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Adult Health Nursing I > Fluid and Electrolytes > Flashcards

Fluid and Electrolytes Flashcards

1
Q

Dehydration

A

Loss of water alone with increased serum sodium levels

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2
Q

Hypovolemia

A

Fluid volume deficit related to active fluid volume loss

Characterized by change in mental state, decreased BP, decreased turgor, decreased urine output, dry skin, elevated hematocrit, etc.

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3
Q

Normal BUN

A

8-23 mg/dL

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4
Q

Normal Creatinine

A

0.7-1.6 mg/dL

Elevated levels indicate diminished kidney function

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5
Q

Hypokalemia

A

Decreased potassium

GI losses and renal losses

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6
Q

Hyperkalemia

A

Increased potassium

Adrenal insufficiency

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7
Q

Hyponatremia

A

Decreased sodium

Increased thirst and ADH release

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8
Q

Hypernatremia

A

Increased sodium

Increased insensible losses and diabetes insipidus

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9
Q

Elevated Hematocrit

A

Indicates decreased plasma volume

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10
Q

Normal Urine Specific Gravity

A

1.010-1.025

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11
Q

Solutions for Fluid Volume Deficit

A

IV isotonic electrolyte solutions (Lactated Ringer’s 0.9% NaCl when BP is low, 0.45% NaCl when BP is normal)

Rate of fluid administration depends on severity of initial fluid loss and hemodynamic abilities of the patient

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12
Q

Assessment of Fluid Status

A

Intake and output, vital signs, central venous pressure, level of consciousness, breath sounds, skin color

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13
Q

Fluid Challenge for those with Decreased Urine Output

A

Caused by pre-renal azotemia or acute tubular necrosis

Give 100-200 mL of normal saline over 15 minutes

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14
Q

Glomerular Filtration Rate

A

Nephrons filter blood at a rate of 125 mL per minute

Leads to 1-2 L of urine per day

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15
Q

Simple and Accurate Method of Determining Water Balance

A

WEIGH THE PATIENT

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16
Q

Intake and Output

A

Record in milliliters

Daily should be around 2500 mL

Intake includes IV fluids, tube feedings, anything that goes into the body for any reason

Minimum Output should be 30 mL/hour

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17
Q

Hypervolemia

A

Increased isotonic fluid retention

Caused by simple fluid overload (too much sodium and water), diminished function of homeostatic regulation of fluid (heart failure, renal failure, cirrhosis)

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18
Q

Diagnostic Test Results of Hypervolemia

A

BUN: decreased due to dilution caused by plasma

Hematocrit: decreased due to dilution caused by plasma

Chest X-Ray: pulmonary vascular congestion

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19
Q

Assessment Findings of Hypervolemia

A

Crackles in the lungs, edema, distended neck veins, elevated central venous pressure, shortness of breath, elevated blood pressure, bounding pulses, increased respiratory rate, increased urine output

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20
Q

Treatment of Hypervolemia

A

Diuretics, fluid restriction, sodium restriction, dialysis

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21
Q

Parenteral Nutrition Support

A

Needed when patient is unable to eat or has a non-functioning GI tract

22
Q

TPN

A

Total Parenteral Nutrition

Hypertonic, given in large central vein

23
Q

PPN

A

Peripheral Parenteral Nutrition

Not as concentrated, can be given peripherally, contains some glucose, amino acids, vitamins, minerals, electrolytes

24
Q

Nursing Interventions for Parenteral Nutrition

A

Verify solution ordered

Monitor infusion rate

Maintain the patency of the IV catheter

Monitor site every 1 to 2 hours

During parenteral therapy, the patient’s I&O should be recorded

25
Complications of Parenteral Nutrition
Infiltration, phlebitis, thrombosis, circulatory overload
26
Hypotonic Parenteral Fluids
Osmolarity lower than 290 Use 0.45% normal saline
27
Isotonic Parenteral Fluids
Osmolarity between 240-349 0.9% normal saline
28
Hypertonic Parenteral Fluids
Osmolarity greater than 290 3% NaCl
29
Sodium
Normal level: 135-145 mEq/L Most abundant electrolyte in the body Functions include regulating water balance, increasing cell membrane permeability, stimulates conduction of nerve impulses, and controls the contractility of muscles
30
Hyponatremia
Sodium level less than 135 mEq/L Likely to have problems with potassium Body compensates by decreasing excretion Headache, irritability, muscle weakness, twitching, tremors, fatigue, apathy, orthostatic hypotension, nausea, vomiting, confusion Treatment is 3% NaCl if severe, 0.9% normal saline if not
31
Hypernatremia
Sodium level greater than 145 mEq/L Body compensates by conserving water through renal reabsorption Fluid shifts from the cells into the interstitial spaces, resulting in cellular dehydration Dry mucous membranes, decreased urine output, restlessness, agitation, flushed skin, THIRST
32
Potassium
Normal Level: 3.5-5 mEq/L Excreted through kidneys, feces, and perspiration Regulates neuromuscular excitability, important for muscular contraction, works with metabolism of glycogen and protein, plays a role in acid-base metabolism
33
Hypokalemia
Potassium less than 3.5 mEq/L Caused by renal excretion, excessive GI losses, diuretics Weakness, leg cramps, EKG changes, paresthesia, lethargy, confusion, orthostatic hypotension Give potassium (NEVER PUSH)
34
Hyperkalemia
Potassium greater than 5 mEq/L Caused by renal disease, severe tissue damage, excessive increase in foods high in potassium Irritability, EKG changes (peaked T wave), nausea, vomiting, irregular pulse, can cause cardiac arrest Chase it out of the body with K-Exolate enemas
35
Chloride
Normal level is 96-105 mEq/L
36
Hypochloremia
Occurs when sodium is lost Caused by vomiting or prolonged nasogastric or fistula drainage
37
Hyperchloremia
Rarely occurs but may be seen when bicarbonate levels fall
38
Calcium
Normal level is 4.5-5.8 mEq/L Vitamin D, calcitonin, and parathyroid hormone are necessary for absorption and utilization of calcium
39
Hypocalcemia
Level below 4.5 mEq/L Caused by infusion of excess amounts of citrated blood Also caused by diarrhea, inadequate dietary intake, issues with parathyroid, pancreatic diseases, small bowel diseases Hyperactive deep tendon reflexes, tetany, anxiety, confusion
40
Hypercalcemia
Level exceeds 5.8 mEq/L Caused by calcium stores in the bones entering the circulation (as a result of immobilization) which leads to renal calculi or osteoporosis Behavior changes, nausea, vomiting, confusion, decreased deep tendon reflexes, bone pain, decreased muscle tone
41
Phosphorus
Normal level is 4 mEq/L Phosphorus and calcium have an inverse relationship
42
Hypophosphatemia
Caused by dietary insufficiency, impaired kidney function, or maldistribution of phosphate Muscle weakness is possible
43
Hyperphosphatemia
Caused by renal insufficiency or increased phosphate or vitamin D Tetany, numbness and tingling around the mouth, muscle spasms
44
Magnesium
Normal level is 1.5-2.4 mEq/L Found in small amounts in the blood, bone, muscle, and soft tissue Excreted by the kidneys
45
Hypomagnesemia
Level below 1.5 mEq/L Parallels decreased potassium Caused by chronic alcoholism, malnutrition Increased neuromuscular excitability, anorexia, mental status changes, agitation, depression, confusion
46
Hypermagnesemia
Level exceeds 2.5 mEq/L Rare with normal kidney function Caused by impaired renal function, excess magnesium administration Restriction of nerve and muscle activity
47
Bicarbonate
Normal level is 22-24 mEq/L Regulates the acid-base balance Regulated by the kidneys
48
PaCO2
Normal level is 35-45
49
Respiratory Acidosis
Caused by any condition that impairs normal ventilation PCO2 level increases and pH falls Shallow respirations lead to retained CO2 Treatment is to turn cough and deep breathe, pursed lip breathing, improve the ventilation
50
Respiratory Alkalosis
Caused by hyperventilation and blowing off too much CO2 Treatment is to slow down the breathing, sedation
51
Metabolic Acidosis
Caused by diabetic ketoacidosis, lactic acidosis related to code situation Lungs try to compensate by hyperventilation (Kussmaul's Respirations) Treatment is sodium bicarbonate
52
Metabolic Alkalosis
Acid is lost or bicarbonate level is increased Most common cause is excessive vomiting Also caused by too many antacids Treatment is aimed at correcting the cause

Adult Health Nursing I (22 decks)

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