Fluid and Electrolytes Flashcards
What is the intracellular space ?
space within the cell
- holds about 67% of the body’s water
What is the extracellular space ?
space outside the cell (includes the interstitial and intravascular)
- holds 25% of the body’s water
How much water does the intravascular space hold ?
8% of the body’s water
What is the interstitial fluid ?
fluids between cells and outside the blood vessels
- include lymph
What is the intravascular fluid ?
blood plasma found in the vascular system
What is the transcellular fluids ?
secreted by epithelial cells and include cerebrospinal, pleural, peritoneal, and synovial fluids
What does the hemoglobin test measure ?
the amount of hemoglobin in blood and is a good measure of the blood’s ability to carry oxygen throughout the body
What does the hematocrit test measure ?
amount of space (volume) red blood cells take up in the blood
- value is given as a % of RBCs in a volume of blood
- Ex.) hematocrit of 38 means that 38% of the blood’s volume is made of RBCs
What is the best indicator of fluid retention and overload ?
weight gain
- congestive heart failure and renal failure and great examples of diseases that can retain large amounts of fluid
How much of weight gain does one gain per liter ?
2.2 lbs= 1 L (1000mL)
What are some causes of hypervolemia ?
- excessive intake of fluids
- abnormal retention of fluids
- heart failure
- renal failure
- long term corticosteroid therapy
What is hypervolemia ?
where the liquid portion of the blood (plasma) is too high
- or fluid in the body is too high
What are signs and symptoms of hypervolemia ?
- increased pulse: full and bounding distended neck veins
- increased BP
- polyuria/nocturia
- edema
- SOB
- moist crackles
- headache
What is a classic sign of hypervolemia ?
full and bounding distended neck veins
What are some nursing consideration for hypervolemia ?
- maintain oxygenation (semi or full fowler’s to improve gas exchange)
- fluid restriction: I & O
- promote excretion of excess fluids
- monitor electrolytes (prevent tissue injury)
- evaluate feet for edema and discoloration when pt is OOB (out of bed)
- observe suture line on surgical pt’s (potential evisceration due to fluid retention)
What are some causes of hypovolemia ?
- abnormal fluid loss
- diarrhea
- hemorrhage
- fever (increased perspiration)
- inadequate intake
- DKA (diabetic ketoacidosis)
What are some signs and symptoms of hypovolemia ?
- increased HR (due to SNS: sympathetic NS)
- weak/thready pulses
- change in position may cause increased HR or decreased BP
- dizziness/light-headedness
- UO <500 mL/day
- altered mental status
- restlessness
- lethargy
What are some RN considerations for hypovolemia ?
- maintain pt’s safety
- Skin care: edematous tissues protected from extreme temps, pressure, and trauma
- frequent skin care and changes in position
- elevate edematous extremities to promote venous return and fluid reabsorption
What is the goal of IV therapy ?
- correct or prevent fluid and electrolyte disturbances
- provide direct access to the vascular system
What is isotonic fluid ?
fluid with the same concentration of normal blood
- most common
What is isotonic fluid used for ?
used for volume replacement (after prolonged vomiting)
- 0.9% sodium chloride (normal saline)
- LR
What is hypotonic fluid ?
fluid that is more dilute than blood
What is hypotonic fluid used for ?
used to rehydrate the cells
- 0.45% NaCl
- D5 0.45% NaCl (once infused, dextrose enters cells rapidly leaving free water)
What is hypertonic fluid ?
fluid is more concentrated than normal blood