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N110 Exam #4 > Fluid and Electrolytes > Flashcards

Fluid and Electrolytes Flashcards

1
Q

Functions of Water in the Body

A
  • Aides in digestion
  • Maintains blood volume
  • Waste removal
  • Solvent
  • Electrolytes in/out of cells
  • Lubricates
  • Regulates body temperature
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2
Q

Fluid Loss: Sensible

A

• Measurable
• Urine, diarrhea, wound/gastric drainage
*Softer the stool= greater the fluid loss

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3
Q

Fluid Loss: Insensible

A

• Unmeasurable
• Breathing, sweating
*Breaks in skin/burns= potential fluid loss

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4
Q

Factors Affecting Water Distribution in Body

A
  • Body Fat
  • Age
  • Gender
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5
Q

Fluid Compartments in Body: Intracellular Fluid

A
  • Fluid in cells
  • Volume= 25 L
  • 60% (2/3) bw
  • Oxygen, electrolytes, glucose
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6
Q

Fluid Compartments in Body: Extracellular Fluid

A 
• Fluid outside of cells
• Volume= 15 L
• 20% (1/3) bw
*Transports water/O2/electrolytes/nutrients
*Removes waste
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7
Q

Fluid Compartments in Body: Extracellular: Interstitial Fluid

A

EXCESS= EDEMA
• Fluid surrounding cells
• Volume= 12 L
• 80% of ECF

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8
Q

Fluid Compartments in Body: Extracellular: Intravascular Fluid

A 
*TRANSPORTS RBCs*
• Fluid in vascular system
• i.e. Plasma
• Volume= 3 L
• 20% of ECF
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9
Q

Third Spacing↑↓

A
  • Symptoms: ↓ BP, urine output; ↑ HR, thirst, fatigue
  • Fluid moving into interstitial areas
  • Fluid in lungs= Pulmonary Edema
  • Fluid in abdomen= Ascites/Peritoneum
  • Fluid in skin/mucous/viscera= Angioedema
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10
Q

Sodium (Na+)

A
  • 135-145 mEq/L

* Functions: Nervous System, conducts nerve impulse, regulates fluid volume

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11
Q

Hyponatremia

A
  • Cause: GI loss, diuretics
  • Signs: confusion, seizures
  • Treatment: water restricting, ↑ Na+ intake
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12
Q

Hypernatremia

A
  • Cause: excessive sodium, water deprivation, water loss
  • Signs: thirst, dry mucous membrane, lethargy
  • Treat: ↑ fluids, restrict Na+ intake
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13
Q

Chloride (Cl-)

A
  • 95-105 mEq/L

* Osmotic pressure with Na+, production of HCl

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14
Q

Potassium (K+)

A
  • 3.5-5 mEq/L

* Cardiac muscle contraction, transmits electrical impulses

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15
Q

Hypokalemia

A
  • Cause: GI loss, diuretics
  • Signs: muscle weakness, dysrhythmias, paresthesia
  • Treatment: K+ supplement (Potassium Chloride KCl)
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16
Q

Hyperkalemia

A
  • Cause: renal failure, ↑ K+ intake, medications
  • Signs: muscle weakness, dysrhythmias
  • Treatments: Loop diuretics (non-potassium sparing), Sodium Polystyrene Sulfonate (Kayexalate), dialysis
17
Q

Calcium (Ca+)

A
  • 8.5-10.5 mg/dL

* Skeletal/cardiac muscle contraction, bone formation, blood clotting

18
Q

Hypocalcemia

A
  • Cause: Hypoparathyroidism, malabsorption
  • Signs: tetany, paresthesia
  • Treatment: Ca+ supplements (calcium carbonate, tums), ↑ Ca+ intake
19
Q

Hypercalcemia

A
  • Cause: Hyperparathyroidism, malignancy, prolonged immobility
  • Signs: muscle weakness, constipation, kidney stones
  • Treatment: ↑ Ca+ intake, physical activity, encourage fluids
20
Q

Magnesium (Mg++)

A
  • 1.6-2.6 mEq/L

* Skeletal muscle contraction, electrical activity in nerve/muscle membranes

21
Q

Hypomagnesemia

A
  • Cause: NG suction, malabsorption
  • Signs: dysrhythmia
  • Treatment: magnesium sulfate, ↑ intake
22
Q

Hypermagnesemia

A
  • Cause: renal failure
  • Signs: hypoactive reflex, bradycardia
  • Treatment: restrict intake, avoid magnesium based antacids/laxatives
23
Q

Phosphorus (P-)

A
  • 1.7-2.6 mEq/L

* Acid-base balance, promotes muscle/nerve action

24
Q

Hypophosphatemia

A
  • Cause: alcohol withdrawal, respiratory acidosis
  • Signs: paresthesia, seizures
  • Treatment: monitor P- levels with replacement
25
Q

Hyperphosphatemia

A
  • Cause: renal failure
  • Signs: tetany
  • Treatment: monitor for tetany, phosphorus binding medication
26
Q

Bicarbonate (HCO3-)

A

• 22-26 mEq/L
• Acid-base balance, buffer (homeostasis, pH)
*Body naturally produces bicarbonate

27
Q

Urine Specific Gravity

A
  • 1.002-1.030
  • increases with FVD
  • decreases with FVE
28
Q

Hemoconcentration: Fluid Volume Deficit (hypovolemia)

A
  • Causes: poor fluid intake, GI loss, sweating, fever, meds, hemorrhage, diuretics
  • Signs: changes in LOC, tachycardia, hypotension/low BP, concentrated (amber) urine, increased urine SG, increased hematocrit, increased thirst, decreased skin turgor, dry mucous membranes, weight loss, weakness
  • Tests: serum electrolytes, hematocrit, urine SG, BUN/Creatinine (high with FVD)
  • Treatments: increased fluids, blood products, treat cause
29
Q

Hemodilution: Fluid Volume Excess (hypervolemia)

A
  • Causes: renal failure, excessive sodium intake, meds, CHF, burn treatments, albumin infusion, blood products
  • Signs: edema, tachycardia, high BP/hypertension, bounding pulse, crackles/rales lung sounds, S3 heart sounds, weight-gain, decreased urine SG, dyspnea, tachypnea, JVD, ascites, changes in LOC, confusion, seizures, anorexia, nausea
  • Tests: serum electrolytes, BUN/Creatinine, urine SG, natriuretic peptides (higher if CHF), chest-xray
  • Treatments: restrict fluids, loop diuretic, potassium sparing diuretic, dietary restrictions
30
Q

Regulation of Fluids/Electrolyes: Neurological System

A

• LOC (hypo/hypernatremia, hypomagnesemia)
• Irritability (hypernatremia, hypomagnesemia)
• Reflexes (hypermagnesemia)
• Fatigue (hypo/hypernatremia, hypokalemia, hypermagnesemia)
*Cannot directly measure blood volume
*Baroreceptors sense BP and send signals to retain/excrete fluid

31
Q

Regulation of Fluids/Electrolyes: Cardiovascular System

A

*TRANSPORTS HORMONES that control kidney to restrict or excrete fluid
*Vasodialation/vasoconstriction
• History
• Physical Exam (pulse, BP, neck, pericordium, hands, face, eyes, abdomen, legs peripheral vascular system)
• Tachycardia (potassium, magnesium, sodium, calcium)
• Dysrhythmias (potassium, magnesium)
• Increased BP (hypernatremia)
• Decreased BP (high intake of potassium)
• Pulse (thready/weak or bounding)
• Cap Refill (delayed/decreased=FVD)
• Perfusion (palor, cyanosis)
• Veins (JVD=FVE, flat=FVD)

32
Q

Regulation of Fluids/Electrolyes: Respiratory System

A 
• Evaporation (insensible loss)
• FVD=thickened mucous membranes (retains fluids)
• Acid-base balance (resp inc/dec due to pH disturbance)
• Assess:
-Lung sounds (crackles/rales= FVE)
-Rate
-Depth
-Pattern
-O2 saturation
-Increased resp rate= dyspnea
33
Q

Regulation of Fluids/Electrolyes: Genitourinary System

A 
• Regulates BV/BP and blood pH
• Controls electrolytes
• Eliminates waster
• Assess:
-I/O
-usual diet
-diet changes
-incontinence
-daily weights
34
Q

Regulation of Fluids/Electrolyes: Integumentary System

A 
• Regulates body temperature
• Eliminates waste
• Assess:
-Edema
-Color
-Circulation
-Skin turgor
-Fever (flushed, diaphoretic)
-Moisture (dry/scaly= FVD)
-Dry mucous membranes
35
Q

Interventions for FVD

A
  • Monitor LOC
  • Increase PO intake/fluids
  • Daily labs
  • Treat the cause
36
Q

Interventions for FVE

A
  • Activity (reduces dependent pitting edema)
  • Diuretics
  • Restrict fluid/sodium intake
  • I/O
  • TEDS/SCD stockings
  • Meds
  • High fowlers

N110 Exam #4 (3 decks)

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