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Hesi 2 > fluid and electrolytes archer > Flashcards

fluid and electrolytes archer Flashcards

1
Q

normal sodium levels

A

135-145

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2
Q

causes of euvolemic hypernatremia

A

increased insensible water loss
diabetes insipidus

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3
Q

treatment of euvolemic hypernatremia

A

give po water

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4
Q

causes of hypovolemic hypernatremia

A

dehydration
diarrhea
burns
NPO
vomiting
diuretics

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5
Q

treatment of hypovolemic hypernatremia

A

give isotonic fluids “NS”

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6
Q

causes of hypervolemic hypernatremia

A

hypertonic IV
increased sodium intake
cushings
sodium bicarb
corticosteroids
hyperaldosteronism

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7
Q

treatment of hypervolemic hypernatremia

A

stop sodium and water
find cause
loop diuretics
free water administration

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8
Q

Neuro changes in hypernatremia

A

restless
agitated
lethargic
drowsy
stupor
coma

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9
Q

musculoskeletal signs of hypernatremia

A

twitching
cramps
weakness

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10
Q

cardiovascular signs of hypernatremia

A

fever
HYPERVOLEMIC-
edema
hypertension
bounding pulse
HYPOVOLEMIC
hypotension
weak pulse

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11
Q

misc signs of hypernatremia

A

flushed skin
decreased top
dry mouth

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12
Q

causes of euvolemic hyponatremia

A

SIADH
adrenal insufficiency
addisons
polydipsia
excessive hypotonic IVF
low dietary sodium

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13
Q

causes of hypervolemic hyponatremia

A

CHF
kidney failure
liver failure
water intoxication

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14
Q

treatment for euvolemic/hypervolemic hyponatremia

A

restrict free water
osmotic diuretics
sodium tablets
increased sodium in diet

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15
Q

causes of hypovolemic hyponatremia

A

vomiting
diarrhea
ng suction
diuretics
burns
excessive sweating

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16
Q

treatment for hypovolemic hyponatremia

A

mild 0.9 NS
severe 3 NS

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17
Q

near signs of hyponatremia

A

seizures
confusion
lethargy
stupor
cerebral edema
increased ICP

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18
Q

musculoskeletal signs of hyponatremia

A

abdominal cramps
weakness
shallow respirations
decreased deep tendon reflexes
muscle spasm
orthostatic hypotension

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19
Q

cardiovascular signs of hyponatremia

A

HYPOVOLEMIC
weak pulse
tachycardia
dizziness
HYPERVOLEMIC
bounding pulses
hypertension

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20
Q

what rate should you replace sodium

A

0.5%meq/hr too fast causes cerebral edema and increased icp

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21
Q

characteristics of chloride

A

inversely related to bicarb
directly related to sodium and potassium

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22
Q

chloride lab values

A

96-108

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23
Q

causes of hypochloremia

A

FLUID LOSS
sweating
dehydration
vomit
STEROIDS
cushings
excess corticosteroids
excessive normal saline

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24
Q

treatment of hyperchloremia

A

treat underlying cause
correct imbalance
give bicarb
discontinue sodium products
use LR instead of NS
monitor all electrolytes

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25
Q

causes of hypochloremia

A

CHF
water intoxication
SALT LOSS
sweating
burns
vomiting
diarrhea
cystic fibrosis
addisons

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26
Q

treatment of hypochloremia

A

treat underlying cause
correct imbalance (0.9% ns)
monitor all electrolytes

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27
Q

normal potassium levels

A

3.5-5

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28
Q

characteristics of potassium

A

responsible for nerve impulse conduction
acidotic has increased potassium

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29
Q

causes of hyperkalemia

A

too much potassium from intercellular to extracellular
-burns
-tissue damage
-dka
too much total potassium
-renal failure
excessive potassium intake
medications
-ace inhibitors
potassium sparing diuretics

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30
Q

signs hyperkalemia

A

muscle weakness
numbness
increased bowel sounds
impaired contractility
EKG CHANGES
shallow respirations
cramping
diarrhea
decreased CO

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31
Q

treatment for hyperkalemia

A

DRIVE POTASSIUM INTO CELLS
d5w + regular insulin
albuterol
bicarb
REDUCE TOTAL BODY K
kayexalate
diuretics
dialysis if other treatment doesn’t work
MONITOR CARDIAC RHYTHM
IV calcium gluconate or chloride

32
Q

causes of hypokalemia

A

POTASSIUM WASTING DRUGS
laxatives
diuretics
corticosteroids
cushings
INADEQUATE PO INTAKE
NPO, poor diet
anorexia, bulimia, alcoholism
DILUTING K IN BLOOD-TOO MUCH WATER
FLUID LOSS
NG suction
vomiting
wound drainage

33
Q

signs of hypokalemia

A

weak muscles
cramps
decreased deep tendon reflexes
facility
shallow respirations
decreased bowelsounds
constipation
increased uop
orthostatic hypotension
weak thready pulse
cardiac arrhythmia

34
Q

treatment of hypokalemia

A

prevent arrhythmia/ hold digoxin
give potassium
orally with food to prevent GI upset
IV
diet with potassium

35
Q

normal calcium levels

A

9.0-10.5

36
Q

characteristics of calcium

A

important for bones, teeth, nerves and muscles
important for coagulation
controlled by PTH and vitamin D
inverse relationship with phosphorus

37
Q

cause of hypercalcermia

A

excessive intake of calcium
excessive vitamin D
vitamin D toxicity
bone cancer
immobility
glucocorticoids

38
Q

neuromuscular sinus of hypercalcemia

A

weakness
flaccidity
decreased deep tendon reflexes

39
Q

cardiovascular signs of hypercalcemia

A

bradycardia
cyanosis
dVT

40
Q

gastrointestinal signs of hypercalcemia

A

decreased peristalsis
decreased bowel sounds
abdominal pain
nausea
vomiting
constipation
kidney stones

41
Q

treatment of hypercalcemia

A

reduce dietary calcium
cardiac monitoring
IVF (NS)
loof diuretics
encourage oral hydration
dialysis
calcium binders

42
Q

causes of hypocalcemia

A

renal failure
acute pancreatits
malnutrition
alcoholism
bulemia
vitamin d deficiency
hypoparathyroid
hyperphophatemia

43
Q

neuromuscular signs of hypocalcemia

A

irritability
hallucinations
paresthesia
tetany
seizures
muscle spasm
CHVOSTEKS SIGNS
TROUSSEAUS SIGNS

44
Q

gastrointestinal signs of hypocalcemia

A

increased bowel sounds
cramping
diarrhea

45
Q

misc signs of hypocalcemia

A

weak bones
weak brittle nails
arrhythmias-V-TACh

46
Q

treatment of hypocalcemia

A

PO supplements with vitamin d to increase absorption
IV calcium supplement
calcium rich diet

47
Q

normal phosphorus levels

A

3.0-4.5

48
Q

characteristics of phosphorus

A

inverse relationship with calcium
component of bones and teeth
makes phospholipid bilayer

49
Q

causes of hyperphophatemia

A

excesive dietary intake
tumor lysis sundrome
renal failure
hypoparathyroid

50
Q

treatment of hyperphophatemia

A

phosphate binders (give with food)
manage hypocalcemia

51
Q

causes of hypophosphatemia

A

malnutrition
alcoholism
TPN
hyperparathyroidism

52
Q

treatment of hypophosphatemia

A

phosphorus replacement
PO
IV- give slowly
phosphorus rich diet
diet low in calcium

53
Q

magnesium lab values

A

1.6-2.6

54
Q

characteristics of magnesium

A

stored in bone and cartilage
role in muscle contraction
activates vitamins
directly related to calcium

55
Q

causes of hypermagnesemia

A

excessive dietary intake
too many magnesium containing meds- antacids
overcorrection hypomagnesemia
renal failure (time not friends with calcium)

56
Q

neuromuscular signs of hypermagnesemia

A

weakness
shallow breathing

57
Q

cardiovascular signs of hypermagnesimia

A

bardycardia
hypotension
vasodilation

58
Q

near signs of hypermagnesemia

A

drowsy
lethargic
coma

59
Q

treatment of hypermagnesmia

A

hold fluids and meds containing magnesium
loop diuretics
calcium gluconate
dialysis

60
Q

causes of hypomagnesemia

A

ALCOHOLISM
malnutrition
malabsormed
hypoparathyroid
hypocalcemia
diarrhea

61
Q

neuromuscular signs of hypomagnesemia

A

numbness
tingling
cramping
tetany
seizures
increased deep tendon reflexes

62
Q

neuro signs of hypomagnesemia

A

psychosis
confusion

63
Q

cardiovascular symptoms

A

torsades de pointes

64
Q

Gi signs of hypomagnesemia

A

nausea
vomiting
abdominal cramps
anorexia

65
Q

treatment of hypomagnesemia

A

monitor cardiac rhythm
give IV magnesium very slowly
PO magnesium

66
Q

characteristics of isotonic IV fluids

A

osmolarity similar to blood
does not cause fluid shift

67
Q

uses of isotonic IVF

A

increase volume
blood loss
surgery
isotonic dehydration
fluid loss
maintenance fluid
NPO client

68
Q

types of isotonic fluid

A

0.9% NS
lactated ringers
D5W

69
Q

What is special about D5W

A

it is isotonic on its own but hypotonic in the body

70
Q

Characteristics of hypotonic IV fluid

A

osmolarity lower than blood
molders fluid out of blood and into cells

71
Q

uses for hypotonic IVF

A

DKA
HHSN
hypernatremia

72
Q

types of hypotonic fluids

A

0.45% sodium chloride (1/2 NS)
0.33% or 0.2% sodium chloride
D5W
D2.5W

73
Q

characteristics of hypertonic IV fluid

A

osmolarity higher than blood
moves fluid out cells and into vascular/interstitial space

74
Q

uses of hypertonic IVF

A

hyponatremia
cerebral edema

75
Q

types of hypertonic IVF

A

1.5%, 3%, 5% sodium chloride
D5NS
D5LR
D10W

Hesi 2 (10 decks)

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