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SET 2 > Fluid and Electrolytes > Flashcards

Fluid and Electrolytes Flashcards

1
Q

What is hypervolemia?

A

Excess volume in the vas. space caused by any blood vessel

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2
Q

What are the causes of FVE/ Hypervolemia?

A 
HF - decreased kidney perfusion / c/o / u/o - staying only in vascular space 
Kidney failure
Effervesent medications 
Canned foods 
IVF w/ Sodium
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3
Q

What is the mechanism of aldosterone in the body?

A

Normal Action:Aldo is activated by the adrenal gland (sitting on top of kidney) to retain sodium.

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4
Q

What happens when there is too much aldosterone secretion ?

A

Blood volume increases caused by:
Cushing syndrome
Crohns disease

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5
Q

What does ADH do?

A

Retains water activated by the pituitary gland

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6
Q

What happens when there is too much ADH?

A 
Retain too much water
Caused by SIADH 
Urine is concentrated 
Blood volume is diluted 
*Too many letters too many problems*

Concentrated numbers go up.
Diluted numbers go down

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7
Q

What happens when there is too little ADH?

A

Diurese losing water
SHOCK - DI
Urine is diluted
Blood volume is concentrated

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8
Q

Desmopressin

A

A drug to replace ADH for DI pts.

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9
Q

What happens with FVE

A

Volume is third spacing, leaking.

Neck veins distended
CVP UP
bpm UP , bounding 
Lungs Wet 
Because there is so much water instead of going forward its going back up. 
Weight UP.
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10
Q

What are complications of FVE?

A 
SIADH
Hyperadolsterone
Addison's 
Crohns
Renal Failure / Heart failure

Fluid retention think heart problems first

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11
Q

Treatment for FVE

A 
Daily monitor i/o 
Low sodium diet 
Diuretics Furosemide (butamide), hydrochlorothiazide Loop Diuretics 
Potassium Sparing - Spirnolactone 
Bed rest - why? ANP

*Caution with elderly. kidney/cardiac pts.

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12
Q

CVP Normal range

A

2-6 MMHG

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13
Q

Causes of FVD?

A

Loss of fluid
Third spacing from - Burns, Ascites - watch for hypotension shock
Diabetes - Polyuria - Oliguria - Anuria

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14
Q

S/s of FVD

A

Decreased skin turgor
Dry Membranes
weight down

Decreased u/o 
decreased c/o , cvp
BPM Up, thready 
Respiration UP 
B/p - down 
Cool extremites due to vasoconstriction
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15
Q

Treatment for FVD

A

Prevent loss
Mild - Po fluids
Severe IV fluids
*Risk for falls watch for overload

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16
Q

Isotonic fluids?

A

They go into vas. space and stay there
D5W , D51/4 N/S , L/R
Use for: FLUID loss nausea, vomitting, burns, sweating, trauma
Watch for kidney/ cardiac pts can increase BP!

17
Q

Hypotonic Solution?

A

Goes into vas space and goes OUT to replenish cells
Does not cause hypertension
D2.5 /1,2 NS/ 0.33 N/S
Uses for renal and cardiac nausea, vomitting, burns, hemmorhage
* Can lead to FVD and decreased BP.

18
Q

Hypertonic

A 
Packed with particles* highalert*
Draws fluid ENTER vas. space from cells
D10W, NS
Uses : Hyponatremia
Watch for FVE
19
Q

Hypermagnesium?

A 
Cause: Renal failure , antacids
s/s: Muscles first 
Flushing warmth - vasodilation 
DTR - Decreased 
Muscle tone - weak 
Arrythmia Yes
Pulse down
Respiration Down Loc Down

Txt:
Ventilation
Calcium gluconate - helps

20
Q

Hyper- Magnesium and calcium are

A

Sedatives

21
Q

Hypercalcemia

A 
Cause: PTH increase, when calcium takes too much Ca from the bone into the blood CA goes up 
Thiazaides 
Immobilization 
S/S Brittle bones 
Kidney stones 
Same as MG
Txt : Move 
Phosphate foods  (anything with protein)
Fluids to prevent kidney stones 
Calcitonin
22
Q

Hypomagnesemia

A

Not enough sedatives
Caused by: Diarrhea lots of MG
Alcoholism - suppresses

S/S Rigid
prone to seizure
Airway Stridor/ Swallow problem 
Chovostek 
Trouseau 
Arrythmia
DTR increase 
Tx: Give MG 
Check Kidney
Seizure precaution 
Eat Mag 
Stop infusion if pt is flushing/sweating
23
Q

Hypocal

A

Not enough PTH - hypoparathyroidism
Radical Neck
Thyroidectomy
Serum Ca down

Same s/s as hpomag

Txt: Give Ca
Reduce phosphate
Iv Ca slowly , with heart monitor 
Vit D 
Phosphate binders 
Calcium acetate (phoslo)
24
Q

Hypernatremia

A 
Too much sodium 
Dehydration 
Causes:
Hyperventilation
Heat stroke
Diabetes Insipidus 
135-145
S/S
Dry mouth
Thirsty 
swollen tongue 
Neuochanges
Txt: 
Restrict sodium 
Dilute fluids 
Daily weight
Daily i/o
Labwork
25
Q

Hyponatremia

A 
Too much water, too little sodium 
Drinking too much h2o
Psyhogenic polydipsia 
d5w
siadh

s/s
headache
coma
seizure

txt: needs sodium
hypertonic solution

26
Q

Hyperkalemia

A

Causes kidney trouble
Spirnolactone excess

s/s Twitching
muscle weakness
paralysis
ECG changes brady, peaked t waves , widened QRS

Txt: Dialysis
Calcium gluconate arrythmias
Glucose and insulin because they carry potassium but worry about hypogly and hypokal
Kayexalate

27
Q

Hypokal

A 
Causes Vomitting 
NG suction 
Diurectics
Not eating 
s/s muscle cramps
weakness 
arrythmia

TXT : give potassium
spirnolactone
eat more potassium

Sodium and potassium have an inverse relationship.

28
Q

Problems with oral potassium?

A

GI upset

29
Q

What do you assess with IV potassium

A

u/o before and during, use only iv pump, mix well, never push, burning during infusion.

SET 2 (16 decks)

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