Fluid & Electrolytes Flashcards
What is fluid and electrolyte balance?
The process of regulating the extracellular and intracellular fluid volumes, body fluid osmolality, and plasma concentration of electrolytes.
According to Giddens.
List three exemplars of fluid and electrolyte imbalances.
- Specific electrolyte imbalances
- Dehydration
- Fluid volume overload
What is osmosis?
Movement of water molecules across a selectively permeable membrane from an area of low solute concentration to an area of high solute concentration.
Define diffusion in the context of fluid and electrolytes.
Passive movement of molecules from an area of higher concentration to an area of lower concentration.
What is filtration?
Movement of water and solutes across a membrane driven by hydrostatic pressure.
What does active transport require?
Energy, usually in the form of ATP, to move molecules across a cell membrane against their concentration gradient.
What does intracellular refer to?
Anything that occurs inside the cells, including fluid and organelles.
What does extracellular refer to?
Anything outside of the cells, including fluids that surround and support cells.
What is an isotonic solution?
A solution that has the same concentration of solutes as the inside of a cell.
Fill in the blank: A _______ solution has a lower concentration of solutes compared to the inside of the cell.
hypotonic
Fill in the blank: A _______ solution has a higher concentration of solutes compared to the inside of the cell.
hypertonic
Identify a risk factor for dehydration.
Inadequate fluid intake due to nausea, vomiting, or lack of access to water.
What are two causes of fluid volume overload?
- Kidney failure
- Congestive heart failure (CHF)
What is hypernatremia?
High sodium levels in the body.
What can cause hyponatremia?
Excessive water intake diluting sodium levels.
What is hypercalcemia?
High calcium levels in the body.
List two causes of hypocalcemia.
- Vitamin D deficiency
- Chronic kidney disease
What is hyperkalemia?
High potassium levels in the body.
Fill in the blank: A 24-hour urine test helps measure how well the kidneys excrete _______.
electrolytes
What does a Basal Metabolic Panel (BMP) measure?
Electrolyte levels and kidney function.
What is the normal range for sodium (Na⁺) in a BMP?
135–145 mEq/L
What does elevated Blood Urea Nitrogen (BUN) indicate?
Dehydration or kidney dysfunction.
What is the normal range for potassium (K⁺) in a BMP?
3.5–5.0 mEq/L
What can hypokalemia lead to?
Arrhythmias and muscle weakness.
What is the purpose of the 24-hour urine test?
To measure how well the kidneys excrete electrolytes and other substances over a full day.
What are two prevention strategies for dehydration?
- Encourage adequate fluid intake
- Teach early signs of dehydration
What should be monitored to prevent fluid overload?
Daily fluid intake and weight changes.
What is a recommended dietary change for patients at risk of hyperkalemia?
Limit potassium-rich foods.
Fill in the blank: To prevent hypokalemia, encourage _______ foods.
potassium-rich
What role does a nephrologist play in fluid and electrolyte imbalances?
Manages patients with kidney disease and fluid balance.
What is the role of an endocrinologist in fluid and electrolyte management?
Manages hormonal disorders that impact fluid and electrolyte balance.
True or False: Nurses play a collaborative role in reporting lab values and implementing physician orders.
True
What can excessive sodium intake lead to?
Hypernatremia.
What are common electrolyte imbalances associated with kidney disease?
Hyperkalemia, hyperphosphatemia, fluid overload
Kidney disease often leads to disturbances in electrolyte balance due to impaired renal function.
Which healthcare professional collaborates with nurses to manage hormonal disorders affecting electrolyte balance?
Endocrinologist
Endocrinologists manage conditions like diabetes insipidus and adrenal insufficiency that impact fluid and electrolyte homeostasis.
What role does a pharmacist play in managing electrolyte replacements?
Ensures safe administration of electrolytes and monitors for drug interactions
Pharmacists provide guidance on the correct dosing and timing of medications affecting fluid balance.
What dietary considerations should a dietitian make for patients with chronic conditions?
Individualized dietary plans to maintain appropriate electrolyte intake
Dietitians focus on ensuring patients have the right balance of nutrients, particularly in conditions like heart failure and kidney disease.
What is the primary concern of a respiratory therapist in relation to electrolyte imbalances?
Managing respiratory complications like metabolic acidosis or alkalosis
Respiratory therapists monitor ABGs and provide interventions for patients with acid-base imbalances.
What is a key role of a case manager or social worker in electrolyte management?
Coordinate care and facilitate discharge planning for patients
They help ensure patients have access to necessary resources post-discharge.
What is the importance of patient and family education in electrolyte management?
Recognizing symptoms of imbalances and managing medication and diet
Educating families helps in the ongoing management of fluid and electrolyte needs after discharge.
What are essential nursing interventions for collaboration in patient care?
Communication, documentation, patient education, coordination
These interventions ensure continuity of care and effective management of patient needs.
Fill in the blank: The nursing process includes assessment, diagnosis, ________, implementation, and evaluation.
planning
The nursing process is a systematic method for providing patient care.
What is the relationship between fluid and electrolyte balance and perfusion?
Fluid and electrolytes are crucial for maintaining adequate perfusion to tissues
Impaired fluid balance can lead to decreased tissue perfusion, affecting overall health.
What are the expected findings in a patient with fluid volume overload?
Crackles in the lungs, distended neck veins, peripheral edema
These signs indicate fluid accumulation in the body.
What is a common lab finding in a patient experiencing severe dehydration?
High sodium levels (e.g., Sodium: 150 mEq/L)
Severe dehydration often results in hypernatremia due to fluid loss.
What is the priority action for a patient showing signs of hypovolemic shock?
Administer an IV fluid bolus
Rapid fluid resuscitation is critical to stabilize the patient.
List the interventions for a patient with hypokalemia in order of priority.
- Place the patient on a cardiac monitor
- Administer IV potassium as prescribed
- Assess for muscle weakness and fatigue
- Encourage potassium-rich foods
Cardiac monitoring is crucial due to the risk of arrhythmias associated with low potassium.
Which ECG change is expected in a patient with hypokalemia?
U waves
Hypokalemia is associated with characteristic changes on an ECG, including U waves.
What interventions should be included in the care plan for a patient with hyponatremia?
Implement seizure precautions, administer 3% hypertonic saline IV slowly, monitor for signs of fluid overload
These interventions help manage the risks associated with low sodium levels.
Which electrolyte imbalance is most critical in a postoperative patient with low potassium?
Potassium decrease
Hypokalemia poses a significant risk for cardiac arrhythmias and requires immediate attention.
High potassium foods to encourage include _______.
Bananas, sweet potatoes, spinach, oranges
These foods are rich in potassium and help correct deficiencies.
Why are infants and young children at greater risk for dehydration than adults?
They have a higher percentage of total body water and increased insensible fluid loss
Infants are also less able to concentrate urine effectively.
What percentage of total body water do infants and young children have?
70-80%
Infants have a higher percentage of body water, making them more vulnerable to fluid loss.
What factor increases the vulnerability of infants to dehydration?
Higher metabolic rate
Infants have a higher metabolic rate, leading to increased fluid needs.
What is a classic sign of dehydration in infants?
Poor skin turgor with tenting
Skin remains ‘tented’ when pinched due to decreased fluid volume.
What assessment finding indicates dehydration related to mucous membranes?
Dry mucous membranes
Commonly observed in dehydration due to lack of fluid.
What vital signs are indicative of dehydration?
Hypotension and tachycardia
Low blood pressure and increased heart rate result from decreased circulating volume.
What type of urine output is associated with dehydration?
Dark, concentrated urine
Oliguria and concentrated urine occur as kidneys conserve fluid.
True or False: Bounding peripheral pulses are a sign of dehydration.
False
Dehydration leads to weak, thready pulses, not bounding pulses.
What weight gain in 24 hours suggests acute fluid retention?
2.2 lb (1 kg)
Rapid weight gain indicates possible progression to pulmonary edema.
What is a sign of fluid overload that is less urgent than rapid weight gain?
Bilateral pitting edema
A sign of fluid overload but not as critical as rapid weight gain.
What does jugular vein distention while sitting indicate?
Increased central venous pressure
Suggests chronic fluid overload rather than an acute crisis.
What is considered a normal urine output in this context?
≥30 mL/hour
Urine output of 50 mL per hour is within the normal range.
