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My NUR 325 Flash Cards > Fluid and Electrolytes Exam 3 > Flashcards

Fluid and Electrolytes Exam 3 Flashcards

1
Q

what is osmosis

A

the movement of WATER down a concentration gradient

-moves from a region of LOW solute concentration to a region of HIGH solute concentration THROUGH A SEMIPERMEABLE MEMBRANE

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2
Q

when does osmosis stop

A

when concentration differences disappear
OR
when hydrostatic pressure builds and opposes further movement

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3
Q

what is diffusion

A

movement of MOLECULES from an area of high concentration to a lower concentration

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4
Q

when does movement stop for diffusion

A

when concentrations are equal in both areas

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5
Q

what are colloids

A

substances that increase colloid oncotic pressure

-they move fluid from the interstitial compartment to plasma (blood) compartment

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6
Q

what are the 3 primary colloids

A

albumin, globulin, fibrinogen

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7
Q

does colloid oncotic pressure increase or decrease with age and malnutrition

A

DECREASE

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8
Q

what is hydrostatic pressure

A

force of fluid in compartment pushing against a cell membrane (or vessel wall)

THINK CAPILLARY LEVEL - major force that pushes water OUT of the vascular system into interstitial space

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9
Q

how is hydrostatic pressure generated

A

generated by blood pressure

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10
Q

what is oncotic pressure

A

OR colloid osmotic pressure

caused by plasma colloids in solution

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11
Q

fill in the blank:

Hydrostatic pressure pushed fluid _______ of the capillary

A

OUT

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12
Q

Fill in the blank:

Oncotic pressure pulls fluid ______ the capillary

A

INTO

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13
Q

what are electrolytes

A

substances that are ELECTRICALLY charged when in solution

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14
Q

what do electrolytes influence

A

fluid balance, acid base balance, nerve impulses, muscle contraction, heart rhythm, and other cell functions

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15
Q

what are concentrations of electrolytes dependent on

A

intake, absorption, distribution, excretion

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16
Q

what electrolytes live inside the cell (intracellular)

A

potassium
magnesium
phosphorous

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17
Q

what electrolytes live outside the cells (extracellular)

A

sodium
chloride
bicarbonate

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18
Q

normal sodium lab value

A

136-145meq/L

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19
Q

normal potassium lab value

A

3.5-5.0meq/L

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20
Q

normal magnesium lab values

A

1.7-2.2 mg/dl

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21
Q

normal calcium lab values

A

9-11 mg/dL

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22
Q

normal phosphate lab values

A

3.2-4.3 mg/dL

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23
Q

what is sodium

A

influences water distribution
aids in acid-base balance
activates muscle and nerve cells

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24
Q

Someone has a sodium of < 136 meq/L… what is that called

A

Hyponatremia

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25
Q

Someone has a sodium of > 145 meq/L… what is that called

A

Hypernatremia

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26
Q

what are causes of hyponatremia

A

GI losses –> diarrhea, vomiting, fistulas, NG suction
renal losses –> diuretics, adrenal insufficiency
skin losses –> burns, wound damage
fasting diets, polydipsia (water intoxication)
excess hypotonic fluid

27
Q

S/S of hyponatremia

A

confusion/altered LOC
anorexia, muscle weakness
can lead to seizures/coma

28
Q

what is dilutional hyponatremia

A 
low sodium because of too much fluid
HYPERVOLEMIC
this person has too much water/fluid on board
-increase BP
-weight gain
-bounding rapid pulse
29
Q

what is depletional hyponatremia

A 
not enough volume on board
HYPOVOLEMIC
-low BP
-tachy pulse
-weight loss
-decreased urine sp. gravity
30
Q

hyponatremia treatment

A
  • sodium replacement (SLOWLY)
  • PO/IV
  • IV NS (0.9%)
  • Fluid restriction
  • treat underlying problem
31
Q

causes of hypernatremia

A
  • IV fluids, tube feeds, near drowning in salt water –> excess sodium intake
  • not enough water intake or too much water loss –> cognitively impaired, diarrhea, high fever, heatstroke
  • profound diuresis
32
Q

S/S of hypernatremia

A

alter LOC/Confusion, seizure, coma
extreme thirst (hyperosmolality)
dry, sticky mucous membranes
muscle cramps

33
Q

treatment for hypernatremia

A

If H20 loss is cause ADD WATER

if sodium excess is cause REMOVE SODIUM

34
Q

what is potassium

A

helps regulate cell excitability and electrical status

helps control intracellular osmolality

35
Q

Potassium < 3.5 meq/L is?

A

Hypokalemia

36
Q

Potassium > 5.0 meq/L is?

A

Hyperkalemia

37
Q

what is the main source of potassium loss

A

Kidneys

38
Q

Causes of hypokalemia

A

renal or GI losses - diuresis

acid base disorders

39
Q

S/S of hypokalemia

A

Cardiac rhythm disturbances –> can be lethal
muscle weakness, leg cramps
decreased bowel motility - constipation, nausea, ileus

40
Q

treatment for hypokalemia

A

GIVE POTASSIUM

41
Q

causes of hyperkalemia

A

decreased potassium OUTPUT (renal failure, not peeing)
burns, crush injuries, sepsis –> anything with massive cell injury
drugs - potassium sparing diuretics, ACE, ARBs, NSAIDs

42
Q

S/S for hyperkalemia

A

cardiac rhythm disturbances
muscle weakness, cramps
abdominal cramping, diarrhea, vomiting

43
Q

what is D50/Insulin

A

for hyerkalemia
combo shifts potassium into the cell temporarily
usually give 10units of regular insulin and 1 ampule of D50

44
Q

what is magnesium

A

helps stabilize cardiac muscle cells

  • blocks/controls movement of K+ out of cardiac cells
  • helps to stabilize smooth muscle
45
Q

what are causes of hypomagnesemia

A

diuresis, GI or renal losses, limited intake (fasting or starvation), alcohol abuse, pancreatitis, hyperglycemia

46
Q

S/S of hypomagnesemia

A

hyperactive reflexes, confusion, cramps, tremors, seizures
nystagmus

-over active muscles

47
Q

treatment for hypomagnesemia

A

giving magnesium

Orally: mylanta, magnesium sulfate
IV: magnesium sulfate - replace over several days, can give IV push if necessary

48
Q

causes of hypermagnesemia

A

increased intake accompanied by renal failure

  • chronic renal failure who take milk of mag
  • OB patients
49
Q

S/S of hypermagnesemia

A

lethargy, floppiness, muscle weakness, decreased reflexes, flushed/warm skin, decreased pulse/BP

50
Q

what is calcium

A

hormones released by the thyroid and parathyroid glands

-thyroid and parathyroid are controllers for the amount of calcium that is released from and absorbed into the bone

51
Q

causes of hypocalcemia

A 
calcium unable to mobilize from bone 
increased renal loss
increased binding 
decreased intake of absorption (decreased Vitamin D)
acute pancreatitis 
thyroid and parathyroid surgery
52
Q

S/S of hypocalcemia

A 
increased neuromuscular excitability 
-parasthesias (numbness/tingling)
-muscle cramps
-bone pain
-tetany
-laryngeal spasm 
-hyperactive reflexes 
cardiac insufficiency

positive Chvostek’s -twitching
positive Trousseau’s - spasm

53
Q

causes of hypercalcemia

A

hyperparathyroidism, cancers

54
Q

S/S for hypercalcemia

A

calcium acts like a sedative, fatigue, lethargy, confusion, weakness, leading to seizures, coma

55
Q

treatment of hypercalcemia

A

adequate hydration
increased urine output
diuretics and NaCl
dialysis in renal failure

56
Q

calcium and phosphate work together, ___ serum calcium = _____ phosphate

A

low serum calcium = high phosphate

57
Q

phosphorus

A

role in bone formation
essential for ATP formation and enzymes needed for glucose, protein, and fat metabolism
acid-base buffer

58
Q

causes of hypophosphatemia

A 
decreased absorption
antacids overdose 
severe diarrhea
incerased kidney elimination 
malnutrition
59
Q

S/S of hypophosphatemia

A 
tremor 
paresthesia
confusion to coma
seizure
muscle weakness 
joint stiffness
bone pain
hemolytic anemia
Plt dysfunction 
impaired WBC function
60
Q

causes of hyperphosphatemia

A

kidney failure
laxatives/enemas with phosphorus
shift from intra- to extra cellular compartment
hypoparathyroidism

61
Q

S/S of hyperphosphatemia

A

usually asymptomatic

S/S usually related to hypocalcemia

62
Q

Hypophosphatemia treatment

A

IV or oral replacement
-Given IV over a LONG period of time

increase oral intake
take care with CKD or hypercalcemia
-increased risk of calcifications

63
Q

hyperphosphatemia treatment

A

treat the cause

  • calcium-based phosphate binders
  • hemodialysis - renal failure

My NUR 325 Flash Cards (25 decks)

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