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N150 > Fluid, electrolyte, and acid-base balance > Flashcards

Fluid, electrolyte, and acid-base balance Flashcards

1
Q

Intracellular:

A

2/3 of total body water (majority)

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2
Q

Extracellular:

A

1/3 of total body water

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3
Q

Human body composed of ___% water:

A

60%

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4
Q

2 major divisions of extracellular component:

A

Intravascular

Interstitial

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5
Q

1 minor division of extracellular component:

A

Transcellular

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6
Q

Intravascular:

A

Liquid part of the blood (plasma)

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7
Q

Interstitial fluid:

A

Between cells and outside blood the vessels

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8
Q

Transcellular fluid:

A
  • Secreted by epithelial cells

- cerebrospinal , placental, peritoneal, synovial

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9
Q

Osmosis:

A

Passive movement of water from low to high conc. across a membrane

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10
Q

Filtration:

A

Mediated by fluid pressure from high to low pressure

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11
Q

Diffusion:

A

Passive movement of electrolytes down a conc. gradient from high to low conc.

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12
Q

Active transport:

A

Requires energy in the form of ATP to move electrolytes against conc. gradient (low to high)

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13
Q

Steps to start peripheral IV therapy:

A
  1. Apply tourniquet.
  2. Select vein.
  3. Release tourniquet.
  4. Clean site.
  5. Reapply tourniquet.
  6. Insert vascular access device.
  7. Advance and secure.
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14
Q

Most abundant cation in blood:

A

Sodium

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15
Q

Cations:

A

Positively charged ions

-Sodium, potassium, calcium, magnesium

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16
Q

Anion:

A

Negatively charged ions

-Chloride, bicarbonate

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17
Q

Normal value for sodium:

A

135-145

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18
Q

Normal value for potassium:

A

3.5-5.0

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19
Q

Normal value for calcium:

A

8.4-10.5

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20
Q

Normal value for magnesium:

A

1.3-2.5

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21
Q

Calcium is elevated. When checking phosphate level, nurse expects to see?

A

Phosphate decreased due to their inverse relationship

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22
Q

The patient has an intravenous (IV) line and the nurse needs to remove the gown. In which order will the nurse perform the steps, starting with the first one?

A
  1. Remove the sleeve of the gown from the arm without the IV.
  2. Remove the sleeve of the gown from the arm with the IV.
  3. Remove the IV solution container from its stand.
  4. Pass the IV bag and tubing through the sleeve.
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23
Q

Positive Chvotek sign represents:

A

Hypocalcemia or hypomagnesemia

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24
Q

Tasks the RN can delegate to an NAP when caring for a pt with a peripheral IV therapy:

Can’t do?

A

Recording intake and output

Regulate flow rate, start IV, or change an IV

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25
Q

ADH:

A
  • Produced by hypothalamus
  • Stored in pituitary
  • Restores blood volume by increasing or decreasing excretion of water
26
Q

RAAS:

A
  • Secreted in kidneys
  • Regulates ECV by influencing how much sodium and water are excreted into urine
  • Regulates BP
27
Q

ANP (atrial natriuretic peptide):

A

Regulates ECV by influencing how much sodium and water are excreted into urine

28
Q

Sxs of hypokalemia:

A
  • Muscle weakness that may ascend to resp. muscles
  • abd distention
  • decreased bowel sounds/constipation
29
Q

Sxs of hyperkalemia:

A
  • Muscle weakness
  • abd cramps
  • diarrhea
  • cardiac arrest
30
Q

Sxs of hypocalcemia:

A 
-Numbness/tingling fingers/toes/mouth
\+ Chvosteks sign
-hyperactive reflexes
-muscle twitching/cramping
-spasm, tetany, seizure
31
Q

Sxs of hypercalcemia:

A
  • Anorexia
  • Nausea and vomiting
  • Constipation
  • fatigue
  • diminished reflexes
  • lethargy
  • decreased level of consciousness
32
Q

Sxs of hyponatremia:

A
  • Decreased level of consciousness

- seizures

33
Q

Sxs of hypernatremia/ ECV deficit:

A
  • Rapid weight loss
  • Postural hypotension
  • tachy
  • dry mucous membranes
  • thready pulse
  • poor skin turgor
34
Q

Sxs of hypermagnesemia:

A
  • Lethargy
  • hypoactive DTR
  • hypotension/brady
35
Q

Clinical dehydration:

A

ECV deficit plus hypernatremia

36
Q

What IV fluid is administered w blood transfusion?

A

Normal saline

37
Q

Max transfusion time:

38
Q

Complications of IV therapy:

A
  • Infiltration
  • Phlebitis
  • Infection
  • Adverse effects- fluid overload
  • Bleeding
39
Q

Hypotonic IV soln:

A
  1. 45% saline (1/2 NaCI)

0. 225% saline (1/4 NaCI)

40
Q

TPN:

A

IV composed of nutrients and electrolytes

41
Q

Isotonic IV soln:

A

0.9% sodium chloride (NS)

42
Q

Hypernatremia dx’d by:

A

Elevated serum sodium conc.

43
Q

Patients with NG suctioning are at risk for:

A

Potassium deficit

44
Q

Infiltration:

A

IV fluid enters subQ tissue around puncture site and causes edema

45
Q

Phlebitis:

A

Inflammation of inner layer of vein

46
Q

Recommended bundle insertion of central line protocol (CLABSI):

A
  • hand hygiene
  • max sterile precautions
  • chlorhexidine skin asepsis
  • avoid femoral vein
  • daily evaluation
47
Q

When preparing to administer blood…

A

Prime the tubing with 0.9% sodium chloride (nml saline) to prevent hemolysis of RBC

48
Q

Pts with diabetes insipidus are at risk for?

A

Dehydration and hypernatremia

49
Q

Actions by the nurse when selecting a site to insert IV: (6)

A
  • Check for contraindications to the extremity (mastectomy, AV fistula, central line)
  • Choose vein with minimal curvature
  • Avoid areas of flexion
  • Choose nondominant arm
  • Start distally and move proximally
  • Good vein should feel spongy- never rigid
50
Q

Sxs of infiltration:

A

Edema
Pale skin
Cool skin

51
Q

Sxs of phlebitis:

A 
Pain
Warmth
Erythema
Red streak
Palpable venous cord
52
Q

A nurse is discontinuing a patient’s peripheral IV access. Which actions should the nurse take? (3)

A
  • Stop infusion before removing IV
  • Keep cath parallel to skin while removing it
  • Apply light pressure to site for 2-3 min after removal
53
Q

Reduces excretion of water:

54
Q

Increases excretion of sodium and water

55
Q

Reduces excretion of sodium and water

A

Aldosterone

56
Q

Major buffer in the extracellular fluid

A

Bicarbonate

57
Q

Vasoconstricts and stimulates aldosterone release

A

Angiotensin II

58
Q

Isotonic solns used to:

A

Increase extracellular fluid volume

59
Q

Hypertonic soln:

Used to treat?

A

3% saline (NaCI)
D5LR (dextrose 5% lactated ringers)

Severe hyponatrermia

60
Q

Sensible losses:

A

Urination
Defecation
Wound drainage

61
Q

Insensible losses:

A

Evaporation from skin

Respiration loss from lungs

N150 (13 decks)

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