
Muscle weakness Tremors Tetany Seisures Cardiac arrhythmia Change in mental Respiratory paralysis Hyperactive deep tendon reflex
68
Interventions for hypomagnesmia
Disscontinue medication that might be causing losing magnesium Magnesium administration Encourage foods high in magnesium
69
What foods are high in magnesium
Whole grain Dark vegetables
70
What is the precaution when giving oral magnesium
It can cause diarrhea further increasing magnesium depletion
71
Hypermagnesemia
Greater than 2.1
72
Common causes of hypermagnesemia
Renal failure Excessive intake of magnesium
73
Signs and symptoms of hypermagnesemia Everything is lethargic
Nausea Vomiting Weakness Flushing Lethargic Hypoactive reflex Respiratory depression Coma Cardiac arrest
74
Interventions for hypermagnesemia
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
What nursing assessment questions should you be asking
Acute and chronic illness Any abnormal loss of body fluids Burns Trauma Surgery Treatment may disrupt fluid and electrolytes balance
76
Physical assessment should include
Skin Muscous membrane Vital signs Neuro exam Look for relative signs and symptoms
77
What are so,e relative signs and symptoms of fluid and electrolytes altercation
Nausea Vomiting Diarrhea Wounds
78
Daily weights
Weighing the patient at the same time each day with them wearing the same clothes
79
what laboratory studies can you complete
CBC Serum electrolyte Blood urea nitrogen Creatinine
80
What is a normal specific gravity
1.005 to 1.030
81
What increased urine specific gravity occur with
Dehydration Vomiting Diarrhea Heart failure
82
Decreased urine specific gravity indicates
Renal damage
83
What would be some planned outcome for a patient with altercation in fluid and electrolytes
- patient will maintain fluid balance between fluid intake and fluid output - patient will maintain a urine specific gravity of 1.005-1.030
84
Implementations
Dietary change Change of fluid intake Medication administration Iv therapy Blood and blood products replacement Patient and family/ caregiver teaching
85
What can you teach the patient
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
Nursing care
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
What counts as patients fluid intake
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
Are sips of water included
Yes
89
Fluid output include
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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