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Fluid & Electrolyte Balance Flashcards

1
Q

What is the primary body fluid?

A

Water

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2
Q

What are the two fluid compartments?

A
  • Intracellular fluids

- Extracellular fluids

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3
Q

What are the two major areas of ECF?

A
  • Intravascular fluid (plasma)

- Interstitial fluid

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4
Q

What is the minor component of ECF?

A

Trans-cellular fluid.

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5
Q

What separates ICF and ECF compartments?

A
  • Capillary walls

- Cell membranes

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6
Q

What makes infants more prone to fluid volume deficits?

A

Having considerably more total body fluid and ECF than adults, where ECF is more easily lost from body than ICF.

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7
Q

What is the cause for a risk of fluid imbalance in older adults?

A
  • Increase in fat cells

- Decrease in muscle mass/lean tissue

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8
Q

What stimulates the thirst control center (hypothalamus)?

A
  • Intracellular dehydration

- Decreased blood volume

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9
Q

What is the difference between a sensible and insensible loss?

A

Sensible can be measured, while insensible cannot.

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10
Q

What is the hierarchy of fluid intake from most to least?

A
  • Ingested water
  • Ingested food
  • Metabolism
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11
Q

What is the hierarchy of fluid output from most to least?

A
  • Kidneys
  • Skin
  • Lungs
  • GI
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12
Q

What are 2 examples of non-electrolytes?

A
  • Urea

- Glucose

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13
Q

What are the major electrolytes of ECF?

A
  • Sodium
  • Chloride
  • Calcium
  • Bicarbonate
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14
Q

What are the major electrolytes of ICF?

A
  • Potassium
  • Phosphorus
  • Magnesium
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15
Q

What is the primary solvent of the body?

A

Water

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16
Q

What are the primary solutes of the body?

A
  • Electrolytes

- Non-electrolytes

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17
Q

What are the mechanisms responsible for regulating shift of fluids and transporting materials to and from the intracellular components?

A
  • Organs and body systems
  • Osmosis
  • Diffusion
  • Active transport
  • Capillary filtration
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18
Q

What is Osmosis?

A

The movement of solvent with lesser solutes to an area of greater solute concentration.

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19
Q

In regards, to osmolarity what is an isotonic solution?

A

A value between 275-295 mOsm/L.

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20
Q

In regards, to osmolarity what is a hypertonic solution?

A

A value greater than 295 mOsm/L.

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21
Q

In regards, to osmolarity what is a hypotonic solution?

A

A value lesser than 275 mOsm/L.

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22
Q

What is Osmotic Potential?

A

An electrolytes affinity for water.

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23
Q

What is Diffusion?

A

A solute moving from high concentration to a lower concentration.

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24
Q

What is Active Transport?

A

Movement of substances from an area of lesser solute concentration to high solute concentration (requires energy).

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25
What is Capillary Filtration?
Fluids moving from an area of high pressure to one with lower pressure.
26
What is the "pushing" force of capillary filtration?
Hydrostatic pressure.
27
What does Reabsorption do?
Prevents too much fluid from leaving the capillaries regardless of hydrostatic pressure.
28
Which component facilitates the "pulling" force in reabsorption?
Plasma proteins such as albumin.
29
What is the "pulling" force of capillary filtration?
Colloid osmotic pressure or oncotic pressure.
30
What is filtration pressure?
Difference between colloid osmotic pressure and blood hydrostatic pressure.
31
What is a Fluid Volume Deficit (FVD) caused by?
A loss of water and solutes in the same proportion from the ECF space.
32
What is Hypovolemia?
- Isotonic dehydration - lack of both water and electrolytes - Decrease in circulating blood - FVD
33
What is Isotonic Fluid Loss?
Loss of both water and solutes from the ECF.
34
What is the Third-space Fluid Shift?
- Fluid shifting from the intravascular spaces into trans-cellular compartments (pleural, peritoneal, etc). - ECF Deficit
35
In regards to fluid volume deficits (FVD), what happens with decreased albumin levels?
Disruption of colloid osmotic pressure.
36
In regards to fluid volume deficits (FVD), what happens with excess IV fluid replacement or renal dysfunction?
Increased fluid volume.
37
In regards to fluid volume deficits (FVD), what happens with heart failure?
Increased capillary hydrostatic pressure.
38
In regards to fluid volume deficits (FVD), what happens from gross tissue trauma?
Increase in permeability of the capillary membrane.
39
What are some interventions for FVD?
- Prevent further fluid loss - Oral rehydration therapy - IV therapy - Medications: antiemetics, antidiarrheals - Monitor CV, Resp, Renal, GI status - Monitor electrolytes - possible supplement rx - Monitor weight - Monitor I&O
40
What is Fluid Volume Excess (FVE)?
- Excessive retention of water and sodium in ECF near high, equal proportions - Hypervolemia
41
What is Hypervolemia?
Excess fluid in intravascular area.
42
What are some common causes of FVE?
- Kidney malfunction | - Heart failure
43
What are some interventions for FVE?
- Restore normal fluid balance, prevent further overload - Drug therapy; diuretics - Diet therapy; decrease Na & fluids - Monitor I &O - Monitor weights - Monitor electrolytes - Monitor CV, Resp, Renal systems
44
What is Hyponatremia and what does it do?
- Sodium deficit caused by loss of sodium or a gain of water | - Delays and slows depolarization of membranes
45
What is Hypernatremia?
Sodium surplus in ECF caused by excess water loss or overall excess of sodium.
46
What is Hypokalemia?
Potassium deficit caused by vomiting, diarrhea, or diuretics.
47
What is Hyperkalemia?
Potassium surplus caused by renal failure, hypoaldosteronism, or med use such as heparin, ACE inhibitors or NSAIDS.
48
What are signs of hypokalemia?
- Muscle weakness - Leg cramps - Fatigue - Paresthesias - Dysrhythmias
49
Excess of which electrolytes may lead to cardiac arrest?
- Sodium - Potassium - Calcium - Magnesium
50
What are two major causes for hypercalcemia?
- Cancer | - Hyperparathyroidism
51
What is the normal phosphorus range?
2.5-4.5 mg/dL.
52
What are two common causes for hyperphosphatemia?
- Impaired kidney excretion | - Hypoparathyroidism
53
What should a nursing assessment r/t fluid and electrolyte imbalance include?
- History - Physical assessment - I & O - Daily weights - Lab studies
54
For fluid and electrolyte imbalances, what does an increased hematocrit value indicate?
- Severe FVD | - Shock
55
For fluid and electrolyte imbalances, what does a decreased hematocrit value indicate?
- Acute, massive blood loss - Hemolytic reaction to blood transfusion - Fluid overload
56
For fluid and electrolyte imbalances, what does an increased hemoglobin value indicate?
Hemoconcentration in blood.
57
For fluid and electrolyte imbalances, what does a decreased hemoglobin value indicate?
- Anemia states - Severe hemorrhage - Post-hemolytic reaction
58
What does an increased BUN value indicate?
- Impaired renal function - Diabetic keto-acidosis - Burns
59
What does an increased creatinine value indicate?
- Impaired renal function - Heart failure - Shock - Dehydration
60
What is the normal pH range for urine?
4.6-8.2.
61
What is the normal specific gravity range for urine?
1.005-1.030.
62
What does an increased specific gravity value in urine indicate?
- Dehydration - Vomiting - Diarrhea - Heart failure
63
What does a decreased specific gravity value in urine indicate?
- Renal damage | - Drug effects
64
What are complications of IV therapy?
- Infiltration - Extravasation - Phlebitis - Thrombophlebitis - Infection
65
*******Look at IV solutions.***********
Table 39-11.
66
******Review pages*****
1593-1597 for blood transfusion therapy
67
What type of foods do you eat for FVD?
- Foods with high water content - Citrus - Melons - Celery
68
What type of foods do you eat for hypokalemia?
- Bananas - Citrus fruits - Apricots - Melons - Broccoli - Potatoes - Raisins - Lima beans
69
What type of foods do you avoid for hypernatremia?
- Processed cheese - Lunch meats - Canned soups and vegetables - Salted snack foods
70
What is Edema?
Excessive fluids in interstitial spaces.
71
What is an expected finding for hypovolemia?
- Tachycardia - Syncope - Decreased skin turgor
72
What osmolarity level is indicative of dehydration?
Blood osmolarity greater than 295 mOsm/kg.
73
What is sodium's function in the body?
- Maintaining acid-base and fluid balance - Active and passive transport mechanisms - Irritability and conduction of nerve and muscle tissue
74
Which electrolyte should you never IV bolus due to risk of cardiac arrest?
Potassium.
75
Which diuretic do you administer to increase potassium excretion?
Furosemide.
76
What are some interventions for hypocalcemia?
- Initiate seizure and fall precautions | - Keep emergency equipment on standby
77
Which foods are high in magnesium?
- Whole grains | - Dark green vegetables
78
What are some interventions for hypokalemia?
- Monitor for cardiac dysrhythmia - Monitor for shallow/ineffective respirations - Encourage consumption of bananas/avocados/cantaloupe - Ensure underlying cause is corrected
79
What are some symptoms of hypercalcemia?
- Confusion - Bone pain - Nausea and vomiting
80
What are the primary extracellular electrolytes?
- Sodium - Chloride - Bicarbonate
81
Which electrolytes are cations?
- Magneisum - Potassium - Calcium

Nursing School (25 decks)

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