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3910 Health Promotion & Caring: Client's with Health Challenges I > Fluid Electrolyte Review > Flashcards

Fluid Electrolyte Review Flashcards

1
Q

Renin-Angiotensin-Aldosterone System RAAS

A
  • Decrease perfusion to kidneys = renin release
  • Renin converts angiotensinogen to angiotensin 1 in blood
  • Ang 1 converts to Ang 2 in the lungs
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2
Q

Atrial Natriuretic Peptide (ANP)

A

Inhibits RAAS when in a state of overdrive

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3
Q

Antidiuretic Hormone (ADH)

A
  • Changes blood osmolarity
  • Stimulate ADH from pituitary
  • ADH stimulates water retention from kidneys
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4
Q

Hypovolemia Causes

A
  • Insufficient intake
  • Excessive loss
  • Fluid shifts in body
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5
Q

Hypervolemia Causes

A
  • Excessive intake
  • Abnormal retention - kidney/heart failure
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6
Q

Intravascular Space Overload

A
  • Raise BP
  • Stress on systems
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7
Q

Intravascular Space Deficit

A
  • Difficulty perfusing body
  • Systems activate to raise BP
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8
Q

Cardiovascular Hypovolemia Findings

A
  • Increased HR
  • Thready pulse
  • Decreased BP - orthostatic hypotension
  • Flat veins
  • Dysrhythmias
  • Decreased peripheral pulses
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9
Q

Respiratory Hypovolemia Findings

A
  • Increased RR
  • Dyspnea
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10
Q

Neuromuscular Hypovolemia Findings

A
  • Confusion
  • Dizziness, weakness, lethargy
  • Decreased LOC - coma
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11
Q

Integumentary Hypovolemia Findings

A
  • Dry mouth
  • Poor skin turgor - tearing
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12
Q

GI Hypovolemia Findings

A
  • Decreased bowel sounds & motility
  • Constipation
  • Weight loss
  • Thirst
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13
Q

Cardiovascular Hypervolemia Findings

A
  • Increased HR
  • Bounding pulse
  • Increased BP
  • Distended veins
  • Dysrhythmias
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14
Q

Respiratory Hypervolemia Findings

A
  • Increased RR
  • Dyspnea
  • Crackles on auscultation
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15
Q

Neuromuscular Hypervolemia Findings

A
  • Confusion
  • Headache
  • Decreased LOC - coma
  • Muscle spasms (electrolytes)
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16
Q

Integumentary Hypervolemia Findings

A
  • Cool, pale skin
  • Edema
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17
Q

GI Hypervolemia Findings

A
  • Increased bowel sounds & motility
  • Diarrhea
  • Weight gain
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18
Q

Furosemide (Lasix) Action

A
  • Increases renal excretion
  • Mobilize excess fluid
  • Decreases BP
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19
Q

Furosemide (Lasix) Side Effects

A
  • Dizziness
  • Headache
  • Hypotension
  • Electrolyte imbalance
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20
Q

Furosemide (Lasix) Nursing Considerations

A
  • Fall risk of older clients
  • Electrolyte imbalance
  • Pre-existing kidney function & impact
  • Monitor weight
  • Avoid taking at night nocturnal urination disrupts sleep
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21
Q

Shock

A
  • Body is not getting enough blood flow
  • Fluid volume deficit - hypovolemic shock
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22
Q

Compensatory Shock Symptoms

A
  • Normal BP
  • Increased HR & RR
  • Blood shunting to vital organs
  • Pale skin
  • Hypoactive bowel sounds
  • Decrease urine output
  • Confusion
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23
Q

Progressive Shock Symptoms

A
  • Decrease BP
  • Decrease LOC
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24
Q

Hypovolemic Shock

A
  • Decreased intravascular fluid volume
  • External fluid losses
  • Fluid shifts between intravascular & interstitial compartments (internal fluid losses)
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25
Q

Hypokalemia

A
  • <3.5mmol/L
  • Not consuming enough K
  • Loss (vomit, GI suction, sweat)
  • Medications that move K (diuretics, insulin (K+ move into cell)
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26
Q

Hyperkalemia

A
  • > 5.0
  • Excessive intake
  • Renal failure
  • Medications that retain (ACE inhibitors, sparing diuretics, NSAIDs)
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27
Q

Hyponatremia Causes

A
  • <135mmol/L
  • Not consuming enough Na
  • Hypovolemic - excessive losses, diuretics, vomiting, sweating
  • Hypervolemic - excess fluid dilutes sodium
  • Decrease serum osmolality
  • Cells swell as water moves in
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28
Q

Hypernatremia Causes

A
  • Overconsumption
  • Syndromes that causes high cortisol/aldosterone = retain Na
  • Water loss
  • Increase serum osmolality
  • Cellular dehydration
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29
Q

Hyponatremia Interventions

A
  • Isotonic (non-severe)
  • Na+ fluids <120
  • Normal/excess fluids: meds (diuretics promote water loss)
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30
Q

Hypernatremia Interventions

A
  • Health teaching - Na restricted diet
  • Administer IV infusion - volume loss (hypotonic/isotonic)
  • Meds (diuretics promote Na loss - loop)
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31
Q

PIV Selection

A
  • Access to upper extremity
  • Short term therapy <7 days
  • Monitor for repeated failed/loss access
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32
Q

PICC

A
  • Enters body on upper arm
  • Catheter runs to superior vena cava
  • Very common in clinical settings
  • RNs can insert & remove
  • Medium term use
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33
Q

Non-Tunneled CVAD

A
  • Enters body at vessel site (internal/external jugular, subclavian, femoral)
  • Catheter outside body at injection site
  • Common in critical care (shorter term)
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34
Q

Increased CO2

A
  • Decreased RR
  • Acidosis
  • CNS depression, lung health issues
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35
Q

Decreased CO2

A
  • Increased RR
  • Alkalosis
  • Hyperventilation
36
Q

Acidosis Compensation

A

Increased RR to blow off CO2

37
Q

Alkalosis Compensation

A

Decreased RR to retain CO2

38
Q

Respiratory Acidosis

A

Low pH high CO2

39
Q

Respiratory Acidosis Causes

A
  • Deficits in lung function = retain CO2
  • Airway obstruction, depression of resp system
40
Q

Respiratory Acidosis Signs/Symptoms

A
  • Hypoventilation
  • Shallow resps
  • Low RR
41
Q

Respiratory Alkalosis

A

High pH low CO2

42
Q

Respiratory Alkalosis Causes

A
  • Increase in RR, blow of CO2
  • Panic attack
43
Q

Respiratory Alkalosis Signs/Symptoms

A
  • Hyperventilation
  • Increased RR
44
Q

Decreased H+

A
  • Alkalosis
  • At risk: upper GI losses, loss of acid
45
Q

Decreased HCO3-/Increased H+

A
  • Acidosis
  • At risk: lower GI, loss of base, kidney failure, inappropriate secretion of base/retention of H+
46
Q

Acidosis Compensation

A
  • Increased H+ secretion
  • Urine output
47
Q

Alkalosis Compensation

A
  • Increased HCO3- secretion
  • Urine output
48
Q

Metabolic Acidosis

A

Low pH & low HCO3-

49
Q

Metabolic Acidosis Causes

A
  • Lower GI losses = loss of bicarb
  • Kidney failure = inappropriate secretion of bicarb
50
Q

Metabolic Acidosis Signs/Symptoms

A
  • Diarrhea
  • Kidney failure
  • Compensation by resp system to get rid of acid = increased RR
51
Q

Metabolic Alkalosis

A

Hight pH & high HCO3

52
Q

Metabolic Alkalosis Causes

A

Upper GI losses = loss of H+

53
Q

Metabolic Alkalosis Signs/Symptoms

A
  • Vomiting, high volume of GI suction
  • S/S kidney failure
  • Compensation by resp - retain acid to bring back neutral decrease RR
54
Q

Uncompensated

A
  • pH abnormal
  • Other measure normal
55
Q

Partially Compensated

A
  • pH abnormal
  • Other measure abnormal + opposite
56
Q

Fully Compensated

A
  • pH normal
  • Measures (1 or both abnormal)
57
Q

High RBCs

A
  • Erythrocytosis
  • Chronic hypoxia
  • Increase erythropoietin
58
Q

Low RBCs

A
  • Anemias
  • Loss/destruction of RBCs
  • Decrease erythropoietin
  • Bone marrow suppression (cancers & chemotherapy)
59
Q

Low Hemoglobin

A
  • Anemias
  • Loss/destruction of RBCs
  • Decrease erythropoietin
  • Bone marrow suppression (cancers & chemotherapy)
60
Q

High Hematocrit

A
  • Fluid deficit
  • High concentration of RBC due to lack of fluid
61
Q

Low Hematocrit

A
  • Fluid excess
  • RBCs diluted due to excess fluid
62
Q

High WBCs

A
  • Leukocytosis
  • Infection
63
Q

Low WBCs

A
  • Leukopenia
  • Immunosuppression
64
Q

High Platelets

A
  • Thrombocytosis
  • Clotting
65
Q

Low Platelets

A
  • Thrombocytopenia
  • Bleeding
66
Q

Low PT/INR

A
  • Blood takes longer to clot
  • Bleeding risk
  • Thinner blood
67
Q

High PT/INR

A

Quick clotting

68
Q

Group/Type & Screen

A
  • Identified patient blood type, always required
  • Exception, emergency give universal donor O-
69
Q

Crossmatch

A
  • Tests patients blood with donor blood
  • Required for all transfusions that are non-emergent/urgent
  • Decrease risk of reaction
70
Q

Transfusion MUSTS

A
  • Start transfusion within 30 minutes of picking up blood
  • Independent double check of blood (2 registered staff)
  • Finish within 4 hours
71
Q

Packed Red Blood Cells Major Uses

A
  • Most common type of transfusion
  • Bleeding/anemia
72
Q

Pack Red Blood Cells Administration

A
  • Blood tubing required
  • Typically infuse over 1.5-2hours
  • Slower infusion for patients at risk for circulatory overload
73
Q

PRBCs Impact

A
  • Changes to Hemoglobin 4-6hrs post transfusion
  • 1 unit of PRBCs typically = increase 10g/L Hbg 3%Hct
  • No increase, think bleeding
74
Q

Fresh Frozen Plasma Uses

A
  • Volume expansion - massive transfusion with PRBCs
  • Clotting factors, coagulopathy, plasma exchange
75
Q

Fresh Frozen Plasma Administration

A
  • Blood tubing required
  • 30mins-2 hours
76
Q

Platelets Uses

A
  • Control/prevent bleeding
  • Low platelet counts
  • Congenital platelet dysfunction
  • Poor function of platelets - medications
  • Post cardiopulmonary bypass
77
Q

Platelet Administration

A
  • Blood tubing required
  • Infuse over 60mins
78
Q

S/S of Transfusion Reaction

A
  • Within 6 hours post transfusion
  • Change in body temp*****
  • Shaking, chills, rigors
  • Hives, rash, itchiness, swelling
  • Dyspnea, SOB, wheezing
  • Hypo/hypertension
  • Hematuria, diffuse bleeding
  • Pain at IV site
  • Nausea, vomit
  • Headache
79
Q

Minor Allergic Reaction

A
  • Reaction to allergen in the blood component/product
  • Mild rash, itching, warm
  • Administer antihistamines
  • Slow transfusion
  • Most common reaction
80
Q

Anaphylaxis

A
  • Potentially fatal
  • Emergency, difficulty breathing, loss of airway, hives
  • Stop transfusion
81
Q

Febrile Non-Hemolytic

A
  • Self-limit reaction associated with donor WBCs/cytokines
  • Mild fever, rigors
  • Administer antipyretics
  • Slow transfusion
82
Q

Bacterial Sepsis - Platelet Pool & RBCs

A
  • Potentially fatal, bacteria introduced to blood
  • Room temp storage - Platelets more common
  • Emergency
  • Stop transfusion
83
Q

Acute Hemolytic Transfusion Reaction

A
  • Potentially fatal, blood group incompatibility
  • Emergency, hypotension, back pain, fever
  • Stop transfusion
84
Q

Transfusion Related Acute Lung Injury TRALI

A
  • Acute hypoxemia, no evidence of circulatory overload
  • Emergency, dyspnea & tachypnea, SpO2 below 90%
  • Stop transfusion
85
Q

Transfusion Associated Circulatory Overload TACO

A
  • Due to rapid transfusion
  • Mild fluid volume overload symptoms - Tachycardia, hypotension, SpO2 drops
  • Administer diuretics
  • Prevent by transfusing very slowly

3910 Health Promotion & Caring: Client's with Health Challenges I (15 decks)

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