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Nursing Fundamentals > Fluid & Electrolytes > Flashcards

Fluid & Electrolytes Flashcards

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1
Q

Normal urine output rate

A

1 ml/kg/hour

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2
Q

What is a normal hourly urine output?

A

40-80 ml/hour

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3
Q

What is urine output during illness?

A

~ 0.5 ml/kg/hour

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4
Q

Intercellular Fluid

A

Fluid located within cells

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5
Q

Extracellular Fluid

A

Fluid outside of cells

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6
Q

Intravascular fluid

A

Fluid within blood vessels and Lymphatic vessels

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7
Q

Interstitial or extracellular Fluid

A

Fluid found between cells

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8
Q

How is fluid balanced achieved?

A

Fluid and electrolytes flows between IVS, EXCS, ICS to maintain homeostasis

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9
Q

What are some things that can effect fluid and electrolyte balance?

A

Treatments or disorders can disrupt fluid/electrolyte balance

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10
Q

Electrolytes

A

Electrically charged ions that become so by being broken down/dissolved in a solution

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11
Q

What are two major electrolytes?

A

Na+ and K+

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12
Q

What is Na+ normal range?

A

125-135 mEq/L

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13
Q

List functions of Na+

A
  1. Control/regulate water balance
  2. Maintain acid:base balance
  3. Muscle contraction
  4. Transmit nerve impulses
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14
Q

List risk factors that can lead to HYPOnatremia

A
  1. Decreased Na+ intake
  2. Increased fluid intake (oral or HYPOtonic solutions)
  3. SIADH
  4. HF
  5. Diarrhea/vomiting
  6. NG sxn
  7. Diuretics
  8. Impaired kidney fnxn
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15
Q

List risk factors leading to HYPERnatremia

A
  1. Increased Na+ intake
  2. Dehydration
  3. Sweating
  4. Diabetes Insipudus(dehydration occurs due to increased urine output = high sodium volume)
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16
Q

What are some SxS that HYPOnatremia and HYPERnatremia share?

A
  • Confusion
  • Irritable
  • Lethargic
  • Restless
  • Siezures
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17
Q

What are SxS of HYPOnatremia?

A
  • Muscle cramps
  • weakness
  • USG < 1.010
  • Shared sxs = Lethargy, confusion, restless, irritable, and seizures
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18
Q

What are SxS of HYPERnatremia?

A
  • Dry muc. membrane
  • Thirst
  • Increased body temp
  • USG> 1.015
  • Shared SxS: Lethargy, restless, confused, irritable, seizures
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19
Q

List nursing interventions for HYPOnatremia

A
  1. Remove cause whenever possible
  2. Restrict Oral/IV fluids
  3. Hypertonic soln. ( 3% NS)
  4. Increase sodium intake in diet
  5. Implement seizure precautions
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20
Q

List nursing interventions for HYPERnatremia

A
  1. Eliminate cause if possible
  2. Decrease sodium intake
  3. Hypotonic solution (0.45 NS or D5W) to decrease sodium levels
  4. Diuretics to excrete sodium
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21
Q

List functions of Chloride

A
  1. Maintain osmotic pressure

2. Maintain acid base balance

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22
Q

What increases Cl- levels? What decreases Cl- levels?

A

Increased levels: with poor kidney function

Decreased levels: excessive vomit/diarrhea

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23
Q

What is the normal range for Chloride?

A

95-105 mEq/L

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24
Q

What is the normal range for K+?

A

3.5-5.0 mEq/L

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25
Q

What are functions of potassium?

A
  1. Maintain water balance
  2. Carbohydrate and protein metabolism
  3. Regulate acid:base balance
  4. Transmit nerve impulses to heart, skeletal muscle, intestinal muscle and lungs
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26
Q

What are risk factors that contribute to HYPOkalemia?

A
  1. Decreased K+ intake
  2. K+ wasting Diuretics
  3. NG sxn
  4. Diarrhea/Vomitting
  5. Laxatives
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27
Q

What are some risk factors of HYPERkalemia?

A
  1. Increases K+ intake
  2. K+ sparing diuretics
  3. ACE inhibitors
  4. Decreased kidney function
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28
Q

What SxS do HYPERkalemia and HYPOkalemia have in common?

A
  1. Arrhythmias

2. Muscle weakness

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29
Q

What are SxS of HYPOkalemia?

A
  1. Muscle cramping
  2. FLAT T wave on EKG
  3. Decrease in peristalsis
  4. Shared SxS: Arrhythmias and muscle weakness
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30
Q

What are SxS of HYPERkalemia?

A
  1. Tall/peaked T wave on EKG
  2. Paralysis
  3. Paresthesia of face, tongue, hands, and feet
  4. Shared SxS: Arrhythmias and muscle weakness
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31
Q

List nursing interventions for HYPOkalemia

A
  1. Remove cause if possible
  2. K+ supplements: oral or IV
  3. Increase K+ in diet
  4. Assess renal function (BUN,Cre, and GFR) before administering
  5. Assess SxS digoxin toxicity
  6. Teach proper laxative or diuretic use
  7. Monitor cardiac rhythm
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32
Q

List nurse interventions for HYPERkalemia

A
  1. Monitor cardiac rhythm
  2. Restrict K+ intake in diet
  3. Discontinue K+ supplements
  4. Administer Kayexalate(treat high levels of K+)
  5. Administer K+ wasting diuretics
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33
Q

What is the normal range for Calcium?

A

8.4-10.6 mEq/L

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34
Q

What are functions of calcium?

A
  1. Transmit nerve impulses
  2. Heart & muscle contractions/relaxation
  3. Blood clotting
  4. Formation of teeth and bones
35
Q

What are dietary sources of Calcium?

A
  • Milk and milk products
  • green leafy veggies
  • dried beans
  • dried peas
  • fish with bones
36
Q

What are dietary sources of K+?

A
  • fruits
  • veggies
  • whole grains
  • milk
  • meat
  • dried peas/beans
37
Q

What are dietary sources of Na+?

A
  • sodium preservatives
  • salt in processed foods
  • beef broth
  • tomato juice
38
Q

What are dietary sources of Magnesium?

A
  • leafy greens
  • nuts
  • seafood
  • whole grains
  • dry peas/beans
  • cocoa
39
Q

How is sodium gained and lost in the body?

A

Sodium is GAINED through diet and LOST through the GI tract, kidneys, and skin

40
Q

How is K+ gained and lost in the body?

A

GAINED by dietary sources and LOST by vomit, diarrhea, and kidneys

41
Q

How is Calcium gained and lost in body?

A

GAINED through dietary sources and LOST through feces/urine

42
Q

What are risk factors for HYPOcalcemia?

A
  • decreased calcium intake
  • vitamin D deficiency
  • malabsorption (A condition that prevents absorption of nutrients through the small intestine)
  • loop diuretics
43
Q

What are risk factors of HYPERcalcemia?

A
  • increased calcium intake
  • increased vitamin D intake
  • bone cancer
  • thiazides
  • prolonged immobilization
44
Q

What are SXS of HYPOcalcemia?

A
  • trousseau (contraction of face muscle when tapping facial nerve anterior of ear) and Chvostek (inversion of hand when inflating BP cuff for 3 mins)
  • numbness and tingling in fingers
  • spasm of laryngeal muscles
  • bone fractures
  • seizures
  • Shared SxS: Arrhythmias
45
Q

What is a shared SxS of HYPERcalcemia and HYPOcalcemia?

A

Arrhythmias

46
Q

What are SxS of HYPERcalcemia?

A
  • constipation
  • renal stones
  • muscle weakness
47
Q

What are nursing interventions for HYPOcalcemia?

A
  1. Remove cause when possible
  2. Increase Ca2+ and Vitamin D in diet
  3. Administer Ca2+ supplements (oral or IV) w/ OJ to increase absorption
  4. Monitor cardiac rhythm
  5. Monitor airway (laryngeal spasm possible)
  6. Seizure precautions
48
Q

What are nursing interventions for HYPERcalcemia?

A
  1. Restrict calcium intake in diet
  2. Increase fluid intake (will decrease Ca2+ levels and decrease chance of constipation and kidney stones)
  3. Hypotonic IV 0.45% NS to decrease Ca2+ levels
  4. Loop diuretics
  5. Increase physical activity to promote Ca2+ uptake into bones
49
Q

What is the normal range of Magnesium?

A

1.6-2.0 mEq/L

50
Q

What are some functions of Magnesium?

A
  1. Metabolize carbohydrates and proteins
  2. C.V function (vasodilation)
  3. Electrical activity in nervous tissue and muscle membranes
51
Q

What are risk factors for HYPOmagnesemia?

A
  • decreased mg2+ intake
  • malabsorption
  • Diarrhea/vomit
  • NG sxn
  • Thiazides
52
Q

What are SxS of HYPOmagnesemia?

A
  • tachycardia
  • HTN
  • mood swings
  • confusion
  • increased deep tendon reflexes
53
Q

What is a shared SXS of HYPOmagnesemia and HYPERmagnesemia?

A

Arrhythmias

54
Q

What are nursing interventions of HYPOmagnesemia?

A
  • Increase Mg2+ intake

- shared NI: monitor cardiac rhythm, BP/HR, and monitor DT reflexes

55
Q

What are some shared nursing interventions of HYPOmagnesemia and HYPOmagnesemia?

A
  • Monitor DT reflexes

- monitor cardiac rhythm, and BP/HR

56
Q

What are risk factors of HYPERmagnesemia?

A
  • increased Mg2+ intake

- decreased kidney fnxn

57
Q

What are some SXS of HYPERmagnesemia?

A
  • Bradycardia
  • Hypotension
  • Decreased RR
  • Decreased or absent DT reflexes
  • facial flushing
58
Q

What are some nursing interventions for HYPERmagnesemia?

A

-monitor airway (due to possible impaired breathing)

Shared SxS: monitor cardiac rhythm, HR/BP, and DT reflexes

59
Q

Hypervolemia

A

Also called “Fluid volume excess”; this happens when you consume high amounts of water and salt, causing fluid retention

60
Q

Hypovolemia

A

Also called “Fluid volume excess”— occurs from decreased fluid intake, which causes loss of body fluids.

61
Q

Sensible fluid loss and examples

A

Fluid that is lost that is measurable. Some examples include urine, NG suction drainage, vomit, diarrhea, wound drainage

62
Q

Insensible fluid loss

A

This is fluid loss that is not able to be measured. Some examples are fluid loss by exhalation or fluid loss from skin(sweating)

63
Q

What are dietary sources of Sodium?

A

Sodium preservatives
Tomato juice
Beef broth
Processed foods

64
Q

What are dietary sources of calcium?

A

Milk/milk products, leafy green veggies, fish w/bones, dried peas/beans

65
Q

What are dietary sources of Potassium?

A

Meat, dried peas/beans, milk, fruits, veggies, whole grains

66
Q

What are dietary sources of magnesium?

A

Nuts, seafood, leafy green veggies, whole grains, dried peas/beans, cocoa

67
Q

food sources of sodium

A

Sodium preservatives
Salt in processed foods
Beef broth
Tomato juice

68
Q

Food sources of potassium

A 
Fruits 
Veggies 
Whole grains
Milk 
Dried peas/beans
69
Q

Food sources of calcium

A

Milk or milk prods
Green leafy veggies
Dried beans/peas
Fish w/bones

70
Q

Food sources of magnesium

A 
Leafy greens 
Nuts 
Seafood 
Whole grains 
Dried peas/beans 
Cocoa
71
Q

Functions of phosphorus

A
  1. Acid base balance
  2. Nerve and muscle contraction
  3. Required for vitamin B + carbohydrate metabolism
72
Q

What is the relationship between phosphorus and calcium?

A

They are inversely related. If someone has hyperphosphatemia, then they will have low calcium levels.

73
Q

Risk factors of hypophosatemia

A
  1. Total parenteral nutrition

2. Decreased phosphorus intake

74
Q

Risk factors of hyperphosphatemia

A
  1. Decreased kidney function
  2. Increased milk intake
  3. Increased vitamin D
  4. Excessive fleets enema use
75
Q

List SxS of hypophosphetemia

A

Respiratory failure

Due to poor contractility of diaphragm and Arrhythmias

76
Q

Nursing interventions for hypophosphatemia

A
  1. Monitor heart rhythm
  2. Monitor respiratory suction
  3. Administer TPN (prevent referring syndrome)— ability for body to process food is compromised when someone goes into starvation; commonly caused by decrease in electrolytes such as phosphorus
  4. Administer phosphorus via IV
  5. Monitor calcium (sudden spike in phosphorus = HYPOcalcemia
77
Q

What is a shared SXS of hyperphosphatemia and hypophosphetemia?

A

Arrhythmias

78
Q

SxS of hyperphosphatemia

A

Few clinical signs but will reflect SXS HYPOcalcemia due to inverse relationship

  • Tross/chvst signs
  • numbness/tingling of fingers, toes,
  • spasm of laryngeal muscles
  • Arrhythmias
79
Q

Nursing interventions for hyperphosphatemia

A
  1. Decrease phosphorus intake
  2. Monitor muscle tetany
  3. Monitor airway (possible laryngeal spasm)
  4. Teach proper laxative use (laxatives may contain phosphorus)
80
Q

What vitamin helps absorb calcium in body

A

Vitamin D helps body absorb calcium

81
Q

Nursing interventions for cognitive impairment

A

Speak calm, slow, clear
Face to face
Emphasize strengths

82
Q

Nursing interventions for unconscious patients

A

Notify before touching

Talk in normal tone

83
Q

Nurse interventions for language barriers

A

Interpret telephone
Family for non medical translation
In person interpreter

84
Q

Does HYPOkalemia increase or decrease chance of dig toxicity

A

It increases risk of Dig toxicity bc drug needs K+ to bind to Dig receptors (not able to bind so levels in blood are toxic)

Nursing Fundamentals (8 decks)

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