Fluid & Electrolytes Flashcards by Jami Smart

What are the 2 major electrolytes in the ECF?

Sodium and Chloride (They have and affinity for each other)

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What is the major electrolyte in the ICF?

Potassium

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Describe the Syndrome of Inappropriate ADH (SIADH).

It’s when too much ADH (unregulated) is produced by hypothalamus. This can cause severe hyponetremia and excess fluid volume. (It is the opposite of diabetes insipidus).

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Name 5 different actions of Angiotensin II.

1) Tubular reabsorption of Na+, Cl-, & H2O.
2) Secretion of aldosterone from the adrenal glands.
3) Arteriolar vasoconstriction
4) Secretion of ADH from the posterior pituitary
5) Increases sympathetic activity

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Where is Antidiuretic Hormone (ADH) produced and stored.

ADH is produced in the hypothalamus and stored in the posterior pituitary gland.

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Describe the condition of diabetes insipidus.

It is the underproduction of ADH by the hypothalamus causing polyuria.

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What is the normal range of plasma osmolarity (isotonic solutions) and what osmolarity would be considered hypertonic? hypotonic?

Isotonic = between 275 and 295 mOsm/L
Hypertonic = greater than 295 mOsm/L
Hypotonic = less than 275 mOsm/L

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What are the signs and symptoms of Hyponatremia (<135 mEq/L)?

1) Nausea
2) Confusion
3) Muscle Cramps
4) Muscle Twitching
5) Coma
6) Seizures

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What are normal blood glucose levels?

70 to 120 mg/dL (fasting)

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What are the 13 signs and symptoms of hyperglycemia?

1) High BG level 2) Lethargy/Sleepiness
3) Irritability 4) Blurred Vision
5) Thirst 6) Polyuria
7) Leg cramps/Numbness 8) Nausea or Vomitting
9) Upset Stomach 10) Weight Loss
11) Recurrent Infections 12) Fruity Breath
13) Coma

Cold and Dry, Blood Sugar too High

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What are the 8 signs and symptoms of hypoglycemia?

1) Shaking
2) Irritability/Confusion
3) Weakness/Fatigue
4) Dizziness
5) Personality Change
6) Slurred Speech
7) Siezures
8) Loss of consciousness

Cold and Clammy need some Candy*

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How are type I and type II diabetes usually diagnosed?

1) Type I - Usually diagnosed because the PT experiences a significant event (i.e., seizure)
2) Type II - Usually diagnosed because the PT experiences lifestyle symptoms (i.e., lethargy, polyuria)

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Why should whole milk NOT be given as a source of sugar to someone experiencing hypoglycemia?

The fat in milk inhibits absorption, so give fat free or skim milk only

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Define Azotemia

An excess level of urea in the blood, usually due to renal insufficiency.

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What is the normal urine output for an average adult?

40 to 80 mL/hr

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What are the signs and symptoms of Hypernatremia (> 145 mEq/L)?

1) Thirst
2) Increased Temp
3) Dry, swollen, red tongue
4) Stick Mucous Membranes
4) Irritabilty and Restlessness
5) Tachycardia

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What are the signs and symptoms of Hypokalemia (<3.5 mEq/L)?

1) Weak peripheral pulses
2) Muscle weakness
3) Cardiac arryhthmias
4) ECG changes
5) Polyuria

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What are the signs and symptoms of Hyperkalemia (>5.0 mEq/L)?

1) Cardiac Arrhythmias
2) Paresthesia of the face, tongue, feet, and hands
3) ECG Changes

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What are the signs and symptoms of Hypocalcemia (<8.5 mG/dL)?

1) Numbness and tingling of fingers and toes
2) Spasm of laryngeal muscles
3) Cramps in muscles of the extremities
4) Mental Changes

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What are the signs and symptoms of Hypercalcemia (> 10.5 mg/dL)?

1) Lethargy
2) Constipated
3) Decreased memory and attention span
4) Renal Stones
5) Muscular Weakness

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What are the signs and symptoms of Hypomagnesemia (<1.3 mEq/L)?

1) Muscle Weakness
2) Deep Tendon Reflexes
3) Tetany
4) Heartblock
5) Change in Mental Status
6) Respiratory Paralysis

What are the signs and symptoms of Hypermagnesemia (>2.5 mEq/L)?

1) Loss of Deep Tendon Reflexes
2) Flushing and sense of skin warmth
3) Hypotension
4) Respiratory Depression

What are the signs and symptoms of Hypophosphatemia (<2.5 mg/dL)?

1) Cardiomyaopathy
2) Acute Respiratory
3) Seizures
4) Joint Stiffness
5) Decreased Tissue Oxygenation

What are the signs and symptoms of Hyperphosphatemia (> 4.5 mg/dL)?

1) (Tetany) Tingling of the fingertips and around the mouth, numbness, and muscle cramps.
2) Precipitation of calcium phosphate in kidneys, joints, arteries, skin or cornea.

Adrenal Insufficiency can cause an excess of which electrolyte?

It can cause hypermagnesemia.

A patient has a history of diabetes insipidus. What electrolyte imbalance is MOST likely to develop if this medical problem recurs?

Hypernatremia - Diabetes insipidus = a deficiency of of ADH. Large amounts of water are lost from the body causing a buildup of sodium in the body.

What does moist crackles in the absence of cardiopulmonary disease indicate?

Fluid Volume Excess

_________ is usually the earliest sign of decreased vascular volume associated with fluid volume deficit.

Tachycardia

(T/F) Postural hypotension usually indicates fluid volume deficit?

True

What is a normal range of Hgb for males? Females?

Males 14 to 18

Females - 12 to 16

What is a normal hematocrit range for males? Females?

Males - 42 to 50%

Females - 40 to 48%

What is a normal serum level for Sodium?

135 to 145 mEq/L

What is a normal serum level for Potassium?

3.5 to 5 mEq/L

What is a normal serum level for Magnesium?

1.3 to 2.1 mEq/L

What are normal serum levels of BUN?

10 to 20 mg/dL

What are normal serum levels of Phosphorous?

3 to 4.5 mg/dL

What are normal serum levels of calcium?

8.5 to 10.5 mg/dL

What are normal serum levels of Chloride?

95 to 105 mEq/L

What are the signs and symptoms of Hypochloremia (<95 mEq/L)?

1) Hyperexcitability
2) Tetany
3) Shallow Breathing
4) Hypotension

What are the signs and symptoms of Hyperchloremia (>105 mEq/L)?

1) Lethargy
2) Weakness
3) Deep Breathing

If your patient has hyperphosphatemia, he may also have what secondary electrolyte disturbance?

Hypocalcemia - Phosphorus and Calcium have an inverse relationship: if the serum phosphorous levels are increased, then the the serum calcium levels are decreased.

Many of the signs and symptoms of hypophosphatemia are related to…?

Low energy stores - the body needs phosphorous to make triphosphate, which provides all the cells, especially muscles, with energy.

What are the 5 symptoms of an air embolism?

1) Respiratory Distress
2) Increased HR
3) Cyanosis
4) decreased BP
5) Change in Level of Conciousness

What can the RN do if the fluid does not easily flow into the vein?

1) Reposition the extremity because the patient might have kinked the IV tubing and therefore prevent the IV from infusing properly
2) If the IV is free flowing, raise the height of the IV pole –> may ⬆ IV flow
3) Attempt to flush the IV w/ 2-3 mL of saline and check that clamp is fully open
4) If resistance is still present, IV may be against a valve –> might need to remove and restart IV at different site

What can the RN do if the fluid of an IV does not flow easily and the skin around e insertion site is edematous and cool to the touch?

IV has INFILTRATED –> Remove IV and restart at different site

Treat infiltration

What can the RN do if a small hematoma is forming at the IV site while inserting the catheter?

A small hole has been made in the vein and blood is leaking out into the tissue –> Remove and discard

A new site will be chosen

What can the RN do if fluids are leaking out around the insertion of the IV site?

1) Change dressing on IV

2) If site continues to leak = remove and restart elsewhere to ⬇ risk of infection

What can be done if the IV catheter is partially pulled out of the insertion site?

DO NOT reinsert the catheter. If its only pulled out a bit, it might be left alone –> Monitor for risk of infiltration
If it is quite dislodged –> Remove an start over

What can the RN do if the infusion does not flow or flow rate changes after bag and tubing is changed?

Make sure that the flow clamp is open

- check that the drip chamber is approximately half full

What can the RN do if upon auscultation of a patient’s lungs, on IV infusion therapy, crackles can be heard in the base of the lungs?

1) Notify physician immediately –> S xS of fluid overload

2) RN reports to physician previous I & O, VS and O2 sat

Upon flushing an IV, the RN notices resistance and pain is reported by the patient. What should the RN do next?

D/C the iV and restart in another site

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Fluid & Electrolytes Flashcards

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