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Adult Health 380 Exam 3 > Fluid and Electrolytes > Flashcards

Fluid and Electrolytes Flashcards

1
Q

What is homeostasis?

A

-ability to maintain internal equilibrium by adjusting physiologic processes
-reestablishment and maintenance a goal in managing fluid, electrolyte, and acid-base imbalance

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2
Q

What does water do in body fluid composition?

A

-transport nutrients
-medium for metabolic reactions
-regulation of body temp

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3
Q

What do electrolytes do in body fluid composition?

A

-water balance regulation
-acid base balance
-enzyme reactions
-neuromuscular activity

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4
Q

What is Intracellular fluid?

A

-found WITHIN the cells
-essential for normal cell functions

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5
Q

What electrolytes are in the ICF?

A

-potassium
-magnesium
-phosphate
-glucose
-oxygen

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6
Q

What is Extracellular fluid?

A

-fluid outside the cell
-interstitial fluid
-intravascular fluid
-transcellular fluid

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7
Q

What electrolytes are found in the ECF?

A

-sodium
-chloride
-bicarbonate

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8
Q

What are the major fluid compartments of the body?

A

-total body fluid: 60% body weight
-ICF: 40% of body weight
-plasma: 5% of body weight

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9
Q

What are some normal intake values?

A

-fluids: 1200cc
-solid foods: 1000cc
-oxidation: 300cc
-total: 2500cc

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10
Q

What are some normal output values?

A

-insensible: 900cc
-feces: 100cc
-urine: 1500cc
-total: 2500cc

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11
Q

What are key implications for elderly in normal fluid balance?

A

-decreased percentage of fluid
-hormone regulators respond more slowly
-increased loss of moisture through skin
-decreased thirst mechanism

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12
Q

Key values for weight loss

A

-up to 2 lb/ week or 1 lb per day is normal
-30 to 50 cc/hr urine output

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13
Q

What is the Specific gravity of urine?

A

1.010-1.030

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14
Q

Who is at higher risk for dehydration and electrolyte imbalances?

A

Elderly

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15
Q

Diluted vs Concentrated Urine

A

-concentrated: less water; more heavy (dehydration)
-diluted: more water

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16
Q

You notice the following intake and output pattern on an adult patient for an 8 hour shift. What should be your interpretation?

Oral Intake- 50cc; IV Intake- 1100cc; Urinary Output- 500cc; Vomitus- 500cc

A

this would represent an adequate pattern (there will always be a little more going in than coming out)

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17
Q

What is osmosis?

A

movement of water molecules from less concentrated area to more concentrated area

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18
Q

What is diffusion?

A

movement of molecules from an area of higher concentration to lower concentration

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19
Q

What are the types of diffusion?

A

simple and facilitated

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20
Q

What is simple diffusion?

A

molecules move through membrane w/o help

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21
Q

What is facilitated diffusion?

A

diffusion that’s assisted by integral (channel) proteins

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22
Q

What is filtration?

A

separation of solids from fluids (liquids or gases)

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23
Q

What is the purpose of filtration?

A

balance hydrostatic, colloid osmotic pressure. push and pull that occurs in the capillary bed and glomerulus

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24
Q

What is active transport?

A

-movement of ions or molecules across a cell membrane from low to high concentration requiring energy or enzymes
-sodium potassium pump

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25
Q

What does the sodium potassium pump do?

A

moves sodium out of the cell and potassium into the cell against their concentration gradients

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26
Q

Where is fluid balance between intravascular and interstitial spaces?

A

maintained in the capillary beds by a balance of filtration at the arterial end and osmotic draw at the venous end

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27
Q

What do the veins do?

A

carries away waste using osmotic pressure

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28
Q

What is the active transport process fueled by?

A

energy from ATP

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29
Q

If albumin is low what does that mean?

A

it is a blood product

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30
Q

What are the Isotonic solutions?

A

0.9% NS
LR (favorite for SHOCK)
D5W

31
Q

What are hypotonic solutions?

A

-0.45% NS (1/2 NS)
-1/4 NS

32
Q

What are hypertonic solutions?

A

-D5 NS
-D5 LR
-D10W

33
Q

What do isotonic solutions do to a RBC?

A

neither gain nor lose water, retaining their normal biconcave shape

34
Q

What do hypertonic solutions do to a RBC?

A

cells LOSE water and shrink in size

35
Q

cellular dehydration=

A

hypernatremia

36
Q

What do hypotonic solutions do to a RBC?

A

cells absorb water and may burst (hemolysis)

37
Q

If the nurse were to administer 1/2 NS IV solution, what would be the expected outcome?

A

the fluid would move from the vascular volume to the cells (solution is hypotonic)

38
Q

What is thirst?

A

primary regulator of water intake

39
Q

What do the kidneys do?

A

regulates volume, osmolality of body fluids

40
Q

What is renin-angiotensin-aldosterone system?

A

helps maintain intravascular fluid balance and BP

41
Q

What is Antidiuretic hormone and what does it do?

A

-made by the hypothalamus and stores in the posterior pituitary gland

-regulates water excretion from kidneys

42
Q

What is the Atrial natriuretic peptide?

A

released by atrial muscle cells in response to distention from fluid overload

43
Q

What does the atrial natriuretic peptide do?

A

inhibits aldosterone and dilates the afferent arteriole to reduce blood volume

44
Q

What does aldosterone do?

A

causes the reabsorption of sodium in the kidney tubule

45
Q

Where water goes…

A

sodium and potassium follow

46
Q

What do increased levels of aldosterone regulate?

A

sodium and potassium, BP, and water balance

47
Q

Why is aldosterone released?

A

decreased blood volume and renal perfusion sets off a chain reaction leading to the release

48
Q

What stimulates the release of ADH from the posterior pituitary?

A

increased serum osmolality or a fall in blood volume

49
Q

What does ADH INCREASE?

A

the permeability of distal tubules, promoting water reabsorption

50
Q

What are some risks for loss of water and electrolytes?

A

-vomiting
-diarrhea
-excess sweating
-polyuria
-fever
-abnormal drainage or wound losses

51
Q

What can insufficient intake be due to?

A

-anorexia
-nausea
-inability to access fluids
-impaired swallowing
-confusion

52
Q

What are some weight loss clinical manifestations ?

A

-2% loss: MILD FVD

-5% loss: MODERATE

-8% loss: SEVERE

53
Q

What are fluid volume deficit clinical manifestations?

A

-weight loss
-fluid intake less than output
-dry mucous membranes
-weak, rapid pulse
-hypotension (BP drops when moving from lying to sitting)
-decreased capillary refill
-decreased urine volume

54
Q

What are some nursing interventions for fluid volume deficit?

A

-assess
-monitor vitals and weight
-assess tissue turgor
-monitor I & O
-monitor lab findings
-provide frequent mouth care

55
Q

NANDAs for fluid volume deficit

A

-deficient fluid volumes
-ineffective tissue perfusion
-risk for injury

56
Q

When fluid is low what happens to the hematocrit?

A

increased hematocrit due to increased formed elements

57
Q

Why is a person with fever most likely to have a fluid volume problem?

A

they are likely to have increased perspiration and respiration (insensible loss)

58
Q

What is the primary rationale for good skin care in the patient with the nursing diagnosis of fluid volume deficit from any cause?

A

there is likely to be decreased tissue perfusion to the skin and higher breakdown risk

59
Q

Fluid Volume Excess- Risk factors

A

-heart failure
-renal failure
-cirrhosis of liver

60
Q

Clinical Manifestations- Fluid Volume Excess

A

-weight gain
-intake greater than output
-full, bounding pulse
-increased BP and venous pressure
-distended neck veins
-crackles in lungs (bilaterally)
-dyspnea, SOA
-mental confusion

61
Q

What are nursing interventions for fluid volume excess?

A

-monitor weight and vitals
-assess for edema
-assess breath sounds
-monitor I & O
-place in Fowler’s position
-administer diuretics
-restrict fluid intake and dietary sodium
-implement measures to prevent skin breakdown

62
Q

What are the priorities of care for a patient with fluid volumes excess?

A

supporting cardiovascular, respiratory function

63
Q

What are some fluid volumes excess NANDAs?

A

-fluid volume excess
-risk for impaired skin integrity
-impaired gas exchange

64
Q

Fluid Volume Deficit vs. Fluid Volume Excess: BP

A

-FVD: decreased
-FVE: increased

65
Q

Fluid Volume Deficit vs. Fluid Volume Excess: HR

A

-FVD: increased
-FVE: increased

66
Q

Fluid Volume Deficit vs. Fluid Volume Excess: pulse

A

-FVD: decreased
-FVE: increased

67
Q

Fluid Volume Deficit vs. Fluid Volume Excess: Respirations

A

-FVD: normal
-FVE: moist crackles, wheezing

68
Q

Fluid Volume Deficit vs. Fluid Volume Excess: Edema

A

-FVD: rare
-FVE: dependent

69
Q

Fluid Volume Deficit vs. Fluid Volume Excess: Skin Turgor

A

-FVD: loose, poor
-FVE: taut

70
Q

Fluid Volume Deficit vs. Fluid Volume Excess: Urine Specific Gravity

A

-FVD: high
-FVE: low

71
Q

Which of the following assessment findings in an adult patient most clearly supports the nursing diagnosis of fluid volume OVERLOAD

A

intake greater than output

72
Q

What are electrolytes important for?

A

-maintaining fluid balance
-contributing to acid base
-facilitating enzyme reactions
-transmitting neuromuscular reactions

73
Q

Where are most electrolytes obtained?

A

through the diet and excreted in urine; some are not stored and must be consumed daily

Adult Health 380 Exam 3 (4 decks)

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