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Exam 4 > Fluid and Electrolytes 2 > Flashcards

Fluid and Electrolytes 2 Flashcards

1
Q

A client has been taught the need to restrict sodium. Which food selections indicates appropriate choices
A. 1 cup of cottage cheese and sliced tomatoes
B. grilled American cheese on 2 pieces of white bread
C. ham and cheddar cheese sandwich on 2 whole wheat bread
D. chicken leg, 1 slice of whole wheat bread with butter and 1/2 cup of steamed carrots

A

D. chicken leg, 1 slice of whole wheat bread with butter and 1/2 cup of steamed carrots

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2
Q

a nurse is caring for an elderly with renal disease what is NPO. Yesterday the clients serum sodium level was 127 mEq/L. When the nurse assess vital signs , the client states that they are feeling much weaker then earlier in the day . what is the nurses first action
A. call the healthcare provider
B. Assess respiratory effort and circulation
C. raise the head of the bed
D. request dietary consult

A

B. Assess respiratory effort and circulation

BC hyponatermia causes muscle weakness that could affect the respiratory muscles

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3
Q

Active transport

A

occurs when molecules move across cell membranes against a concentration gradient from an area of low concentration to an area of high concentration— requires energy

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4
Q

calcium normal lab value range

A

8.5-10.5

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5
Q

can you give more the 20 mEq/hr for potassium replacement

A

NO

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6
Q

Can you give potassium replacement IM or SC or IV push

A

no it can irritate skin at insertion site, and can cause necrosis
NEVER IV PUSH

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7
Q

Capillary Filtration

A

movement of fluid through a permeable membrane from an area of higher pressure to one of lower pressure

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8
Q

causes of hyperkalemia

MACHINE

A 
medications 
acidosis 
cellular destruction 
hypoaldosteronism 
intake -excess 
nephrons- renal failure
excretion - impaired
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9
Q

chronic fluid overload nutritional therapy means

A

fluid and sodium restrictions

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10
Q

Colloids are…..

A

larger molecules that do not dissolve readily

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11
Q

Common causes of hypokalemia

A

medications - furoseide
vomiting
diarrhea
renal failure

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12
Q

Diffusion

A

passive process by which molecules of a solute move through a cell membrane from an area of higher concentration to an area of lower concentration until equilibrium

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13
Q

each pound of weight = ____ ml of retained water

A

500ml

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14
Q

Excess fluid within the interstitial space is called _____

A

Edema

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15
Q

Extracellular Fluid (ECF) is found _____

A

outside the cells.

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16
Q

Filtration

A

The movement of both water and smaller particles from an area of high pressure to one of low pressure

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17
Q

Fluid and electrolyte balance is the process of regulating…..

A

extracellular fluid volume,

body fluid osmolality,

plasma concentration of electrolytes.

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18
Q

fluid is regulated primarily by

A

the thirst mechanism

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19
Q

Fluid volume depends on ____, _____, and _____

A

age
body fat
gender

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20
Q

functions of calcium

A
  • bone strength and density
  • activates enzymes
  • skeletal muscle and cardiac muscle to contract
  • nerve transmission
  • blood clotting
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21
Q

Hemoconcentration

A

is a decrease in plasma volume, which causes a simultaneous increase in the concentration of red blood cells

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22
Q

Hydrostatic pressure

A

The force created by fluid within a closed system and is responsible for normal circulation of blood.

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23
Q

hypercalcemia interventions

A 
drug therapy to reduce calcium 
monitor EKG 
ROM to muscles 
evaluate mental status 
seizure precaution  
injury prevention
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24
Q

hypercalcemia symptoms

A 
severe muscle weakness 
LOC changes 
increased BP 
decreased peristalsis 
bone pain
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25
Q

hyperkalemia symptoms

A 
bradycardia 
hypotension
EKG changes 
decreased breath sounds 
muscle weakness
increased bowel sounds
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26
Q

hypernatemia symptoms

A 
changes in LOC 
short attention span
agitation 
confusion 
thirst 
twitching muscles 
diarrhea 
tachycardia
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27
Q

Hypernatermia interventions

A

monitor I and O
assess muscle activity
push PO water
salt restriction

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28
Q

hypertonic solution contains…

A

a higher concentration of solutes than does blood

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29
Q

hypervolemia

A

fluid excess

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30
Q

Hypocalcemia symptoms

A 
Trousseaus sign 
chvosteks sign 
parathesia 
weak pulse 
increase peristalsis 
bone pain or fractures
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31
Q

hypokalemia interventions

A

check EKG
potassium replacement by IV, PO, or NG
spirolactone

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32
Q

Hypokalemia symptoms

A SIC WALT

A 
Alkalosis 
shallow respirations 
irritability 
confusion 
weakness, fatigue 
arrhythmia 
lethargy 
thready pulse
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33
Q

Hypotonic solution is of _____ osmolarity then blood

A

of lower osmolality than blood

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34
Q

Hypovolemia

A

fluid deficit

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35
Q

if there is an decreased in blood osmolarity how will ADH (Antidiuretic Hormone) react

A

inhibits release

which causes concentration of blood

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36
Q

If there is an increased blood osmolarity how will ADH (Antidiuretic Hormone) do

A

stimulates release and causes dilution of blood

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37
Q

Interstitial fluid lies _____

A

in the spaces between the body cells

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38
Q

Interventions for Hypocalcemia

A

oral or IV replacement of calcium
seizure precaution
decrease environment stimuli
injury prevention

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39
Q

Interventions for hyponatermia

A

assess neuro every 1 hour
monitor sodium level
reduce water intake
seizure precautions

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40
Q

interventions of hyperkalemia

A

monitor EKG changes
assess muscle strength
potassium restriction

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41
Q

Intracellular Fluid (ICF) is where

A

is contained within the cells

42
Q

Intravascular fluid is the _____ within the ____

A

the plasma within the blood

43
Q

low calcium =

A

high phosphorus

44
Q

low calicum levels increase sodium movement across membranes which increases _____

A

Excitability

45
Q

mild fluid overload nutritional therapy means

A

no salt added

46
Q

normal intake for food

A

800-1000

47
Q

normal intake for oral fluids

A

around 2,000

48
Q

normal output

A

2,200-2,700

49
Q

Osmosis

A

involves movement of water across a membrane from an area of a less concentrated solution to an area of high concentrated solution.

50
Q

Potassium normal lab value range

A

3.5-5

51
Q

Purpose of fluids

A
  • transport nutrient to and wastes from cells
  • transport hormones, enzymes, blood cells, and platelets
  • facilitate cellular metabolism and proper cellular chemical functioning
  • Act as a solvent
  • Maintain body temperatures
  • Facilitate digestion, promote elimination
  • Act as tissue lubricant
52
Q

serum osmolarity range

A

270-300

53
Q

severe fluid overload nutritional therapy means

A

restricted: 2g/day to 4g/day of sodium

54
Q

signs of hypervolemia

A 
Hypertension
Tachycardia
Raised JVP on lying
Edema
Plural effusions
Pulmonary edema
Ascites
Organ failure
55
Q

Signs of hypovolemia

A 
Postural/supine hypotension
Tachycardia
Absence of JVP@45o
Decreased turgor
Dry mucosa
Oliguria
Organ failure
56
Q

sodium normal lab value range

A

135-145

57
Q

Solute

A

substances that are dissolved in a solution

58
Q

Solvents

A

liquids that hold substances in solution – water is primary solvent

59
Q 
The following are functions of what 
Maintains bone strength and density
Activates enzymes, 
Allows skeletal muscle and cardiac muscle to contract 
Controls nerve impulse transmission
Facilitates blood clotting.
A

Calcium

60
Q

The particle concentration ……

A

the number of particles dissolved in the solvent

61
Q

Transcellular fluid includes _______

A

specialized fluids that are contained in body spaces (ex.plureal space)

62
Q

What are Crystalloids

A

are solutes that readily dissolve

63
Q

What are electrolytes

A

substances (e.g., sodium, potassium) that develop an electrical charge when dissolved in water

64
Q

what are some foods high in potassium

A

leafy vegtables
dried fruits
nuts

65
Q

what are some functions of potassium

A
  • Helps control intracellular volume
  • Chief regulator of cellular enzyme activity
  • Vital role in transmission of nerve impulses
  • Protein and carbohydrate metabolism,
  • cellular building
  • Assists in acid-base regulation
66
Q

what are some Hyponatermia symptoms

A 
lethargy 
headache 
confusion 
apprehension 
seizures 
coma 
muscle weakness
67
Q

what are some objective assessments for fluid deficit

A 
weight loss 
fever
urine concentration 
tachycardia 
tachypnea 
neck vein collapse 
weak pulse 
increased labs
68
Q

what are some objective assessments for fluid overload

A 
dependent edema, 
facial swelling, 
changes in VS
 – Increase heart rate, bounding pulses, 
BP, inrease 
weight gain, 
change in loc
69
Q

What are some risk factors to consider when assessing imbalances

A

Presence of other illness (acute or chronic) – renal, respiratory, cardiac, mental status change, burns, trauma,
Nausea and vomiting and/or diarrhea
Inability to communicate fluid needs
Age
Medications (including IV fluids) – adverse effects, under or over treatment

70
Q

what are some situations you will see hyponatermia

A
  • stomach suctioning
  • vomiting
  • diarrhea
  • inadequate salt intake
  • hypertonic solutions (leads to dilution)
  • diuretics
71
Q

what are some subjective assessments for fluid deficit/overload

A

nutritional assessment
report of acute/chronic conditions
medications
illness recent and past

72
Q

what does ADH (Antidiuretic Hormone)

A

cause kidney to retain fluid

73
Q

what does aldosterone do

A

retains sodium (and thus water), excrete potassium

74
Q

What does ANP do

A

increases sodium and water loss – which decreases volume and osmolarity

75
Q

what does tachycardia occur in hypervolemia

A

cardiac output has increased and heart rate must increased to handle excess volume.

76
Q

what hormone regulates calcium balance

A

parathyroid hormone

77
Q

what is Insensible fluid loss

A

is loss that we do not perceive and is not easily measured

78
Q

What is a colloid

A

fluids with large molecules that do not pass through semi-permeable membranes

  • volume expander
79
Q

What is a crystalloid

A

easily mixed solutions with molecules small enough to cross semipermeable membranes

80
Q

what is actual dehydration

A

decrease in total body water from too little intake or too great a loss

81
Q

what is fluid

A

water plus the substances dissolved and suspended in it.

82
Q

what is ionized calicum

A

calcium in the blood that is not attached to protein (free)

83
Q

What is non electrolytes

A

are substances that do not conduct electricity

84
Q

What is obligatory urine output

A

minimum output of urine necessary to remove wastes

85
Q

what is relative dehydration

A

non-total loss but water shifts from plasma to interstitial fluid

86
Q

what is Sensible fluid loss

A

is measurable and/or perceived. (urine)

87
Q

What is solubility

A

the ability to be dissolved

88
Q

what is the cause of hyponatermia internally

A

excess H2O or loss of sodium

89
Q

what is the ionized lab value range

A

4.5-5.1

90
Q

what is the most abundant mineral in the body

A

calcium

91
Q

what is the normal albumin level

A

3.5-5.0

92
Q

what is third spacing

A

conditions cause fluid to move into an area that makes it physiologically unavailable, such as into the peritoneal space (in ascites), the pericardial space (with pericardial effusion), or into the vesicles (blisters) with a burn wound.

93
Q

what populations are at risk for fluid imbalances

A

the very young
the very old
those with serious injury
those with significant health conditions

94
Q

When a hypertonic solution is infused, water moves by osmosis from where to where

A

from the cells into the ECF.

95
Q

When a hypotonic solution is infused, water moves by osmosis from the ______ into the ____

A

vascular system

into the cell

96
Q

when serum osmolarity is elevated (above 300) that means

A

volume deficit bc it is more concentrated

97
Q

when serum osmolarity is reduced (below 270) that means

A

volume overload

98
Q

When taking the blood pressure of a very ill client , the nurse observes that the clients hand undergoes flexion contractions. What is the nurses primary intervention?
A. placing the client in high fowlers and administering IV fluid
B. Deflating the BP cuff and administer O2
C. Document the finding as the only action
D. Notify the health care provider

A

B. Deflating the BP cuff and administer O2

99
Q

where does second fluid spacing occur

A

interstitial edema

100
Q

why does tachycardia occur in hypovolemia

A

heart is trying to compensate for lower volume to circulate enough O2 to tissues

Exam 4 (14 decks)

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