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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
Hypokalemia
- <3.5mmol/L - Not consuming enough K - Loss (vomit, GI suction, sweat) - Medications that move K (diuretics, insulin (K+ move into cell)
26
Hyperkalemia
- >5.0 - Excessive intake - Renal failure - Medications that retain (ACE inhibitors, sparing diuretics, NSAIDs)
27
Hyponatremia Causes
- <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
28
Hypernatremia Causes
- Overconsumption - Syndromes that causes high cortisol/aldosterone = retain Na - Water loss - Increase serum osmolality - Cellular dehydration
29
Hyponatremia Interventions
- Isotonic (non-severe) - Na+ fluids <120 - Normal/excess fluids: meds (diuretics promote water loss)
30
Hypernatremia Interventions
- Health teaching - Na restricted diet - Administer IV infusion - volume loss (hypotonic/isotonic) - Meds (diuretics promote Na loss - loop)
31
PIV Selection
- Access to upper extremity - Short term therapy <7 days - Monitor for repeated failed/loss access
32
PICC
- Enters body on upper arm - Catheter runs to superior vena cava - Very common in clinical settings - RNs can insert & remove - Medium term use
33
Non-Tunneled CVAD
- Enters body at vessel site (internal/external jugular, subclavian, femoral) - Catheter outside body at injection site - Common in critical care (shorter term)
34
Increased CO2
- Decreased RR - Acidosis - CNS depression, lung health issues
35
Decreased CO2
- Increased RR - Alkalosis - Hyperventilation
36
Acidosis Compensation
Increased RR to blow off CO2
37
Alkalosis Compensation
Decreased RR to retain CO2
38
Respiratory Acidosis
Low pH high CO2
39
Respiratory Acidosis Causes
- Deficits in lung function = retain CO2 - Airway obstruction, depression of resp system
40
Respiratory Acidosis Signs/Symptoms
- Hypoventilation - Shallow resps - Low RR
41
Respiratory Alkalosis
High pH low CO2
42
Respiratory Alkalosis Causes
- Increase in RR, blow of CO2 - Panic attack
43
Respiratory Alkalosis Signs/Symptoms
- Hyperventilation - Increased RR
44
Decreased H+
- Alkalosis - At risk: upper GI losses, loss of acid
45
Decreased HCO3-/Increased H+
- Acidosis - At risk: lower GI, loss of base, kidney failure, inappropriate secretion of base/retention of H+
46
Acidosis Compensation
- Increased H+ secretion - Urine output
47
Alkalosis Compensation
- Increased HCO3- secretion - Urine output
48
Metabolic Acidosis
Low pH & low HCO3-
49
Metabolic Acidosis Causes
- Lower GI losses = loss of bicarb - Kidney failure = inappropriate secretion of bicarb
50
Metabolic Acidosis Signs/Symptoms
- Diarrhea - Kidney failure - Compensation by resp system to get rid of acid = increased RR
51
Metabolic Alkalosis
Hight pH & high HCO3
52
Metabolic Alkalosis Causes
Upper GI losses = loss of H+
53
Metabolic Alkalosis Signs/Symptoms
- Vomiting, high volume of GI suction - S/S kidney failure - Compensation by resp - retain acid to bring back neutral decrease RR
54
Uncompensated
- pH abnormal - Other measure normal
55
Partially Compensated
- pH abnormal - Other measure abnormal + opposite
56
Fully Compensated
- pH normal - Measures (1 or both abnormal)
57
High RBCs
- Erythrocytosis - Chronic hypoxia - Increase erythropoietin
58
Low RBCs
- Anemias - Loss/destruction of RBCs - Decrease erythropoietin - Bone marrow suppression (cancers & chemotherapy)
59
Low Hemoglobin
- Anemias - Loss/destruction of RBCs - Decrease erythropoietin - Bone marrow suppression (cancers & chemotherapy)
60
High Hematocrit
- Fluid deficit - High concentration of RBC due to lack of fluid
61
Low Hematocrit
- Fluid excess - RBCs diluted due to excess fluid
62
High WBCs
- Leukocytosis - Infection
63
Low WBCs
- Leukopenia - Immunosuppression
64
High Platelets
- Thrombocytosis - Clotting
65
Low Platelets
- Thrombocytopenia - Bleeding
66
Low PT/INR
- Blood takes longer to clot - Bleeding risk - Thinner blood
67
High PT/INR
Quick clotting
68
Group/Type & Screen
- Identified patient blood type, always required - Exception, emergency give universal donor O-
69
Crossmatch
- Tests patients blood with donor blood - Required for all transfusions that are non-emergent/urgent - Decrease risk of reaction
70
Transfusion MUSTS
- Start transfusion within 30 minutes of picking up blood - Independent double check of blood (2 registered staff) - Finish within 4 hours
71
Packed Red Blood Cells Major Uses
- Most common type of transfusion - Bleeding/anemia
72
Pack Red Blood Cells Administration
- Blood tubing required - Typically infuse over 1.5-2hours - Slower infusion for patients at risk for circulatory overload
73
PRBCs Impact
- Changes to Hemoglobin 4-6hrs post transfusion - 1 unit of PRBCs typically = increase 10g/L Hbg 3%Hct - No increase, think bleeding
74
Fresh Frozen Plasma Uses
- Volume expansion - massive transfusion with PRBCs - Clotting factors, coagulopathy, plasma exchange
75
Fresh Frozen Plasma Administration
- Blood tubing required - 30mins-2 hours
76
Platelets Uses
- Control/prevent bleeding - Low platelet counts - Congenital platelet dysfunction - Poor function of platelets - medications - Post cardiopulmonary bypass
77
Platelet Administration
- Blood tubing required - Infuse over 60mins
78
S/S of Transfusion Reaction
- 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
Minor Allergic Reaction
- Reaction to allergen in the blood component/product - Mild rash, itching, warm - Administer antihistamines - Slow transfusion - Most common reaction
80
Anaphylaxis
- Potentially fatal - Emergency, difficulty breathing, loss of airway, hives - Stop transfusion
81
Febrile Non-Hemolytic
- Self-limit reaction associated with donor WBCs/cytokines - Mild fever, rigors - Administer antipyretics - Slow transfusion
82
Bacterial Sepsis - Platelet Pool & RBCs
- Potentially fatal, bacteria introduced to blood - Room temp storage - Platelets more common - Emergency - Stop transfusion
83
Acute Hemolytic Transfusion Reaction
- Potentially fatal, blood group incompatibility - Emergency, hypotension, back pain, fever - Stop transfusion
84
Transfusion Related Acute Lung Injury TRALI
- Acute hypoxemia, no evidence of circulatory overload - Emergency, dyspnea & tachypnea, SpO2 below 90% - Stop transfusion
85
Transfusion Associated Circulatory Overload TACO
- 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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