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NSG 102 > Fluid & Electrolytes > Flashcards

Fluid & Electrolytes Flashcards

1
Q

causes of fluid imbalances

A

Vomiting, excessive wound drainage, hemorrhaging

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2
Q

Causes of dehydration

A

vomiting, diarrhea, hemorrhage, burns, GI suction, fever, difficulty swallowing, impaired motor function

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3
Q

Causes of fluid overload

A

kidney failure, HF, excess fluid replacements, over-secretion of ADH

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4
Q

Acidosis

A

pH below 7.35

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5
Q

Alkalosis

A

pH above 7.45

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6
Q

Normal sodium range

A

136-145

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7
Q

hyponatremia

A

sodium level below 136

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8
Q

Hypernatremia

A

sodium level above 145

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9
Q

Normal potassium range

A

3.5-5.0

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10
Q

Hypokalemia

A

potassium below 3.5

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11
Q

Hyperkalemia

A

potassium above 5.0

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12
Q

Calcium normal range

A

9-10.5

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13
Q

Foods high in calcium

A

milk, yogurt, ice cream, cheese, green leafy vegetables, whole grains

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14
Q

Hypocalcemia

A

Calcium below 9.0

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15
Q

Causes of hypocalcemia

A
  • lactose intolerance
  • end stage renal failure
  • diarrhea
  • immobility
  • alcoholic
  • elevated phosphorus
  • malabsorption (ex. Crohn’s disease)
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16
Q

Signs & symptoms of hypocalcemia

A
  • painful muscle spasms/cramps
  • paresthesia
  • easily fractured bones
  • positive Trousseau’s and Chvostek’s test
  • increased peristalsis
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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
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18
Q

Hypercalcemia

A

calcium above 10.5

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19
Q

Causes of hypercalcemia

A
  • renal failure
  • immobility
  • dehydration
  • malignancy (bone cancer)
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20
Q

Signs & symptoms of hypercalcemia

A
  • mild: increased HR and BP
  • severe: slow HR
  • poor perfusion, cyanosis, pallor
  • DVT
  • decreased peristalsis
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21
Q

Interventions for hypercalcemia

A
  • no Ca/vitamin D intake
  • IV fluids (so kidneys can filter Ca out)
  • furosemide
  • monitor calcium
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22
Q

Magnesium normal range

A

1.3-2.1

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23
Q

What happens when magnesium is too high or low?

A

cardiac dysrhythmias

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24
Q

Foods high in Mg

A

steak, nuts, green leafy vegetables, almonds, chocolate, dried beans

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25
Q

Hypomagnesemia

A

magnesium below 1.3

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26
Q

Causes of hypomagnesemia

A
  • low intake
  • diuretics (loop, furosemide, thiazide
  • malabsorption
  • diarrhea
  • alcoholics - malnutrition
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27
Q

Signs & symptoms of hypomagnesemia

A
  • dysrhythmias
  • atherosclerosis
  • severe paralytic ileus
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28
Q

Interventions for hypomagnesemia

A

give magnesium

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29
Q

Hypermagnesemia

A

magnesium above 2.1

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30
Q

Causes of hypermagnesemia

A
  • increased intake
  • excessive use of antacids & laxatives
  • kidney disease
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31
Q

Signs & symptoms of hypermagnesemia

A
  • bradycardia
  • hypotension
  • dysrhythmias
  • lethargy
  • weak muscle contraction
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32
Q

Interventions for hypermagnesemia

A
  • loop diuretics (furosemide)
  • reduce Mg intake
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33
Q

Furosemide (lasix)

A
  • decreases K, Na, Cl, Mg
  • decreases BP
  • eat bananas, citrus, steak, sodium
  • causes dehydration
  • can mess up kidneys
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34
Q

Bumetanide (bumex)

A
  • decreases Na, K, Mg, Ca
  • controls edema
  • decreases BP
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35
Q

Spironolactone (Aldactone)

A
  • increases K
  • decreases Na, Mg, Cl
  • decreases BP
  • give foods with sodium, steak, nuts
  • NO salt substitutes
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36
Q

should you administer a diuretic to a patient whose Na is 137?

A

NO BITCH

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37
Q

how much does a liter of fluid weigh?

A

2.2 lbs

38
Q

pts at risk for insensible water loss

A

high RR, continuous GI suction, severe diarrhea, fistula drainage, fever, burns, trauma

39
Q

what should you assess for if a post op patient’s urine output is only 20mL for 2 consecutive hours?

A

s/s of blood loss

40
Q

why are older adults more prone to dehydration

A

decreased thirst sensation, decreased mobility, often take diuretics and/or laxatives

41
Q

how will the body react to hypovolemia?

A

vasoconstriction to maintain BP - decreased perfusion

42
Q

how will dehydration affect vital signs

A

increased HR and RR, decreased BP, +1 pulses

43
Q

how will dehydration affect the skin?

A

dry mucous membranes, can cause skin tenting

44
Q

first indicator of dehydration in older adults

A

changes in mental status

45
Q

how will dehydration affect labs?

A

increased H&H, BUN & electrolytes

46
Q

how would fluid overload affect vital signs?

A

+4 pulse, increased BP, increased RR

47
Q

how would fluid overload affect labs?

A

decreased protein & H&H

48
Q

assessment findings w fluid overload

A

weight gain, SOB, crackles, pitting edema, altered LOC, headache, skeletal muscle weakness, increased GI motility

49
Q

for fluid overload patients, what med should they recieve?

A

diuretics

50
Q

fluid overload interventions - respiratory

A

monitor RR, auscultate lung sounds, position in semi-fowlers, administer oxygen if needed

51
Q

why is it important to reposition fluid overload pts q2h?

A

increased risk of skin breakdown

52
Q

fluid overload interventions

A

daily weight, I&Os, monitor for edema, restrict fluid & sodium intake

53
Q

deadly pH levels

A

below 6.8
above 7.8

54
Q

first line of defense for pH changes in the body

A

chemical buffers

55
Q

second line of defense for pH changes in the body

A

lungs/respiratory system

56
Q

last resort for pH changes in the body

A

kidneys

57
Q

how does the respiratory system maintain pH in the body?

A

lungs are quick acting but have temporary effects
regulates CO2 levels

58
Q

how do the kidneys regulate pH in the body?

A

long-term effects, but acts slowly
either excretes or retains bicarb

59
Q

foods high in sodium

A

processed, preserved, canned, smoked, or pickled foods, snack foods, condiments

60
Q

foods low in sodium

A

fresh fish, poultry, fresh or frozen fruits & vegetables,

61
Q

what is dilutional hyponatremia?

A

from excess water in the plasma

62
Q

causes of dilutional hyponatremia

A

HF

63
Q

what is actual hyponatremia?

A

actual deficit of sodium

64
Q

causes of actual hyponatremia

A

diuretic administration, wound drains, low sodium diet, being NPO

65
Q

very very low sodium will cause…

A

seizures, coma, death

66
Q

s/s of hyponatremia

A

generalized muscle weakness, decreased respiratory effectiveness, increased GI motility

67
Q

for dilution hyponatremia, will the BP increase or decrease?

A

increase - overloaded w fluids

68
Q

interventions for dilution hyponatremia

A

increase dietary sodium/supplements, fluid restriction, diuretic (only if electrolytes are high enough)

69
Q

for actual hyponatremia, will the BP increase or decrease

A

decrease - low volume

70
Q

interventions for actual hyponatremia

A

give IV fluids, do NOT give diuretic, monitor BP, orthostatic hypotension

71
Q

causes of actual hypernatremia

A

renal failure, Cushing’s, excess oral intake

72
Q

causes of relative hypernatremia

A

fever, infection, dehydration

73
Q

how does hypernatremia affect skeletal muscle?

A

causes muscle twitching, as sodium continues to rise, the muscles will become weaker

74
Q

how does hypernatremia affect the heart?

A

decreased contractility

75
Q

how to treat hypernatremia from fluid loss

A

duh IV fluids (0.9% saline)

76
Q

how to treat hyponatremia from renal failure

A

diuretic

77
Q

foods high in potassium

A

fish, potatoes, tomatoes, fruit, bananas, citrus

78
Q

how does renal failure affect level of potassium?

A

kidneys won’t excrete K, will need dialysis to get rid of excess

79
Q

s/s of hyperkalemia

A

respiratory & skeletal muscle weakness, dysrhythmias, impaired perfusion, decreased peristalsis

80
Q

one important thing to remember about IV K

A

DO NOT PUSH

81
Q

interventions for hypokalemia

A

increase K - dietary or supplemental, potassium-sparing diuretics only, monitor RR & SpO2, assess ability to cough, place on fall risk precautions

82
Q

causes of hyperkalemia

A

renal failure; high dietary K - salt substitutes contain K; potassium-sparing diuretics

83
Q

most common s/s of hyperkalemia

A

palpitations, paresthesia around hands/mouth, muscle twitching, increased GI motility

84
Q

kayexalate (sodium polystyrene sulfonate)

A

oral or rectal; draws K into GI tract, then causes diarrhea

85
Q

kayexalate indications

A

hyperkalemia

86
Q

hyperkalemia interventions

A

administer sodium polystyrene sulfonate; discontinue IVs with K, hold K supplements/ foods high in K, give insulin

87
Q

how does insulin affect potassium?

A

pulls K into cells - serum is lowered

88
Q

foods low in potassium

A

eggs, bread, cereal

89
Q

high amounts of what electrolyte can cause DVTs?

A

calcium

90
Q

what could low albumin mean?

A

liver failure; poor nutrition

91
Q

dietary sources of calcium

A

milk, yogurt, cheese, green leafy vegetables, whole grains

NSG 102 (11 decks)

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