Fluid & Electrolytes Flashcards
1
Q
causes of fluid imbalances
A
Vomiting, excessive wound drainage, hemorrhaging
2
Q
Causes of dehydration
A
vomiting, diarrhea, hemorrhage, burns, GI suction, fever, difficulty swallowing, impaired motor function
3
Q
Causes of fluid overload
A
kidney failure, HF, excess fluid replacements, over-secretion of ADH
4
Q
Acidosis
A
pH below 7.35
5
Q
Alkalosis
A
pH above 7.45
6
Q
Normal sodium range
A
136-145
7
Q
hyponatremia
A
sodium level below 136
8
Q
Hypernatremia
A
sodium level above 145
9
Q
Normal potassium range
A
3.5-5.0
10
Q
Hypokalemia
A
potassium below 3.5
11
Q
Hyperkalemia
A
potassium above 5.0
12
Q
Calcium normal range
A
9-10.5
13
Q
Foods high in calcium
A
milk, yogurt, ice cream, cheese, green leafy vegetables, whole grains
14
Q
Hypocalcemia
A
Calcium below 9.0
15
Q
Causes of hypocalcemia
A
- lactose intolerance
- end stage renal failure
- diarrhea
- immobility
- alcoholic
- elevated phosphorus
- malabsorption (ex. Crohn’s disease)
16
Q
Signs & symptoms of hypocalcemia
A
- painful muscle spasms/cramps
- paresthesia
- easily fractured bones
- positive Trousseau’s and Chvostek’s test
- increased peristalsis
17
Q
Interventions for hypocalcemia
A
- supplements (give vitamin D too)
- tums
- eat foods with calcium
- keep room quiet & dark
- safety precautions to prevent fractures
18
Q
Hypercalcemia
A
calcium above 10.5
19
Q
Causes of hypercalcemia
A
- renal failure
- immobility
- dehydration
- malignancy (bone cancer)
20
Q
Signs & symptoms of hypercalcemia
A
- mild: increased HR and BP
- severe: slow HR
- poor perfusion, cyanosis, pallor
- DVT
- decreased peristalsis
21
Q
Interventions for hypercalcemia
A
- no Ca/vitamin D intake
- IV fluids (so kidneys can filter Ca out)
- furosemide
- monitor calcium
22
Q
Magnesium normal range
A
1.3-2.1
23
Q
What happens when magnesium is too high or low?
A
cardiac dysrhythmias
24
Q
Foods high in Mg
A
steak, nuts, green leafy vegetables, almonds, chocolate, dried beans
25
Hypomagnesemia
magnesium below 1.3
26
Causes of hypomagnesemia
- low intake
- diuretics (loop, furosemide, thiazide
- malabsorption
- diarrhea
- alcoholics - malnutrition
27
Signs & symptoms of hypomagnesemia
- dysrhythmias
- atherosclerosis
- severe paralytic ileus
28
Interventions for hypomagnesemia
give magnesium
29
Hypermagnesemia
magnesium above 2.1
30
Causes of hypermagnesemia
- increased intake
- excessive use of antacids & laxatives
- kidney disease
31
Signs & symptoms of hypermagnesemia
- bradycardia
- hypotension
- dysrhythmias
- lethargy
- weak muscle contraction
32
Interventions for hypermagnesemia
- loop diuretics (furosemide)
- reduce Mg intake
33
Furosemide (lasix)
- decreases K, Na, Cl, Mg
- decreases BP
- eat bananas, citrus, steak, sodium
- causes dehydration
- can mess up kidneys
34
Bumetanide (bumex)
- decreases Na, K, Mg, Ca
- controls edema
- decreases BP
35
Spironolactone (Aldactone)
- increases K
- decreases Na, Mg, Cl
- decreases BP
- give foods with sodium, steak, nuts
- NO salt substitutes
36
should you administer a diuretic to a patient whose Na is 137?
NO BITCH
37
how much does a liter of fluid weigh?
2.2 lbs
38
pts at risk for insensible water loss
high RR, continuous GI suction, severe diarrhea, fistula drainage, fever, burns, trauma
39
what should you assess for if a post op patient's urine output is only 20mL for 2 consecutive hours?
s/s of blood loss
40
why are older adults more prone to dehydration
decreased thirst sensation, decreased mobility, often take diuretics and/or laxatives
41
how will the body react to hypovolemia?
vasoconstriction to maintain BP - decreased perfusion
42
how will dehydration affect vital signs
increased HR and RR, decreased BP, +1 pulses
43
how will dehydration affect the skin?
dry mucous membranes, can cause skin tenting
44
first indicator of dehydration in older adults
changes in mental status
45
how will dehydration affect labs?
increased H&H, BUN & electrolytes
46
how would fluid overload affect vital signs?
+4 pulse, increased BP, increased RR
47
how would fluid overload affect labs?
decreased protein & H&H
48
assessment findings w fluid overload
weight gain, SOB, crackles, pitting edema, altered LOC, headache, skeletal muscle weakness, increased GI motility
49
for fluid overload patients, what med should they recieve?
diuretics
50
fluid overload interventions - respiratory
monitor RR, auscultate lung sounds, position in semi-fowlers, administer oxygen if needed
51
why is it important to reposition fluid overload pts q2h?
increased risk of skin breakdown
52
fluid overload interventions
daily weight, I&Os, monitor for edema, restrict fluid & sodium intake
53
deadly pH levels
below 6.8
above 7.8
54
first line of defense for pH changes in the body
chemical buffers
55
second line of defense for pH changes in the body
lungs/respiratory system
56
last resort for pH changes in the body
kidneys
57
how does the respiratory system maintain pH in the body?
lungs are quick acting but have temporary effects
regulates CO2 levels
58
how do the kidneys regulate pH in the body?
long-term effects, but acts slowly
either excretes or retains bicarb
59
foods high in sodium
processed, preserved, canned, smoked, or pickled foods, snack foods, condiments
60
foods low in sodium
fresh fish, poultry, fresh or frozen fruits & vegetables,
61
what is dilutional hyponatremia?
from excess water in the plasma
62
causes of dilutional hyponatremia
HF
63
what is actual hyponatremia?
actual deficit of sodium
64
causes of actual hyponatremia
diuretic administration, wound drains, low sodium diet, being NPO
65
very very low sodium will cause...
seizures, coma, death
66
s/s of hyponatremia
generalized muscle weakness, decreased respiratory effectiveness, increased GI motility
67
for dilution hyponatremia, will the BP increase or decrease?
increase - overloaded w fluids
68
interventions for dilution hyponatremia
increase dietary sodium/supplements, fluid restriction, diuretic (only if electrolytes are high enough)
69
for actual hyponatremia, will the BP increase or decrease
decrease - low volume
70
interventions for actual hyponatremia
give IV fluids, do NOT give diuretic, monitor BP, orthostatic hypotension
71
causes of actual hypernatremia
renal failure, Cushing's, excess oral intake
72
causes of relative hypernatremia
fever, infection, dehydration
73
how does hypernatremia affect skeletal muscle?
causes muscle twitching, as sodium continues to rise, the muscles will become weaker
74
how does hypernatremia affect the heart?
decreased contractility
75
how to treat hypernatremia from fluid loss
duh IV fluids (0.9% saline)
76
how to treat hyponatremia from renal failure
diuretic
77
foods high in potassium
fish, potatoes, tomatoes, fruit, bananas, citrus
78
how does renal failure affect level of potassium?
kidneys won't excrete K, will need dialysis to get rid of excess
79
s/s of hyperkalemia
respiratory & skeletal muscle weakness, dysrhythmias, impaired perfusion, decreased peristalsis
80
one important thing to remember about IV K
DO NOT PUSH
81
interventions for hypokalemia
increase K - dietary or supplemental, potassium-sparing diuretics only, monitor RR & SpO2, assess ability to cough, place on fall risk precautions
82
causes of hyperkalemia
renal failure; high dietary K - salt substitutes contain K; potassium-sparing diuretics
83
most common s/s of hyperkalemia
palpitations, paresthesia around hands/mouth, muscle twitching, increased GI motility
84
kayexalate (sodium polystyrene sulfonate)
oral or rectal; draws K into GI tract, then causes diarrhea
85
kayexalate indications
hyperkalemia
86
hyperkalemia interventions
administer sodium polystyrene sulfonate; discontinue IVs with K, hold K supplements/ foods high in K, give insulin
87
how does insulin affect potassium?
pulls K into cells - serum is lowered
88
foods low in potassium
eggs, bread, cereal
89
high amounts of what electrolyte can cause DVTs?
calcium
90
what could low albumin mean?
liver failure; poor nutrition
91
dietary sources of calcium
milk, yogurt, cheese, green leafy vegetables, whole grains
