Fluid & Electrolytes Flashcards
pH
7.35-7.45
PaCO2
35-45
PaO2
80-100
HCO3
22-26
Metabolic Acidosis S/S
Weakness & fatigue
Anorexia, N/V
Decreased LOC
Warm, flushed skin
Metabolic Acidosis Risk Factors
Tissue hypoxia
DKA
Renal failure
Diarrhea, intestinal suction/drainage
Metabolic Alkalosis S/S
Altered LOC
Tetany
Respiratory failure
Dysrhythmias
Respiratory Acidosis Risk Factors
Acute or chronic lung disease COPD
Narcotics
Neuromuscular disease
Respiratory Acidosis S/S
Hypoventilation
Headache
Blurred vision
Confusion
Respiratory Alkalosis Risk Factors
Anxiety, hyperventilation
Fever, infection
Mechanical ventilation
Respiratory Alkalosis S/S
Hyperventilation Lightheaded Chest tightness Palpitations Tetany Numbness and tingling around mouth
Aldosterone
Retains Na+ therefore retaining water, and excretes K+
Secreted when Na+ decreased, K+ increased, or increased BP or volume
Natriuretic Peptides
Synthesized in the kidney
Antagonists to RAAS
Causes vasodilation, sodium & water excretion, decreasing BP
ADH
Secreted when:
- Plasma osmolality increases
- Circulating blood volume decreases & BP drops
Increases water reabsorption into plasma
S/S of SIADH
Cerebral edema
Muscle twitching
Headache
Weight gain
Fluid Volume Deficit S/S
Thirst Dizziness Fatigue Altered LOC Anxiety Oliguria Dry mucous membranes Weak, thready pulse Tachycardia
Fluid Volume Deficit Risk Factors
NG Suctioning Burns Vomiting DKA Fever Vomiting Inadequate fluid intake
Fluid Volume Excess Risk Factors
CHF
Renal or hormonal failure
Excessive Na+ Intake
Liver disease
Fluid Volume Excess S/S
Weight gain Edema Crackles & dyspnea Ascites Headache Confusion Bounding pulse Decreased hematocrit
D5W, D10W
Provides free water
No electrolytes
Small amount of calories
Treats water losses and hypernatremia
D5.225, D5.45, D5.9, LR
Replaces electrolytes
Colloids
Contains albumin
Increases oncotic pressure in vascular space
Dextran
Synthetic sugar
Metabolized slowly pulling fluid & maintaining it in vascular space
Causes of Hyponatremia
Increased Na+ excretion
Inadequate intake
Dilution of serum Na+
Hyponatremia S/S
Lethargy, headache, confusion, coma
Muscle weakness
Anorexia, N/V, abdominal cramping
Causes of Hypernatremia
Decreased Na+ excretion
Increased Na+ intake
Decreased water intake or loss of H2O
Hypernatremia S/S
Thirst
Fever, dry mucous membranes
Restlessness, agitation
Convulsions, hyperreflexia
Causes of Hypokalemia
Increased K+ excretion (N/V, diarrhea, NG suction, diuretics, increased aldosterone)
Inadequate K+ intake
Increased K+ into cells (from insulin, H+ exchange like DKA because K+ goes out but is still excreted)
Hypokalemia S/S
Cardiac dysrhythmias
Skeletal muscle weakness
Smooth muscle atony
Glucose intolerance
Causes of Hyperkalemia
Increased K+ sparing
Decreased renal secretion
Increased shift of K+ into ECF
Hyperkalemia S/S
Restlessness
Intestinal cramping, diarrhea
Muscle weakness
Cardiac conduction changes
Urine Osmolality values
1.005-1.030
BUN level
7-18
Creatinine level
0.6-1.5
