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Adult Health 1 > Fluid & Electrolytes > Flashcards

Fluid & Electrolytes Flashcards

1
Q

HypOnatremia - Nursing Interventions

A
  • GI suctioning, burns, wound drainage, 3rd space fluid shift
  • Monitor fluid volume therapy (water intoxication)
  • I&O, weight, skin care
  • VS BP best indicator
  • Safety & seizure precautions
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2
Q

HypOnatremia - Treatment

A
  • Pharmacological: diuretics
  • hypertonic IV if severe 3%NS given slowly to increase 1-2 mEq/hr
  • monitor fluid volume during therapy, restrict fluid intake & provide high sodium foods
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3
Q

HypERnatremia - Nursing Interventions

A
  • Monitor VS w/fluid replacement, esp for cerebral edema/ICP
  • Monitor fluid volume replacement or removal
  • I&O, weight, skin care
  • Vascular profusion, blood clots, DVT & clot care
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4
Q

HypERnatremia - Treatment

A
  • undiluted formula for babies
  • limit salt intake
  • drink plenty of fluids in hot weather
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5
Q

HypOkalemia - Nursing Interventions

A
  • Monitor VS & EKG changes
  • Assess ab & bowel sounds
  • Replacement therapy (IV,PO) * All K+ via IV SHOULD GO ON A PUMP; never more than 20mEq/hr for K+ runs
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6
Q

HypOkalemia - Treatment

A 
* MEDICATIONS: Diuretics (loop - Lasix, Bumex), Thiazide (HCTZ), Steroids (retain Na+, loose K+)
Digoxin Toxicity (dependent on K+ to work correctly  DO NOT give if K+ is too ↑or↓) monitor GI for ANVD, irregular heartbeat, halos/blurred vision
* Diet: oranges, strawberries, peaches, cherries, prunes,  apricots, dates, figs, potatoes, cantaloupe
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7
Q

HypERkalemia - Nursing Intervention

A
  • monitor bowel movements
  • GI, CV, and MS
  • Eliminate K+ via meds & diet
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8
Q

HypERkalemia - Treatment

A
  • MEDICATIONS: Kayexalate, K+ sparing diuretics (Spironolactone), ace inhibitors (PRILS)
  • ER: D5W & insulin drip (pulls K+ into cell)
    Calcium Gluconate (quiets cardiac irritability)
    Na+HCO3 (alkalosis > K+ into cell)
  • Dialysis – short or long term
  • Low K+ diet
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9
Q

HypOcalcemia - Nursing Interventions

A
  • AIRWAY – tracheotomy tray at bedside; decreased DTR
  • total protein & albumin
  • provide a diet that’s rich in calcium, Vitamin D, & protein
  • Monitor VS, peripheral profusion,
    & cardiac status
  • monitor for infiltration – vesicant
  • safety convulsions prevention
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10
Q

HypOcalcemia - Treatment

A
  • MEDICATIONS: calcium gluconate or calcium chloride, never administer rapidly via IV
  • TUMS, 750mg/dose with meals
  • Diet: milk, cheese, yogurt, pudding, egg yolks, grains, chicken, salmon-canned with bones, nuts, legumes, tofu
  • Vitamin D – green leafys
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11
Q

HypERcalcemia - Nursing Interventions

A
  • assess for S&S of renal calculi
  • decreased DTR, muscle weakness
  • hydrate with NS to promote urinating & Ca+ excretion
  • administer loop diuretic
  • monitor cardiac status
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12
Q

HypERcalcemia - Treatment

A

*MEDICATIONS: *diuretics
-calcitonin (brings Ca+↓ alternate nostrils)
-biophosphates (pushes Ca+ back into the bone)
Aredia (pamidronate)
-IV phosphorus-if emergency
* Limit Ca+ intake in diet

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13
Q

HypOmagnesimia - Nursing Interventions

A
  • increased DTR
  • monitor BP, RR &urinary output
  • give foods high in Mg2+
  • monitor HR & rhythm
  • patient safety
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14
Q

HypOmagnesimia - Treatment

A
  • MEDICATIONS: MgSO4 (mag run)
  • give Mg2+ first, then K+
  • Diet: dark green veggies, peanut butter, almonds, bananas, egg yolks, soy, whole-grain cereal
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15
Q

HypERmagnesimia - Nursing Interventions

A
  • decreased DTR “deep tendon reflex”, generalized weakness
  • identify underlying cause & treat
  • monitor cardiac & resp status
  • decreases muscle & nerve activity
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16
Q

HypERmagnesimia - Treatment

A
  • hold all meds with Mg2+

* low Mg2+ diet”

17
Q

HypOvolemia (FVD) - Treatment

A

*3% NS with close monitoring, usually ICU patients

18
Q

HypERvolemia (FVE) - Nursing Interventions

A
  • elevate HOB, TCDB, ambulate, & float heels
  • monitor VS & lung sounds
  • I&O, edema
  • assess for S&S of hypovolemia, can result from over correction
SAFETY: “RESTRICT”
Reduce IV flow rate
Evaluate breath sounds and ABGs 
Semi-Fowler’s position
Treat with oxygen and diuretics as ordered 
Reduce fluid and sodium intake
I & O and weight
Circulation, color, and presence of edema 
Turn and position at least every 2 hrs
19
Q

HypERvolemia - Treatment

A
  • administer loop diuretics (K+ is flushed out)
  • K+ sparing diuretics – aldactone –(pull H2O & not K+)
  • Thiazide diuretics (loose K+)
  • restrict Na+ & fluid intake
20
Q

HypOtonic solutions

A

If we want to move fluids INTO the cell we give HYPOtonic solutions; can’t give water cause that’ll move too fast and explode the cell

Provide salt and water to replace cellular fluid.

Examples:
½ NS (0.45% normal saline)
1/3 NS (0.33%) - rarely see
¼ NS (0.225%)

21
Q

HypERtonic solutions

A

We give this to draw fluid OUT of cells

we give this if we’re quickly trying to increase their intravascular volume; we give to replace sodium and to get fluids into the intravascular space but it results in interstitial dehydration

D51/4NS
D51/2NS
D5NS - this starts out as hypertonic but then body changes it to hypotonic, because dextrose adsorbs quickly so don’t use this at much
D5LR
D10LR
D50W
D10W
22
Q

Isotonic solutions

A

these tend not to alter the cell because they’re closest the osmolality of blood; we use this a lot to give medications; and use lactated ringers for burns and trauma; but watch in pts with high blood pressure

NEVER use lactated ringers in pts with liver disease and alkalosis

  • 0.9% NaCl (NS- normal saline
  • Lactated Ringers solution - this contains small amounts of K+, Cl, Na
  • 5% dextrose in water (D5W
23
Q

Metabolic Acidosis

A

*Low pH (increased H+ concentration) and a low plasma bicarbonate concentration (

24
Q

Metabolic Alkalosis

A
  • High pH (decreased H+ concentration) and a high plasma bicarbonate concentration
  • Can be produced by a gain of bicarbonate or a loss of H+ (usually by vomiting or suction)
  • Often accompanies hypokalemia; manifestations are similar to hypokalemia and hypocalcemia
  • Treatment addresses underlying disorder as well as K+ replacement and fluid volume replacement
25
Q

HypOphosphatemia - Treatment and Nursing Considerations

A

*we need to know what causes this; sx are dependent on cause
*often these pts are dehydrated and so when we rehydrated them, their levels will drop
-Education on diet
-Oral supplementation
-IV replacement- GO SLOW
Watch the site
Monitor Ca + and Phosphorus levels

26
Q

HypERphosphatemia - Treatment and Nursing Considerations

A

Treatment focuses on the underlying disorder, diet and patient education.

27
Q

HyPOvolemia (FVD) - Nursing Considerations

A
  • replace fluids,oral rehydration
  • monitor VS (BP)
  • TCBD, steamy shower, humidity
  • monitor mental state, A&O
  • I&O, specific gravity
  • predisposing disease process

SAFETY: “FLUIDS”
F luid ↑(po), Isotonic fluids, Blood
L evel of consciousness, look at weight
Urine

Adult Health 1 (9 decks)

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