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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
signs and symptoms of hyponatremia
confusion, muscle weakness, nausea, cardiac output, hypovolemia
26
priority during hyponatremia
prevent hypernatremia and fluid overload
27
therapy for hyponatremia
decrease dosage of diuretics and give IV saline (3%)
28
what determines hypernatremia
sodium over 145
29
signs and symptoms of hypernatremia
short attention span, lethargic, muscle twitching/contractions, muscles weakness, increased pulse
30
priority for hypernatremia
prevent hyponatremia and dehydration
31
therapy for hypernatremia
isotonic saline (0.9%) and dextrose 5% in 0.45 % sodium chloride
32
major cation of ICF
potassium
33
why does any change in K seriously affect physiologic activities
K levels in blood and intestinal fluid are already naturally so low
34
what is the main controller of ECF potassium levels
sodium potassium pump (in membranes of cells)
35
what is K removed by
kidney, excretion is enhanced by aldosterone
36
this can be life threatening because every body system is affected
hypokalemia
37
what is important to assess in a pt with hypokalemia
respiration status every 2 hours! | resp insufficiency is major cause of death
38
signs/symptoms of hypokalemia
muscle weakness, weak pulse, decreased bP, decreased peristalsis, dysrhythmia
39
drug therapy of hypokalemia
K is given IV | check dilution of drug (must be diluted by pharmacist)
40
what is severe about K
severe tissue irritant, NEVER given IM of subcut, can cause necrotic tissue
41
what is the maximum IV rate
5-10 m/hr (not given by push)
42
heart is very sensitive to what
potassium, interferes with electrical conduction | can lead to heart block and ventricular fibrillation
43
what are most hyperkalemia patients
hospitalized, those with abnormal kidney function
44
when does kidney function begin to decrease
with age
45
what are the MOST severe changes that occur with hyperkalemia!
cardiovascular! bradycardia, hypotension, ECG changes also skeletal muscle twitches and muscle weakness
46
priority for hyperkalemia
assess for cardiac complications, falls
47
how does insulin affect K
increases K movement into cells
48
therapy for hyperkalemia
IV fluids containing glucose and insulin
49
what is the active form of calcium
free calcium (must be kept within narrow range)
50
what does calcium do
maintains bone strength/density, activates enzymes, allows muscle contractions
51
when is calcium secreted
when PTH is released from parathyroid glands (inhibited if excess calcium)
52
what is secreted if there is excess calcium
TCT by the thyroid gland to decrease calcium levels
53
this is the rapid onset of life threatening symptoms
acute hyopcalccemia
54
signs/symptoms of hyopcalcemia
tingling, muscle cramps/spasms, icreased peristalsis, osteoporosis
55
BP cuff on arm for 1-4 min, watch for spasm
trousseau's sign
56
tap face below and above ear, watch for twitching
chrostek's sign
57
drug therapy for hyopcalcemia
direct calcium replacement and vitamin D (which enhances calcium absorption)
58
signs and symptoms of hypercalcemia
increased HR and BP, muscle weakness, decreased deep tendon reflex and peristalsis, observe for perfusion
59
what are the most severe changes that are life threatening with hypercalcemia
cardiovascular changes
60
what indicates perfusion
cyanosis and pallor | ASSESS temp, color, cap refill
61
what is given for hypercalcemia
IV normal saline (0.9% sodium chloride), given to increase kidney excretion of calcium
62
where is magnesisum stored
bones and cartilgae, very little in blood | more found in ICF not ECF
63
why is magnesium important
muscle contraction, carbohydrate metabolism, generation of energy, vitamin activation, blood coagulation and cell growth
64
what are the two major causes of hypomagnesemia
inadequate intake and use of loop/thiazide diuretics
65
what are the most important changes to watch for with hypomagnesemia
cardiovascular changes | dysrhythmias, increased nerve impulse transmission

Chronic Rehab (18 decks)

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