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Restoration > Fluid and Electrolytes > Flashcards

Fluid and Electrolytes Flashcards

1
Q

Sodium

A

135-145 mEq/L

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2
Q

Potassium

A

3.5-5.0 mEq/L

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3
Q

Chloride

A

98-106 mEq/L

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4
Q

Bicarbonate

A

24-31 mEq/L

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5
Q

Calcium

A

8.5-10.5mg/dL

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6
Q

Phosphorus

A

2.5-4.5 mg/dL

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7
Q

Magnesium

A

1.8-3.0 mg/dL

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8
Q

Isotonic Solution

A

solutions are equally concentrated

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9
Q

Hypotonic Solution

A

Lower solute concentration

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10
Q

Hypertonic solution

A

higher solute concentration

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11
Q

Baroreceptor Reflex

A

responds to a fall in arterial blood pressure

located in the artrial walls, vena cava aortic arch and sinus

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12
Q

What does the baroreceptor reflex do?

A

Constricts afferent arterioles of the kidney resulting in retention of fluid.

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13
Q

Volume receptors

A

respond to fluid in the atria and great vessels.

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14
Q

what do volume receptors create?

A

they create a strong renal response that increases urine output

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15
Q

renin

A

responds to low blood pressure

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16
Q

antidiuretic horomone

A

also called vasopressin

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17
Q

dehydration

A

loss of body fluids, increased concentration of solutes in the blood

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18
Q

what happens to the cells in dehydration?

A

fluid shifts out of the cells into the blood stream to restore balance. Cells shrink from fluid loss and can no longer function properly.

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19
Q

what does a dehydrated person present with

A

irritability, confusion, dizziness, weakness, extreme thirst, decreased urine output, fever, dry mucous membranes, sunken eyes, poor skin turgur, tachycardia

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20
Q

What do we do?

A

fluid replacement, monitor symptoms and vitals, maintain I&O, maintain IV access, skin and mouth care.

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21
Q

hypovolemia

A

isotonic fluid loss from the extracellular space

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22
Q

what is hypovolemia caused by

A

excessive fluid loss, decreased fluid intake, third space fluid shift

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23
Q

what do you see in hypovolemia

A

mental status deteoriation, tachycardia, delayed cap refill, cool pale extremities, weight loss, orthostatic hypotension, urine output less than 30 mll/ hour

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24
Q

What do we do for a patient with hypovolemia

A

fluid replacement, albumin replacement, blood transfusions for hemmorhage, dopamine to maintain BP, assess for overload with treatment.

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25
Q

hypervolemia

A

excess fluid in the extracellular compartment as a result of fluid or sodium retention, excessive intake, or renal failure.

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26
Q

what does hypervolemia lead to

A

CHF and pulmonary edema

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27
Q

what do you see in a hypervolemia patient

A

tachypnea, dyspnea, crackles, rapid bounding pulse, hypertension, JVD, acute weight gain, edema.

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28
Q

anasarca

A

severe generalized edema

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29
Q

edema

A

fluid is foced into tissues by the hydrostatic pressure

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30
Q

what do we do for patients with edema

A

fluid and Na+ restriction, diuretics, monitor vital signs, hourly I & O, breath sounds, monitor ABG’s, Daily weights

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31
Q

water intoxication

A

hypotonic extracellular fluid shifts ino cells to attempt to restore balance, Cells swell

32
Q

what are some causes of water intoxication

A

SIADH, rapid infusion of hypotonic solution

33
Q

what do you see with patients with early water intoxication

A

cahnges in loc, muscle weakness, twitching, cramping

34
Q

what do you see with patients with late water intoxication

A

bradycardia, widened pulse pressure, seizures, coma

35
Q

what do you do for patients with water intoxication

A

prevention is the best treatment, assess neuro status, monitor I&O and vital signs, fluid restrictions, IV access, daily weights, monitor serum Na+, seizure precautions

36
Q

cations

A

sodium, potassium, calcium, magnesium

37
Q

anions

A

chloride, bicarbonate, phosphate, sulfate

38
Q

major cations in the ECF

39
Q

Major cations in the ICF

40
Q

Sodium function

A

attracts fluid and helps preserve fluid volume. Combines with chloride and bicarbonate to help regulate acid-base balance

41
Q

SIADH

A

syndrome of inappropriate antidiuretic hormone–when ADH is released and the body doesn’t need it causing water retention and sodium excretion.

42
Q

Hypornatremia

A

Sodium level less than 135 mEq/L

43
Q

dilutional hyponatremia

A

results from Na+ loss, water gain

44
Q

depletional hyponatremia

A

insufficient Na+ intake

45
Q

hypovolemic hyponatremia

A

Na+ loss is greater than water loss; can be renal (diuretic use) or non-renal ( vomiting)

46
Q

Hypervolemic hyponatremia

A

water gain is greater than Na+ gain; edema occurs

47
Q

Isovolumic hyponatremia

A

normal Na+ level, too much fluid

48
Q

what do you expect your patients to present with in hyponatremia

A

headache, Nausea and vomiting, muscle twitching, altered mental status, stupor, seizures ,coma

49
Q

What do you expect to see in Hypervolemic hyponatremia

A

edema, hypertension, wiehg gain, bounding tachycardia

50
Q

what do you expect to see in hypovolemic hyponatremia

A

poor skin turgor, tachycardia, decreased BP, orthostatic hypo-tension

51
Q

what do we do for a mild case of hyper/isovolumetric hyponatremia

A

restrict fluid intake

52
Q

what do we do for a mild case of hypovolemic hyponatremia

A

Iv fluids or increase po Na+ intake

53
Q

What do we do for a severe case of hyponatremia

A

infuse hypertonic NaCl solution, furosemide to remove excess fluid, monitor client in the ICU

54
Q

hypernatremia

A

More sodium in the blood than water, when this occurs fluid shifts outside the cells.

55
Q

What is hypernatremia caused by

A

water deficit or over-ingestion of Na+

56
Q

What do you see in Hypernatremic patients

A 
S-A-L-T 
Skin flushed 
Agitation
Low grade fever
Thirst
57
Q

What do we do for hypernatremic patients

A

correct underlying disorder, gradual fluid replacement, monitor for s/s of cerebral edema, monitor serum Na+ levels, seizure precautions

58
Q

untreated changes in potassium levels can lead to serious

A

neuromuscular and cardiac problems

59
Q

most potassium ingested is excreted by

A

the kidneys

60
Q

what are the three other influential factors in potassium

A

Na+/K+ pump, renal regulation, pH level

61
Q

sodium potassium pump

A

uses ATP to pump potassium into cells, pumps sodium out of cells and creates a balance

62
Q

Renal Regulation

A

aldosterone secretion causes Na+ reabsorption and K+ excretion

63
Q

what happens to potassium in acidosis

A

K+ moves out of cells

64
Q

what happens to potassium in alkalosis

A

K+ moves into cells

65
Q

Hypokalemia

A

too little potassium

66
Q

what can cause hypokalemia

A

GI losses, diarrhea, insufficient intake, non K+ sparing diuretics

67
Q

what are non K+ sparing diuretics

A

thiazide, furosemide

68
Q

what do you see in a patient with hypokalemia

A 
SUCTION 
Skeletal muscle weakness
Uwave (EKG changes) 
Constipation, ileus 
Toxicity of digialis glycosides
Irregular, weak pulse 
Orthostatic hypotension
Numbness (paresthesias)
69
Q

What do we do for patients with hypokalemia

A 
increase dietary k+ 
oral KCl supplements 
IV and K+ replacements 
Change to K+ sparing diuretics 
Monitor EKG changes
70
Q

Hyperkalemia

A

Too much serum potassium

Caused by altered kidney function, increased intake, blood transfusions, meds

71
Q

What do you see in a patient with hyperkalemia

A

irritability, paresthesia, muscle weakness, EKG changes, irregular pulse, hypotension, nausea, abdominal cramps, diarrhea

72
Q

what do we do for a patient with mild hyperkalemia

A

give them loop diuretics and put them on dietary restrictions

73
Q

what do we do for a patient with moderate hyperkalemis

A

kayexalate

74
Q

what do we do with someone who is in emergency hyperkalemia

A

calcium gluconate for cardiac effects and sodium bicarbonate for acidosis,

75
Q

magnesium function

A

helps produce ATP, role in protein synthesis and carbohydrate metabolism, regulates muscle contractions

76
Q

Hypomagnesemia

A

Too little magnesium

Caused by poor dietary intake, poor GI absorption, excessive GI/urinary losses

77
Q

Who is at risk for hypomagnesemia

A

chronic alcohol users, Sepsis, burns wounds needing debridement.

Restoration (2 decks)

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