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Chronic Rehab > Fluid/Electrolyte > Flashcards

Fluid/Electrolyte Flashcards

1
Q

normal sodium lab values

A

136-145

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2
Q

normal potassium lab values

A

3.5-5

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3
Q

normal calcium lab values

A

9-10.5

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4
Q

normal chloride lab values

A

98-106

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5
Q

normal magnesium lab values

A

1.8-2.6

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6
Q

works on kidney nephrons

increases blood osmolarity, blood volume , and potassium excretion

A

aldosterone

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7
Q

released from pituitary gland
acts on kidney
reabsorbs water (retains)

A

ADH

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8
Q

secreted by ANP in response to increased blood volume and BP
opposite effects of aldosterone
urine output increase, kidney reabsorption of sodium is inhibited

A

natriuretic peptide

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9
Q

triggered when there is a change in blood indicating that perfusion is at risk (ie/ low BP)
activates angiotensin

A

renin

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10
Q

constricts arteries and veins, decreases urine output, aldosterone secretion increases

A

angiotensin

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11
Q

most common type of fluid loss problem

leads to hypovolemia and decreased perfusion

A

isotonic dehydration

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12
Q

body’s response to isotonic dehydration

A

body increases vasoconstriction and peripheral resistance

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13
Q

what is indicative of dehydration

A

weight loss and changes in mental status
increased HR, decreased BP and pulse
increased RR

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14
Q

priority during dehydration

A

fluid replacement (daily fluid intake should be 1500 mL)

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15
Q

excessive fluid in ECF space

A

hypervolemia

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16
Q

drug therapy for fluid overload (overhydration)

A

diuretics to remove excess fluid

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17
Q

who is most at risk for electrolyte imbalance

A

older, ill, chronic kidney and endocrine disorders

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18
Q

when does balance occur

A

when dietary intake of electrolytes matches kidney electrolyte excretion or reabsorption

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19
Q

major cation in ECF and maintains osmolality

A

sodium

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20
Q

where are the sodium levels high and low

A

high in ECF and low in ICF

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21
Q

regulated by kidney

influenced by aldosterone, ADH, and NAP

A

serum sodium

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22
Q

low sodium levels do what

A

inhibit ADH and NP and trigger aldosterone

this causes kidney reabsorption of sodium

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23
Q

high sodium levels do what

A

inhibit aldosterone secretion and stimulated ADH and NP secretion
these increased kidney sodium excretion and water reabsorption

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24
Q

what determines hyponatremia

A

sodium below 136

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25
Q

signs and symptoms of hyponatremia

A

confusion, muscle weakness, nausea, cardiac output, hypovolemia

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26
Q

priority during hyponatremia

A

prevent hypernatremia and fluid overload

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27
Q

therapy for hyponatremia

A

decrease dosage of diuretics and give IV saline (3%)

28
Q

what determines hypernatremia

A

sodium over 145

29
Q

signs and symptoms of hypernatremia

A

short attention span, lethargic, muscle twitching/contractions, muscles weakness, increased pulse

30
Q

priority for hypernatremia

A

prevent hyponatremia and dehydration

31
Q

therapy for hypernatremia

A

isotonic saline (0.9%) and dextrose 5% in 0.45 % sodium chloride

32
Q

major cation of ICF

A

potassium

33
Q

why does any change in K seriously affect physiologic activities

A

K levels in blood and intestinal fluid are already naturally so low

34
Q

what is the main controller of ECF potassium levels

A

sodium potassium pump (in membranes of cells)

35
Q

what is K removed by

A

kidney, excretion is enhanced by aldosterone

36
Q

this can be life threatening because every body system is affected

A

hypokalemia

37
Q

what is important to assess in a pt with hypokalemia

A

respiration status every 2 hours!

resp insufficiency is major cause of death

38
Q

signs/symptoms of hypokalemia

A

muscle weakness, weak pulse, decreased bP, decreased peristalsis, dysrhythmia

39
Q

drug therapy of hypokalemia

A

K is given IV

check dilution of drug (must be diluted by pharmacist)

40
Q

what is severe about K

A

severe tissue irritant, NEVER given IM of subcut, can cause necrotic tissue

41
Q

what is the maximum IV rate

A

5-10 m/hr (not given by push)

42
Q

heart is very sensitive to what

A

potassium, interferes with electrical conduction

can lead to heart block and ventricular fibrillation

43
Q

what are most hyperkalemia patients

A

hospitalized, those with abnormal kidney function

44
Q

when does kidney function begin to decrease

A

with age

45
Q

what are the MOST severe changes that occur with hyperkalemia!

A

cardiovascular!
bradycardia, hypotension, ECG changes
also skeletal muscle twitches and muscle weakness

46
Q

priority for hyperkalemia

A

assess for cardiac complications, falls

47
Q

how does insulin affect K

A

increases K movement into cells

48
Q

therapy for hyperkalemia

A

IV fluids containing glucose and insulin

49
Q

what is the active form of calcium

A

free calcium (must be kept within narrow range)

50
Q

what does calcium do

A

maintains bone strength/density, activates enzymes, allows muscle contractions

51
Q

when is calcium secreted

A

when PTH is released from parathyroid glands (inhibited if excess calcium)

52
Q

what is secreted if there is excess calcium

A

TCT by the thyroid gland to decrease calcium levels

53
Q

this is the rapid onset of life threatening symptoms

A

acute hyopcalccemia

54
Q

signs/symptoms of hyopcalcemia

A

tingling, muscle cramps/spasms, icreased peristalsis, osteoporosis

55
Q

BP cuff on arm for 1-4 min, watch for spasm

A

trousseau’s sign

56
Q

tap face below and above ear, watch for twitching

A

chrostek’s sign

57
Q

drug therapy for hyopcalcemia

A

direct calcium replacement and vitamin D (which enhances calcium absorption)

58
Q

signs and symptoms of hypercalcemia

A

increased HR and BP, muscle weakness, decreased deep tendon reflex and peristalsis, observe for perfusion

59
Q

what are the most severe changes that are life threatening with hypercalcemia

A

cardiovascular changes

60
Q

what indicates perfusion

A

cyanosis and pallor

ASSESS temp, color, cap refill

61
Q

what is given for hypercalcemia

A

IV normal saline (0.9% sodium chloride), given to increase kidney excretion of calcium

62
Q

where is magnesisum stored

A

bones and cartilgae, very little in blood

more found in ICF not ECF

63
Q

why is magnesium important

A

muscle contraction, carbohydrate metabolism, generation of energy, vitamin activation, blood coagulation and cell growth

64
Q

what are the two major causes of hypomagnesemia

A

inadequate intake and use of loop/thiazide diuretics

65
Q

what are the most important changes to watch for with hypomagnesemia

A

cardiovascular changes

dysrhythmias, increased nerve impulse transmission

Chronic Rehab (18 decks)

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