Fluid and electrolytes Flashcards
This category of vitamins are metabolized slowly, stored in fatty tissue, liver, and muscle, excreted slowly in urine:
A,D,E,K
This category of vitamins are not stored in the body, readily excreted in the urine, minimal protein binding:
Water soluble vitamins: B-vitamins, B-12, Vitamin C, folic acid
This vitamin enbles eyes to adjust to changes in the light, maintain healthy eyes, gums, and skin; develps healthy teeth and bones, regulates fat metabolism in formation of cholesterol; what category of vitamins does it belong to
A; fat-soluble
Dry skin, poor teeth development, night blindness are deficiency conditions are caused by what lack of vitamin:
A
This vitamin promotes the use of phospherous and Ca for strong teeth and bone; what category of vitamin does this vitamin belong to:
D; fat-soluble
Rickets, osteomalacia are caused by what vitamin deficiency:
D
This vitamin is an antioxident that protects RBCs/WBCs from destruction, protects A, C, and fatty acids from destruction; may prolong prothrombin time, consideration w/iron; what category does this vitamin belong to:
E; fat-soluble
This vitamin aids in prothrombin formation and blood coagulation; what category of vitamins does it belong to:
K; fat-soluble vitamins
Increased clotting time, which leads to increased bleeding and hemorrhage is caused by what vitamin deficiency:
k
This category of vitamins promotes a sense of well being and increased energy as well as decrease anger, tension, and irritability are:
the complex B vitamins
What type of vitamin helps to convert carbohydrates into energy; helps transmit nerve impulses:
Thiamine/B-1
Beriberi and Wernicke-korsakoff syndrome associated with EtOH abuse are deficiencies caused by what lack of vitamin:
Thiamine
This vitamin is given to manage dermatologic problems;treats migrane HA:
B2/ riobflavin
This vitamin is given to alleviate pellagra, hyperlipidemia, can cause GI irritation and vasodilation in lrg doses is caused by:
B-3/Niacin
This vitamin alleviates S/S of neuritis (nerve inflammation) caused by INH therapy for TB; is an essential building block for nucleic acids/RBCs, and synthesis of Hgb: What’s another name for it:
B6; pyridoxine
Vitamins that are taken frequently are take: prophylactically or therapeutically:
prophylactically
What vitamin is given to treat V B6 deficiency d/t lack of adequate diet or certain medications; also given for neonates with SZ:
B6/pyridoxine
What’s another name for B6
pyridoxine
What vitamin aids in the absorption of iron and in the conversion of folic acid; is used to tx/heal wounds by building new tissue, ESSENTIAL in the formation of collagen:
C; water-soluble
This vitamin is given to tx scurvy, wound healing and burns, to perserve the integrity of bld vessels:
C; water-soluble
Massive doses of vitamins that can cause toxicity resulting in a minimum desired effect is defined as:
megavitamin therapy
Why is it important to gradually d/c megavitamin therapy:
to prevent vitamin deficiency
This vitamin is essential for body growth; needed for DNA SYNTHESIS:
folic acid (folate)
What could cause folate (folic acid deficiencies:
chronic EtOH; poor nutritional intake, pregnancy
Anorexia, N/D, fatigue, alopecia, and is not notice until 2-4 mo after storage depletion is caused by what lack of vitamin:
Folate 9folic acid)
A lack of what vitamin can affect the development of the CNS of the fetus and cause spina bifida (neural tube defects) and anencephaly:
folic acid (folate)
What is the recommended dose for folate in addition to dietary supplement in pregnant women:
400 mcg
This vitamin is essential for DNA synthesis, aids in the conversion of folic acid to its active form to promote cellular division; aids in proper formation of RBCs in bone marrow:
B12
GI disorders (commonly seen in strict vegetarians) is caused by a lack of what vitamin:
B12
What vitamin is given to treat GI surgeries or lack of B12:
cyanocobalamin (another name for B12)
This mineral is vital for Hgb regeneration; controls or corrects anemia:
Iron
What are the types of iron:
ferrous gluconate; ferrous sulfate; ferrous fumarate
What is the prophylactic amount of ferrous sulfate given:
300-325 mg
What is the therapeutic amount of ferrous sulfate given:
600-1200 mg daily in divided doses
What can occur if you take abx with iron:
Iron decreases absorption of Abx
What can occur if vitamin c is taken with iron:
Vitamin C increases iron absorption
What can occur if dairy is taken with iron:
Dairy decreases iron absorption
What are some important pt teaching when taking iron:
increase fluids, activity, and bulk foods
How should liquid iron be administered:
with a straw
What kind of changes in stool would you expect when taking iron:
green or black color
Who is at most risk for iron poisoning:
children (iron looks like candy)
What is primary hemochromatosis:
genetic disorder that cause an increased absorption of iron
What is secondary hemochromatosis:
Increased iron absorption d/t blood transfusions
This mineral produces neurotransmitters: dopamine and norepi; is needed for the formation of RBCs and CT:
copper
WHat is the average dose a day for copper:
1.5-3 mg/day
An excess in this mineral can cause wilson’s disease (ring around the eye):
copper
A lack of this mineral causes anemia, decreased WBCs/skin and hair pigmentation; and glucose intolerance:
copper
This mineral is important for enzymatic reactions; essential for growth and tissue repair; wound healing; sensitivity in smell/taste; decreases length of the common cold:
zinc
Who is at most risk for zinc deficiency:
pts receiving long-term parental nutrition
What may occur if a pt takes zinc and abx together:
zinc decreases abx absorption
What may occur if a pt takes a zinc intranasal preparation:
decreased sense of smell
What large dose of mineral can cause copper deficiency; decreased HDLs; and weaken the immune system:
zinc
What mineral is helpful in the control of DM type 2; promotes weight loss and muscle building:
chromium
What can occur when insulin and chromium are taken together:
decreases insulin/fasting sugar levels
This mineral works with an antioxidant enzyme to protect protein and nucleic acids from oxidative damage; works with vitamin E; has anticarcinogenic effect:
selenium
What mineral is given to tx lung/prostate/colorectal CA:
selenium (<200 mcg)
Drugs given to decrease the concentration of metal ions in the blood by binding to the metal ions is defined as:
chelating agents
This type of chelating agent is used to tx wilson’s disease:
Penicillamine binds to copper
This chelating agent is used to tx acute lead poisoning:
Succimer
This chelating agent is used to tx arsenic poisoning:
BAL (british anti-lewisite)
This chelating agent is used to remove excessive iron:
DeFERoxamine
What is the fluid found within the celss consisting 2/3 of total body fluids:
Intracellular fluid
WHat is the fluid outside of the cells consisting of 1/3 of the total body fluid in adults:
extracellular fluid
What are the two main compartments of extracellular fluid
intravascular fluid (plasma) and interstitial fluid between the cells
Which of the body fluids are vital to normal cell functioning; contains O2, electrolytes, glucose; provides a medium for metabolic process to occur:
ICF
What body fluid is ised as a transport system; carries O2 and nutrients into and wastes from the cells:
ECF
The movement of water from less concentration to more concentration is generally defined as:
osmosis
The power of a solute to pull water across a semipermeable membrane is defined as:
osmotic pressure
The EFFECT of fluid on CELLULAR voulme (Used primarily to measure the concentration of IV fluids:)
tonicity
The CONCENTRATION of body fluids is defined as:
Osmolality
Hypo-osmolality is how many mOsm/kg:
<280 mOsm/kg caused by FVO/excess
Hyper-osmolality is how many mOsm/kg
> 295 mOsm/kg caused by FVD, increased Na intake, DM, ketoacidosis
If there is excessive fluid intake and there’s an inability to excrete the fluids, this means that the osmolality is
Hypo-osmolality (osmolality= (less)CONCENTRATION) <280 mOsm/kg
If there’s excessive fluid loss: diarrhea, increased Na intake, inadequate water intake, ketoacidosis, or sweating, then the osmolality is:
Hyper-osmolality (concentration is more) >295 mOsm/kg
FOr IV fluids, what is the isotonic ranges:
240-340 mOsm/kg
What are the types of isotonic solutions:
NS, LR, RL, D5W
If you rapidly infuse isotonic solution, then what happens to the cells of the body:
becomes HYPOTONIC
Isotonic are administered by:
IV ONLY, not SQ
What are the types of hypertonic solutions:
3% saline, 50% Dextrose; D5 1/2 NS, D5NS
What happens to the cells when given hypertonic solutions:
Tonicity is greater than ICF fluid=Cells shrink d/t fluid being drawn out from the cells
What is the normal range of hypertonic IV solutions:
> 340 mOsm/kg
What are some examples of hypotonic IV solutions:
1/2 NS .45%
What happens to the cells when given hypotonic solutions:
Tonicity is less than ICF=Cells swell d/t water being pulled into the cell
1 L of fluid is equal to:
2.2 lb gain
Decreased UOP, excess thirst, dry M. membranes, tachycardia, and hypotension areS/S of:
fluid volume deficit
Constant cough, dyspnea, rales, HTN, edema, weight gain are S/S of:
fluid volume overload
What are the four classifications of IV solutions:
crystalloids, colloids, blood, lipids
Which of the IV solutions are used for replacement/maintenance fluid therapy:
crystalloids:D5W, NS, LR
What type of IV solutions pulls fluid into the bloodstream, has a 24 hr effect, and are volume expanders:
Colloids: amino acids/dextran/hetastarch/plasmanate
Which IV solutions are used for transfusions:
blood and blood products: whole blood and packed RBCs
When is whole blood used:
for severe anemia ONLY
What are the advantages of using packed RBCs:
decreases: circulatory overload/reaction/transmitting hepatitis
Which IV solution is used to administer fats to balance nutritional needs (calories and fatty acids); FOR WOUND HEALING/RBC PRODUCTION/PG SYNTHESIS
Lipids
How is TPN administered:
Large vein in neck or chest with 10-50% dextrose
How is PPN administered:
Peripheral vein 10-12% dextrose
Complications such as: pnemothorax, hemothorax, infection, hyperglycemia, hypoglycemia, hypervolemia are all S/S of which: TPN or PPN
TPN
THe perferred method for nutritional support is:
enteral nutrition feeding:
Goal of enteral nutrition is to:
intact gastric emptying and decrease risk of aspiration
NG tube, Gastrostomy, nasoduodenal, jejunostomy are all routes for:
enteral nutrition feeding
Intermittent entreal feeding is administered:
300-400 mL over 30 min
Bolus enteral feeding is administered:
rapidly by syringe
Cyclic enteral feeding is administered:
at night less than 24 hr
Dehydration, aspiration PNA, and diarrhea are complications of what type of nutrtion therapy:
Entreal Feeding
What does enteral safety A.L.E.R.T stand for:
a=aseptic technique; L=labeling; E=elevate HOB >30 degrees; R=R pt, R formula, R tube; T=trace all lines and tubings back to pt
skeletal muscle weakness, EKG irregularities, irregular/weak pulse, orthostatic hypotension are S/S of what mineral imbalance:
hypokalemia
PO is administered w/4oz of fluid d/t GI distress; IV must be diluted NEVER IV PUSH/BOLUS (d/t arrhythmias) are tx for what K mineral imbalance:
hypokalemia
EKG changes, tachycardia–>bradycardia, numbness/tingling in extremities, nausea and abd cramps are S/S of what mineral imbalance:
hyperkalemia (caused by meds and renal impairment)
3.5-5.5 is tx using BIGKD:
Hyperkalemia tx: bicarbonate, insulin, glucose, kayexalate, dialysis
The normal range for Na is:
135-145
Mucle weakness, HA, SZ, abd cramps, lethargy, tachycardia, dry mucouse membranes, pale skin are all S/S of what mineral imbalance:
hyponatermia (caused by fluid loss and surgery)
NS (sodium chloride) and 3%hypertonic sodium solution is a tx fro what thyp od Na imbalance:
hyponatermia
Flushed/dry skin, anorexia, tachycardia, HTN, twitching, coma, SZ are all S/S of what mineral imbalance:
hypernatermia (caused by increased Na intake, decreased water intake, water loss)
Restricting diet, taking diuretics, and D5W followed by NS to restrict cerebral edema are tx for what Na imbalce:
hypernateremia
What populations are at risk for hypernatemia:
infants, elderly, immobilized pts
Trousseau’s sign (w BP cuff) and Chvostek’s sign (touching face to ilicit a twitch) are S/s of what mineral imbalance:
hypocalcemia
What is the composition of ECF:
Na, Cl, HO3 (vascular/plasma=albumin/protein)
What is the composition of ICF:
K, Mg, PO4, SO4
What type of IV solutions would I give to a pt with fluid loss:
Isotonic solutions (LR, NS 0.9%, D5W)
What happens if I infuse D5W rapidly or continuously:
Isotonic D5W becomes HYPOTONIC (NO SUBQ)
What is the normal K level:
3.5-5.3
This electrolyte is necessary for TRANSMISSION/CONDUCTION OF NERVE IMPULSES; contracts all muscles:
K
SUCTION IS FOUND IN WHAT ELECTROLYTE IMBALANCE AND WHAT DOES IT STAND FOR:
hypokalemia: skeletal muscle weakness, U wave (EKG) changes, constipation, irregular/weak pulse, orthostatic hypotension, numbness (paresthesia)
What do you give for hyperkalemic pts to protect heart:
calcium gluconate
If your pt has less than 115, what type of solution do you treat them with:
hypertonic 3% NS
If your pt Na ranges fall between 125-135, what solution do you treat them with:
isotonic NS 0.9%
What should IV calcium for hypocalmeic pts be treated with:
mixed with D5W not NS
A pt has tetany like s/s: tremors, twitching of the face and ventricular tachycardia is caused by what electrolyte imbalance:
hypomg, treated with IV magnesium sulate
What’s the normal range of Mg
1.8-3
A pt seems lethargic, drowsy, loss of DTR, paralysis, given to mothers in labor to RELAX muscle contractions. What is the electrolyte imbalance and tx:
hypermg; calcium gluconate (may have positive C and T signs)
What is the normal range of phosphorus:
2.5-4.5
pt has muscle weakness, tremors, paresthesia, bone pain. She has labs of phos of less than 1.7: What does she have and what is she treated with:
hypophos; neutraphos or potassium phosphate
A pt has tetany (with decreased Ca), muscular wwakness, numbness of mouth and fingertips. What does she have and what is she treated with:
hyperphos, renagel (sevelamer) excreted in stool
