Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR352 2018 > Fluid & Electrolyte Balance > Flashcards

Fluid & Electrolyte Balance Flashcards

1
Q

What is Osmolarity

A

Amount of solutes per LITRE of a solution (VOLUME)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is Osmolality

A

Amount of solutes per KILOGRAM of a solution (WEIGHT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is Hydrostatic pressure

A

Ability to push a solution across a membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is oncotic pressure

A

Ability to attract/pull a solution across a membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Tonicity

A

A measurement of Osmotic/Oncotic pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Explain uses, and con’s of CSL/Hartmanns

A

Restores circulating volume & electrolyte deficits
Used in Burns, Acidosis, Hypovolaemia
Readily available, low cost, buffer
X = rapid movement from intravascular space to the extravascular space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Explain uses, pros and cons of Normal Saline

A

Restores circulating volume and is compatible with most drugs
Readily available, safe to use, low cost
X = Can cause Hypercholoraemia acidosis with prolonged
use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Explain uses, pros and cons of 1/2 normal saline

A

Hypotonic solution used in DKA, Hypertonic Dehydration, Sodium Chloride depletions, Gastric fluid loss
Maintains body fluid, Establishes renal function, OK for diabetics (No glucose)
X = Can cause cardiovascular collapse, Increase ICP, Do not use in Trauma, burns or Liver Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Explain uses, pros and cons of D5W

A

Raises fluid volume and has excretory properties. Isotonic in the bag but becomes hypotonic once metabolised in the body.
No sodium, use in dehydrations, hypernatraemia
X = Can lead to hyperglycaemia or Overload. Not calorifically complete.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Explain what Packed Red Blood Cells are used for and the infusion time

A

Restores intravascular volume in Trauma, Surgery or Cancer patients. Replaces 02 - carrying ability of the blood in Anaemia.
Infuse over 1 to 3 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Explain what Platelets are used for and the infusion time

A

To treat haemorrhage in major trauma or surgery, clotting disorders, cancer or leukaemia patients.
Infuse over 15 to 30 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Explain what Fresh Frozen Plasma is used for and the infusion time

A

Replaces clotting factors and other blood proteins.

Infuse over 30 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the Pathophysiology, Signs and symptoms, and treatment of a Haemolytic Transfusion Reaction

A

A systemic reaction provoked by immunologic RBC incompatibility.
Can be immune or non-immune mediated
Occurs within first 24 hours of transfusion

Signs and symptoms = Increased temp and HR, Anxiety, Flank pain, Rigors, Dyspnoea, Pain at IV site.

Treatment = Stop the transfusion
Check and monitor Vital signs
Maintain IV access without flushing existing line (use new if required)
Check pack, documentation and patient ID
Notify MO and transfusion provider
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Preload and the factors which influence it

A

The amount of myocardial stretch prior to contraction. Influenced by anything that affects Ventricular volume at the end of diastole.

  • Circulating Volume
  • Contractility of Myocardium
  • Heart rate
  • Atrial contraction
  • Systemic and Pulmonary pressures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Afterload and the factor which influence it

A

The amount of resistance the heart must overcome to open the Aortic valve and propel blood into systemic circulation.

  • Peripheral Vascular resistance (Vessel length, diameter, and blood viscosity)
  • Contractility of the Myocardium
  • Volume of Blood in Ventricle (LVEDV)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 4 main forces that determine fluid movement in the capillaries and interstitial space

A

Capillary Hydrostatic pressure - (BP) forces out of capillary to interstitium

Capillary Oncotic pressure - Proteins attract fluid from interstitium to capillaries

Interstitial Hydrostatic pressure - Fluid within interstitium forces out of interstitium and into capillaries or Lymphatic vessels

Interstitial Oncotic - Proteins in interstitium attract fluid from the capillaries into the interstitial space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does an increase in capillary hydrostatic pressure or decrease in capillary oncotic pressure lead to oedema

A

Fluid balance relies on constant pressures.
Abnormal increases in capillary hydrostatic pressure forces excess fluid into the interstitial space. Abnormal decrease in capillary oncotic pressure reduces the ability of fluid to be drawn back into the capillaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is ment by fluid being in the third space

A

Fluid that accumulates outside a normal fluid compartment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the different body fluid compartments

A

Intracellular compartment - Fluid within the cells

Extracellular compartment - All fluid outside the cells

  • —>Interstitial compartment - The space between cells and outside blood vessels
  • —> Intravascular - Plasma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How are Sodium, Chloride and Potassium normally kept in balance

A

The kidneys reabsorb Sodium which forces the active transport of Chloride also.

Potassium is secreted into filtrate and excreted via the urine, and sweat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some common causes of water deficit

A 
Insufficient fluid intake
Excess sweating
Overuse of diuretics
Vomiting and Diarrhoea
Severe wound drainage
Haemorrhage
22
Q

What metabolic dysfunctions occur in Hyper/Hypo kalaemia

A 
Hyper - 
Muscle cramps and hyperactive reflexes
Respiratory distress
urine abnormalities
Decreased cardiac contractility
ECG changes
Hypo-
Alkalosis
Shallow resps
Irritability, confusion, drowsiness
Thready pulse
Decreased GI motility
23
Q

What is the most prominent ECG change in HYPOkalaemia

A

U wave formation

24
Q

What is the most prominent ECG change in HYPERkalaemia

A

Peaked T wave

25
Q

What is the normal pH, HCO3, CO2 and Base Excess levels in the blood

A

pH: 7.35 - 7.45
CO2: 35 - 45
HCO3: 22 - 26
B/E: +/- 2 mEq/L

26
Q

What is base excess

A

Meausres the metabolic component of the acid-base balance.

It is the amount of acid required to restore a litre of blood to its normal pH at a PaCO2 of 40 mmHg

27
Q

How does hyperglycaemia contribute to dehydration and metabolic acidosis

A

Excess glucose molecules pass into the filtrate, attracting more fluid via osmotic pressure, which leads to Glycosuria and excessive fluid loss in the urine, thus dehydration :)

In diseases such as T1DM, a complete lack of insulin means that the circulating glucose is unable to be taken up and utilised for fuel. The body begins to break down liver glycogen stores and then fat stores. This produces fatty acids and ketones, resulting in metabolic acidosis.

28
Q

What are 5 risk factors associated with developing fluid, electrolyte and acid-base imbalnces

A 
Diuretic medication use
Endocrine dysfunction
Vomiting + Diarrhoea
Kidney + Liver disease
Excessive sweating
29
Q

What are the clinical implications of Hypovolaemia

A

Hypovolaemia can progress to insufficient circulating volume and hypovolaemic shock. It manifests as tachycardia, hypotension, rapid weight loss, dry skin and mucous membranes, and reduced urine output

30
Q

What are the clinical implications of Hypervolaemia

A

Hypervolaemia is an excess of fluid and increases the circulating blood volume. It causes increased BP and can lead to oedema and heart failure

31
Q

What is ADH

A

A hormone secreted by the posterior pituitary gland that regulates water excretion from the kidneys

32
Q

How does ADH work

A

Decreased blood pressure or volume and increased serum osmolality triggers the secretion of ADH.

ADH increases the permeability of the distal convoluted tubule and collecting ducts to water, reducing fluid loss.

In fluid excess, ADH is inhibited which decreases water reabsorption and leads to more fluid loss.

33
Q

Define Arterial Blood Gases (ABG’s)

A

A lab test used to evaluate acid-base balance and gas exchange. Measures the arterial amount of oxygen, carbon dioxide and bicarbonate

34
Q

Define PaO2

A

The partial pressure of oxygen in arterial blood

35
Q

Define PaCO2

A

The partial pressure of carbon dioxide in arterial blood

36
Q

Define Haematocrit

A

The ratio of the volume of RBCs to the total volume of blood

37
Q

What is Osmotic pressure

A

The power of a solution to draw water across a membrane

38
Q

What is Tonicity

A

Refers to the effect a solution’s osmotic pressure has on water movement across the membrane of cells within that solution

39
Q

What is the mechanism of action of Potassium sparing diuretics

A

Inhibit potassium excretion and block sodium reabsorption at the distal convoluted tubule and collecting duct. Creating a concentration gradient that draws water out
e.g - AMILORIDE

40
Q

What is the mechanism of action of Thiazide diuretics

A

Inhibit Sodium Chloride reabsorption between the ascending loop and beginning of the distal convoluted tubule
e.g - HYDROCHLOROTHIAZIDE

41
Q

What are some causes of Metabolic Acidosis (SKID)

A

Ketoacidosis, Shock, Sever Diarrhoea, Impaired Kidney function

42
Q

What are some signs and symptoms of Metabolic Acidosis (HALK)

A

Headache, Lethargy, Anorexia, kussmals breathing, nausea, diarrhoea, GI cramps, coma, arrhythmias

43
Q

What are some causes of Metabolic Alkalosis (LDPC)

A

Loss of GI secretions, Diuretic use, Primary Hyperaldosteronism, Cushing’s syndrome

44
Q

What are some signs and symptoms of Metabolic Alkalosis (DRAT)

A

Restlessness, lethargy, Nausea, vomiting, diarrhoea, dizziness, irritability, hypoventilation, arrhythmias, tachycardia

45
Q

What are some causes of Respiratory Acidosis

A

Hypoventilation, hypercapnia, decreased alveolar compliance, COPD, drug overdose, chest trauma, neuromuscular disease

46
Q

What are some causes of Respiratory Alkalosis (HHHHPE)

A

Hyperventilation, hypocapnia, hypoxia, pulmonary embolism, fever, anxiety, high altitudes

47
Q

Explain the mechanism of action of Frusemide

A

Inhibits Sodium Chloride reabsorption at the Loop of Henle

48
Q

Explain the uses and nursing considerations of MANNITOL

A

Promotes excretion of fluid via osmosis. Used in Oliguric diuresis, to decrease cerebral oedema and eliminate toxins.

Can cause fluid overload, electrolyte imbalance, Cellular dehydrations and necrosis

49
Q

What are the manifestations of MILD hypovolaemic shock (15-30% loss)

A 
BP - unchanged
HR =/>100bpm
RR >20
Neuro Slightly anxious
Urine =/> 30mL/hr
Capillary refill Normal
50
Q

What are the manifestations of MODERATE hypovolaemic shock (30 - 40% loss)

A 
BP - Lowered
HR =/> 120bpm
RR > 30
Neuro - Anxious/Confused
Urine 20-30mL/hr
Capillary refill >4 secs
51
Q

What are the manifestations of SEVERE hypovolaemic shock (=/> 40% loss)

A 
BP =/< 90 systolic
HR =/> 140bpm
Neuro - Confusion/Lethargy
Urine 5 -15 mL/hr
Capillary refill > 4 secs
52
Q

Explain the Baroreceptor Reflex

A

A rapid negative feedback loop mechanism that maintains BP

Increased BP causes the PARASYMPATHETIC nervous system to reflexively decrease HR and contractility, decreasing BP

Decreased BP causes the SYMPATHETIC nervous system to increase HR and contractility, increasing BP

NUR352 2018 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions