fluid/electrolyte Flashcards
What are the assessment findings of fluid volume excess?
Weight gain, edema, JVD, pulmonary/peripheral edema, polyuria, dyspnea, crackles upon auscultation, bounding pulse.
Which patients commonly experience fluid volume excess?
Congestive heart failure (CHF) patients.
What is the priority intervention for fluid volume excess?
Treating the underlying cause.
How can fluid be removed without altering electrolyte composition or osmolality of ECF?
By carefully managing treatment strategies such as diuretics and fluid restriction.
What should be done with IV infusions in cases of fluid volume excess?
Decrease or stop the IV infusion rate.
What medications are commonly used to manage fluid volume excess?
Diuretics.
What dietary modification is recommended for fluid volume excess?
Low-sodium diet.
What procedures can be performed for patients with ascites or pleural effusion?
Abdominal paracentesis or thoracocentesis.
Why should daily weights be checked in fluid volume excess patients?
To monitor fluid retention and treatment effectiveness.
When should daily weights be measured?
At the same time and under the same conditions each day.
What are the assessment findings of fluid volume deficit?
Weight loss, decreased capillary refill, increased thirst, dry mucous membranes, oliguria, concentrated urine, increased respiratory rate, cold and clammy skin, weak pulse, orthostatic hypotension.
What is the priority intervention for fluid volume deficit?
Treating the underlying cause.
What are the treatment options for fluid volume deficit?
Oral or IV fluid replacement therapy.
Why should daily weights be checked in fluid volume deficit patients?
To monitor fluid status and treatment effectiveness.
When should daily weights be measured?
At the same time and under the same conditions each day.
What can be done to help with dry skin in fluid volume deficit patients?
Moisturize the skin.
Is dehydration the same as fluid volume deficit?
No, dehydration is the loss of only water, while fluid volume deficit involves the loss of both water and electrolytes.
What are common causes of fluid volume deficit?
Vomiting, diarrhea, excessive sweating, hemorrhage, burns, diuretic overuse, inadequate fluid intake.
What vital sign changes are seen in fluid volume deficit?
Increased respiratory rate, weak pulse, orthostatic hypotension.
What are common urine characteristics in fluid volume deficit?
Oliguria (low urine output) and concentrated urine.
What are the EKG changes seen in hypokalemia?
ST depression, U wave, shallow T wave, slightly peaked P wave, prolonged QRS complex.
How does hypokalemia affect the gastrointestinal (GI) system?
Decreased GI motility, leading to constipation, nausea, etc.
What are the neuromuscular symptoms of hypokalemia?
Skeletal muscle weakness or paralysis, hyporeflexia.
How does hypokalemia affect the respiratory system?
Shallow respirations.
What cardiovascular signs may be present in hypokalemia?
Weak pulse.
What are the priority interventions for hypokalemia?
Oral/IV potassium intake, increasing dietary potassium, monitoring EKG for cardiac changes, and monitoring urine output.
How should IV potassium chloride be administered?
It must be diluted, given slowly, never as a push or bolus, and never added to an existing bag.
Why should the IV potassium chloride site be monitored closely?
Because it is an irritant and can cause infiltration, extravasation, or phlebitis.
What are good dietary sources of potassium?
Bananas, oranges, spinach, potatoes, avocados, beans, yogurt.
What should be assessed before administering IV potassium?
Urine output to ensure adequate kidney function and prevent hyperkalemia.
What are the EKG changes seen in hyperkalemia?
Flat P wave, widened QRS complex, depressed ST segment, tall T wave.
What neuromuscular symptoms are associated with hyperkalemia?
Tetany, loss of muscle tone.
How does hyperkalemia affect the gastrointestinal (GI) system?
Abdominal cramping.
How does hyperkalemia impact glucose levels?
It can cause hyperglycemia due to insulin impairment.
What is the first step in managing hyperkalemia?
Stop oral or IV potassium intake.
What types of diuretics are used to treat hyperkalemia?
Loop or thiazide diuretics.
What medication binds potassium in the bowel for excretion?
Potassium polystyrene sulfonate (Kayexalate).
What treatment is used for hyperkalemia in patients with renal failure?
Hemodialysis.
How does glucose and insulin therapy help in hyperkalemia?
It draws potassium from the plasma into the cells.
Why should continuous EKG monitoring be done for hyperkalemia patients?
To detect and manage potentially life-threatening cardiac changes.
What are the mild symptoms of hyponatremia?
Headache, irritability, trouble concentrating.
What are the severe symptoms of hyponatremia?
Confusion, vomiting, seizures, coma.
What type of fluids are used to replace sodium in hyponatremia?
Isotonic sodium-containing solutions.
What oral intervention is encouraged for hyponatremia?
Encouraging oral sodium intake.
What should be done with diuretics in hyponatremia management?
Stop diuretics to prevent further sodium loss.
Why are daily weights important in hyponatremia management?
To monitor fluid balance and treatment effectiveness.
What supplements might be used to manage hyponatremia?
Sodium and potassium supplements.
What medication can be given to increase sodium levels?
Salt tablets (salt tabs).
What complications can arise from untreated severe hyponatremia?
Seizures and coma.
What causes hyponatremia?
Excess water intake, heart failure, renal disease, SIADH (syndrome of inappropriate antidiuretic hormone), diuretic overuse.
What are the neurological symptoms of hypernatremia?
Drowsiness, confusion, lethargy.
What cardiovascular sign is commonly seen in hypernatremia?
Tachycardia.
What musculoskeletal symptoms can occur with hypernatremia?
Muscle weakness, hyporeflexia.
What is the treatment for hypernatremia due to water excess?
Oral/IV rehydration with isotonic fluids (0.9% normal saline).
What is the treatment for hypernatremia due to sodium excess?
Oral/IV rehydration with diluted sodium fluids (5% dextrose in water), sodium restriction, diuretics.
What type of fluid is D5W, and how does it behave in the body?
D5W is isotonic but becomes hypotonic in the body.
What dietary restriction is recommended for hypernatremia?
Sodium restriction.
What type of diuretics are used to manage sodium excess?
Diuretics that promote sodium excretion, such as loop diuretics.
Why is careful monitoring needed when treating hypernatremia?
Rapid correction can cause cerebral edema.
What are common causes of hypernatremia?
Dehydration, excessive sodium intake, diabetes insipidus, heat stroke, osmotic diuresis.
