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NUR 172 Med Surg > Fluid and Electrolytes > Flashcards

Fluid and Electrolytes Flashcards

1
Q

ICF

A

Intracellular Fluid

fluid inside the cells

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2
Q

ECF

A

Extracellular Fluid

fluid outside of the cell

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3
Q

intake for 24hrs

A

2600 ml

fluids: 1500 ml
solids: 800 ml
oxidation: 300 ml

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4
Q

output for 24hrs

A

2600ml

kidneys: 1500 ml
lungs: 400 ml
skin: 600 ml
intestines: 100 ml

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5
Q

particles with pulling power (oncotic pressure)

A

sodium, glucose, albumin

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6
Q

isotonic solution

A

same solute concentration as another solution

balanced

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7
Q

hypotonic solution

A

amount of solute concentration is lower than another solution
lower osmolality
make cells swell (swollen like a hippo)

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8
Q

hypertonic solution

A

amount of solute concentration is higher than another solution
higher osmolality
pulls fluid from intracellular space
causes cells to shrink

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9
Q

body regulation of fluids

A

thirst
ADH
Renin-Angiotensin-Aldosterone System
BNP

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10
Q

ADH

A

antidiuretic hormone “vasopressin”

  • hypothalamus senses low blood volume or increased osmolality
  • signals pituitary gland to secrete ADH
  • ADH causes kidneys to retain water
  • blood volume increases and osmolality decreases
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11
Q

Renin-Angiotensin-Aldosterone system

A
  • blood flow to glomerulus drops
  • juxtaglomerular cells secrete renin
  • renin goes to liver and converts angiotensinogen to angiotensin I
  • angiotensis I goes to lungs and gets converted to angiotensin II by ACE
  • angiotensis II goes to adrenal glands and stimulates them to make aldosterone
  • aldosterone increases resorption of Na and water
  • retention leads to increased volume which increases BP
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12
Q

BNP

A 
brain natriuretic peptide
cardiac hormone
secreted when ventricles stretch
used to assess HF
normal <100 pg/ml
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13
Q

dehydration

A

fluid loss > fluid intake
increased tonicity
cells shrink

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14
Q

dehydration risk factors

A 
confused
comatose
bedridden
elderly
infants
kidneys can't concentrate
highly concentrated tube feedings without adding water
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15
Q

dehydration causes

A 
anything that accelerates fluid loss
-DI
-prolonged fever
GI: diarrhea, emesis, NG drainage
renal failure
hyperglycemia
meds: diuretics, laxatives
excessive diaphoresis
fistulas
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16
Q

cardiac sx of dehydration

A 
TACHYCARDIA
DECREASED BP
weak, thready pulse
orthostatic hypotension
diminished peripheral pulses
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17
Q

neuromuscular sx of dehydration

A 
MENTAL STATUS CHANGES
SEIZURES
DIZZINESS
WEAKNESS
EXTREME THIRST
FEVER
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18
Q

renal sx of dehydration

A

DECREASED URINE OUTPUT

19
Q

integumentary sx of dehydration

A

DRY SKIN
POOR SKIN TURGOR
DRY MUCOUS MEMBRANES

20
Q

GI sx of dehydration

A

WT LOSS
THIRST
constipation
decreased bowel sounds

21
Q

lab findings for dehydration

A

*increased osmolality
*increased HCT
*increased Na
*increased urine specific gravity
increased BUN

22
Q

dehydration tx

A 
replace fluids
PO preferred
AVOID hypertonic solutions
IV replacement
--hypotonic preferred
--isotonic if low BP
--replace slow to avoid cell swelling (cerebral edema)
23
Q

hypervolemia

A

excess of isotonic solution
cells expand
can cause HF and pulmonary edema

24
Q

cardiac sx of hypervolemia

A 
BOUNDING, RAPID PULSE
INCREASED BP
DISTENDED VEINS (JVD)
S3 SOUNDS
**progressed: decreased BP and decreased CO
25
Q

respiratory sx of hypervolemia

A

increased RR
dyspnea
crackles
pulmonary edema

26
Q

neuromuscular sx of hypervolemia

A

altered LOC
HA
visual disturbance

27
Q

renal sx of hypervolemia

A

increased urine output if kidneys can compensate

28
Q

integumentary sx of hypervolemia

A

pitting EDEMA

29
Q

GI sx of hypervolemia

A

diarrhea
WT GAIN
ascites

30
Q

lab findings for hypervolemia

A 
decreased osmolality
decreased HCT
normal Na+
decreased BUN
decreased K+
pulmonary congestion on xray
31
Q

hypervolemia tx

A

restrict fluid and sodium
meds to prevent HF and pulmonary edema (furosimide)
tx cause
monitor I&O

32
Q

Na+

A 
sodium
135--145 mEq/L
major cation of ECF
helps maintain acid-base balance
activate nerve/muscle cells
loss and gain coincide with water loss and gain
33
Q

hyponatremia value

A

Na+ <135 mEq/L
serum Na decreases = ECF moves into cells
less Na available to depolarize nerves
CNS cells most vulnerable

34
Q

hypovolemia and hyponatremia sx

A 
POOR SKIN TURGOR
DRY, CRACKED MUCOUS MEMBRANES
WEAK, RAPID PULSE
LOW BP
ORTHOSTATIC HYPOTENSION
35
Q

hypervolemia and hyponatremia

A

EDEMA
HTN
WT GAIN
RAPID, BOUNDING PULSE

36
Q

lab findings for hyponatremia

A

Na+ <135 mEq/L
serum osmolality <280 (dilute blood)
urine specific gravity < 1.010
elevated HCT and plasma protein

37
Q

hyponatremia tx

A

hypervolemia: restrict fluids, PO Na supplements
hypovolemia: isotonic IV (NS), high sodium foods
severe: ICU, hypertonic solutions slowly with diuretics

38
Q

hypernatremia causes

A 
inability to ingest fluids
hypothalmic disorders
water deficit
HHNS
DI
excess intake
meds: kayexelate
Cushing's
excess IV fluid
39
Q

hypernatremia sx

A

neuro: huge impact on brain;
neuromuscular:
Early: twitch, hyperreflexia, ataxia, tremors, restless, anorexia, N/V
Late: weak, lethargic, confusion, stupor, seizure, coma

fever, flushed skin, intense thirst

if Na gain: hypervolemia, increased BP, bounding pulse, dyspnea

if water loss: hypovolemia, dry mucous membranes, oliguria, orthostatic hypotension

FRIED: fever, restless, irritable/increased BP and increased fluid retention, edema, decreased urine output and dry mouth

40
Q

lab findings for hypernatremia

A

Na+ > 145 mEq/L
urine specific gravity > 1.030
serum osmolality > 300

41
Q

hypernatremia tx

A 
correct underlying cause
PO fluid, IV if needed
fluids over 48 hrs
IV--salt free (D5W)
restrict sodium intake
diuretics with fluids
42
Q

potassium

A 
3.5--4.5 mEq/L
main ICF cation
skeletal/cardiac muscle contraction
nerve impulse transmission
exchanged for H+ ions for pH
43
Q

hypokalemia causes

A

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NUR 172 Med Surg (1 decks)

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