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5031 - Adult Med/Surg > Fluid & Electrolyte Balance > Flashcards

Fluid & Electrolyte Balance Flashcards

Exam 1

1
Q

Fluid & electrolyte balance

A

regulation of body fluid volume, osmolarity, and composition

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2
Q

interstitial fluid

A

fluid between cells; “third space”

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3
Q

movement of fluid (water) through a cell or blood vessel membrane because of hydrostatic pressure

A

Filtration

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4
Q

Pressure exerted by water molecules against the surfaces (membranes or walls) of a confining space

A

Hydrostatic pressure

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5
Q

movement of particles across a semipermeable membrane from an area of higher particle concentration to lower particle concentration

A

Diffusion

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6
Q

two fluid spaces that have different concentrations of the same type of particles

A

Concentration gradient

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7
Q

the movement of water only through a selectively permeable membrane to achieve equilibrium of osmolarity

A

Osmosis

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8
Q

What is the normal osmolarity for plasma and other body fluids?

A

300 mOsm/L

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9
Q

Hyperosmotic / hypertonic fluids means there is more ____ than _____.

A

solute; water

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10
Q

Hyposmotic / hypotonic fluids means there is more ____ than _____.

A

water; solute

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11
Q

Osmoreceptors

A

cells that respond to changes in ECF

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12
Q

dissolved substances that express an electrical charge

A

Electrolytes

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13
Q

What are 3 patient populations that are at risk for fluid and electrolyte imbalance?

A

(1) older adults
(2) CKD or endocrine disorders
(3) taking drugs that alter F&E balance

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14
Q

T/F: All adults who are ill are at some risk for electrolyte imbalances

A

True

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15
Q

Na Normal Range

A

136-145 mEq/L

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16
Q

K normal range

A

3.5-5.0 mEq/L

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17
Q

Ca normal range

A

9.0-10.5 mg/dL

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18
Q

Cl normal range

A

98-106 mEq/L

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19
Q

Mg normal range

A

1.3-2.1 mEq/L

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20
Q

Why are older adults at risk for F&E imbalances?

A

Age-related organ changes

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21
Q

What factors influence the amount and distribution of body fluids?

A

(1) age
(2) gender
(3) amount of fat

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22
Q

Why do females tend to have higher dehydration risk than males?

A

Because males usually have more muscle mass than females, and females have more fat than males. Muscle mass holds more water, while fat holds almost no water.

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23
Q

Name 2 age-related changes in the kidneys that put older adults at risk of F&E imbalance

A

(1) decreased glomerular filtration
(2) decreased concentrating capacity

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24
Q

Name 3 age-related changes in the skin that put older adults at risk of F&E imbalance

A

(1) loss of elasticity
(2) decreased turgor
(3) decreased oil production

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25
Name 1 age-related changes in the muscular system that put older adults at risk of F&E imbalance
decreased muscle mass
26
Name 1 age-related changes in the neurologic system that put older adults at risk of F&E imbalance
Reduced thirst reflex
27
Name 1 age-related changes in the endocrine system that put older adults at risk of F&E imbalance
Adrenal atrophy
28
What are the two things that trigger thirst response?
(1) increase in blood osmolarity (2) decrease in blood volume
29
What is the most important and sensitive water loss route?
Kidney
30
the minimum amount of urine output per day needed to excrete toxic waste (definition)
obligatory urine output
31
What is the obligatory urine output amount?
400-600 mL/day
32
natural water losses without a mechanism to control it
Insensible water loss
33
What is the typical amount of insensible water loss per day?
500-1000 mL/day
34
What puts a pt at increased risk for insensible water loss?
(1) mechanical ventilation (2) rapid respirations (3) continuous GI suctioning
35
What are the most important body fluids to keep in balance for optimal function?
blood, ICF
36
What triggers RAAS (4)?
(1) low BP (2) low blood volume (3) low blood Na (4) low blood oxygen
37
Name the 3 main actions of angiotensin II
(1) vasoconstriction & peripheral resistance (2) lower glomerular filtration rate / lower urine output (3) triggers secretion of aldosterone
38
Why is the Na gradient important?
Muscle contraction Cardiac contraction nerve impulse transmission
39
If Na serum levels are low, we inhibit ____ and ____ ; trigger ____
ADH, NP; RAAS
40
If Na serum levels are high, we inhibit ____ and stimulate ____ and _____.
aldosterone; ADH, NP
41
Why is the K gradient important?
generation of action potentials
42
Why is Ca important?
(1) bone strength and density (2) enzymes (3) muscle contraction (4) nerve impulses (5) clotting
43
____ triggers the release of PTH.
low Ca serum levels
44
_____ triggers the releases of thyrocalcitonin (TCT).
high Ca serum levels
45
Why is Mg important?
(1) muscle contraction (2) carb metabolism (3) generate energy stores (4) blood coagulation (5) cell growth
46
The main goal of PTH is to what?
Increase blood Ca levels
47
The main goal of TCT is what?
To manage blood Ca levels by decreasing them
48
Fluid intake or retention is less than what is needed to meet body's fluid needs
Dehydration
49
loss of total body water, such as when water shifts from plasma into the interstitial space
vascular dehydration
50
Older adults are at higher risk of dehydration because of what?
Age-related muscle mass loss.
51
Name 3 other risks for older adults and dehydration (besides muscle).
(1) decreased thirst sensation (2) decreased mobility (3) medications
52
What is the most common type of fluid loss problem?
Isotonic dehydration
53
Isotonic dehydration
loss of water and electrolytes
54
What is the main overarching risk of dehydration?
Reduced perfusion
55
a weight change of 1 lb corresponds to a fluid volume change of ____.
500 mL
56
Why is orthostatic hypotension important in dehydration?
Increased fall risk
57
Assess skin turgor in older adults by pinching _____ rather than back of hand
skin over sternum
58
What is one early indication of fluid imbalance in older adults?
Changes in cognition
59
What is the threshold of urine output that is cause for concern (no kidney disease)?
500 mL/day
60
Hemoconcentration
Increasing blood concentration
61
Name the 2 priority problems for dehydration
(1) fluid and electrolyte balance (2) potential for injury d/t poor perfusion
62
Name the 3 nursing priority interventions for dehydration
(1) fluid replacement (2) drug therapy (3) patient safety
63
3 key signs of fluid overload are what?
(1) bounding pulse (2) difficulty breathing (3) neck vein distention in upright position
64
IV fluids with water, electrolytes, and other water-soluble substances (glucose)
Crystalloids
65
How do you calculate amount of fluid needed for dehydration tx?
Pt weight loss and symptoms
66
IV fluids that contain larger non-water-soluble molecules to increase osmotic pressure in plasma volume
Colloids
67
What are the two most important areas to monitor during rehydration?
Urine output Pulse rate & quality
68
A well-rehydrated pt should have a daily fluid intake of what?
1500 mL
69
What is the most common type of fluid overload?
Hypervolemia
70
The two conditions related to fluid overload are what?
(1) Excessive intake (2) inadequate excretion of fluids
71
Shallow respirations and increased RR are s/s of what?
Fluid overload
72
Name the 4 nursing priorities for fluid overload
(1) ensure pt safety (2) restore normal fluid balance (3) provide supportive care (4) prevent future fluid overload
73
The nurse should assess the pt with fluid overload at least ____ to recognize pulmonary edema
every 2 hours
74
Patients with fluid overload are at risk for which 4 conditions?
(1) pulmonary edema (2) heart failure (3) electrolyte dilution (4) edema
75
furosemide, conivaptan, and tolvaptan are drugs used to treat what?
Fluid overload
76
Daily weights are important because they determine what?
Treatment decisions
77
What is the best indicator of fluid retention and overload?
Weight gain
78
When should the pt report weight changes?
more than 3 lb gain in a week; 2 lb gain in 24 hours
79
How do you treat dehydration?
Isotonic Na+ containing solution and water
80
.9% normal saline is a ____ solution
isotonic
81
.45% normal saline is a ____ solution
hypotonic
82
If a person has fluid overload, name at least 3 nursing interventions
(1) stop fluids (2) ask for order for diuretics (3) raise HOB to high fowler's / 60 degrees (4) monitor K (5) monitor I&Os (6) daily weights

5031 - Adult Med/Surg (19 decks)

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