Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Med/Surg 1 Exam 1 > Fluid/Electrolytes > Flashcards

Fluid/Electrolytes Flashcards

1
Q

Types of fluids

A 
Blood
Serum
Saline
Albumin 
Bile
Urine
Hormones
Cerebrospinal 
ECF (Extracellular Fluid Volume)
ICF (Intracellular Fluid Volume)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Types of hormones

A

Antidiuretic Hormone
Renin-Angiotensin Aldosterone System
Atrial Natriuretic Factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Internal Body Organs

A

Kidneys
Heart
Lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Electrolytes

A

Charged ions capable of conducting electricity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Function of Water

A 
Medium for metabolic reactions 
Lubricant 
Transport for nutrients, waste products 
Insulator 
Shock absorber
Regulate and maintain body temp
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

___ % of body is water

A

60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Main electrolytes in body fluid

A 
Na+
K+
Cl-
Mg 2+
Ca 2+
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

General Function of Electrolytes

A 
Maintain fluid volume and concentration 
Distribute water between compartments 
Regulate acid/base balance 
Muscle contraction 
Nerve impulse transmission 
Blood clotting 
Regulate enzyme reactions (ATP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cations

A

Positively charged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Anions

A

Negatively charged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Normal loss of fluid and electrolytes occurs:

A

Urine
Stool
Sweat
Evaporation of fluid from lungs and skin (no loss of electrolytes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Water and electrolytes can move through:

A 
Diffusion
Osmosis 
Facilitated diffusion 
Filtration 
Active Transport
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Fluid Compartments: Extracellular

A

Vascular
Interstitial
Transcellular
Lymph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Diffusion

A

Passive movement of electrolytes or other particles down the concentration gradient (from higher to lower concentration)
**Everything but water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Facilitated Diffusion

A

Requires a carrier molecule

Accelerates rate of diffusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Osmosis

A

Movement of water from an area of lesser to one of greater concentration through a semi-permeable membrane
**Just water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Filtration

A

Movement across a membrane under pressure from a higher to lower pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Active Transport

A

Movement of ions against the osmotic pressure to an area of higher pressure: requires energy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Hydrostatic Pressure

A

Major force that PUSHES WATER OUT of the vascular system at the capillary level and into interstitial fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Osmotic Pressure

A

INWARD PULLING force caused by particles in the interstitial and intracellular fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Any condition that changes osmotic pressure in either ICF or ECF compartments will cause…

A

Redistribution of water across semipermeable membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

The major colloid in the vascular system contributing to the total osmotic pressure is…

A

protein (albumin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Hydrostatic pressure and colloid osmotic pressure represent ____ and ____ required to _________ _________ between the _______ and _________ spaces

A

“push” (hydrostatic) and “pull” (Colloid Osmotic Pressure)
maintain homeostasis
interstitial and intravascular spaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

First Spacing

A

Normal distribution of fluid in ICF and ECF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Second Spacing

A

Abnormal accumulation of interstitial fluid (edema)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Third Spacing

A

Fluid accumulation in a part of the body where it is not easily exchanged with ECF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Plasma to interstitial fluid shift results in _____

  • _______ of hydrostatic pressure
  • _______ in plasma colloid osmotic pressure
  • _______ of interstitial colloid osmotic pressure
A

Edema
Elevation
Decrease
Elevation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Interstitial fluid to plasma

A

Fluid drawn into plasma space with increase in plasma osmotic or colloid osmotic pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What can be used to decrease peripheral edema?

A

Diuretics and Compression stockings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is Third space fluid shift?

Examples?

A 
Loss of ECF into a space that does not contribute to equilibrium between ICF and ECF
Severe burns
Bowel obstruction 
Massive bleeding 
Ascites
Peritonitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Ascites

A

fluid collected within abdominal cavity is secreted by capillaries of the abdominal peritoneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Regulation of Body Fluids

A 
Fluid intake (Thirst mechanism)
Fluid Output (Kidneys, lungs, skin, GI tract)
Hormones (Aldosterone)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Tonicity of Solutions

A

Hypotonic 350

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Fluids shift in the body to….

A

Expand the intravascular compartment
Expand the intravascular compartment and deplete the intracellular and interstitial compartments
Expand the intracellular compartment and deplete the intravascular compartment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Main purpose of IVFs

A

Replenish fluid compartments/restore balance between the ECF and ICF
Replace renal and insensible losses
Correct electrolytes
Provide glucose calories if solution contains glucose
Correct/maintain acid-base balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

IV Therapy: Isotonic Solutions

A

Same osmolality in relation to plasma (290)
-Matches the bodys concentration of solutes in the plasma
No fluid shifts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

IV Therapy: Isotonic solutions
Action?
Examples?

A

Expands the bodys fluid (extracellular) volume without causing a fluid shift, replaces fluid loss, expands intravascular (plasma) volume

Examples:
NS
LR
D5W

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

When are isotonic solutions indicated for your patient?

A

When your patient has low intravascular volume from fluid loss or to dilute high concentrations of electrolytes in the serum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Isotonic solutions are best when?

A

You don’t want to shift fluids in or out of the cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Isotonic solutions are given for fluid volume deficit but must be used with caution with what type of patients and why?

A

Heart and renal failure patients

These patients cannot handle a rapid increase in blood volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

IV Therapy: Hypotonic Solutions

A

Low osmolality in relation to plasma

Provides more water than electrolytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

IV Therapy: Hypotonic Solutions
Action ?
Examples ?

A

Dilutes the ECF and produces movement of water from the ECF to the ICF
Given to expand the intracellular space. Commonly infused to dilute extracellular fluid and rehydrate the cells of patients who have hypertonic fluid imbalances
Treat gastric fluid loss and dehydration from excessive diuresis

Examples:
2.5% Dextrose in Water
0.45% NS
5% Dextrose in 0.45%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Hypotonic solution is given to what type of patients?

Whats the goal?

A

Hypertonic dehydration
Water replacement
Diabetic ketoacidosis with corrected sodium level

Goal:
Pull fluid from the ECF and pull into the cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What type of patients shouldn’t receive hypotonic solutions?

A

Patient with low blood pressure since it would pull the fluid dilute out the electrolytes and cause fluid to shift from the serum to the cell
(Less volume in the bloodstream = low blood pressure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

IV Therapy: Hypertonic Solution

A 
High osmolality (concentration) in relation to plasma (>375)
Fluid shifts from ICF to ECF compartments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

IV Therapy: Hypertonic Solutions
Action?
Examples?

A

Draws water from the cells (ICF) into the vascular and interstitial spaces (ECF)

Used to treat patients who have severe hyponatremia

Examples:
D5NS
D5LR
D10W
3% Na+ (2 nurse sign off)
Colloids (Albumin 25%, dextran)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

When do you give hypertonic solutions?

A
  • When your patient has dangerously low concentrations of electrolytes or glucose
  • When you want to draw fluid in from the interstitial space into the plasma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Hypertonic solutions are very ______ to veins

A

Irritating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

How should hypertonic solutions be infused?

To prevent what?

A

Should be infused slowly to prevent circulatory volume overload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Summary: IVF: Isotonic

A

No fluid shifting

Just expands the vascular volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Summary: IVF: Hypotonic

A

Shifts fluid from within the vascular space into the cells

Cells swell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Summary: IVF: Hypertonic

A

Shift fluid from within the cell to the vascular space

Cells shrink

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

REGULATION of water balance maintaining homeostasis

A 
Hypothalamic 
Pituitary 
Adrenal cortical 
Renal 
Cardiac
GI
Insensible water loss
54
Q

Nursing assessment for fluid and electrolyte status

What to ask the patient?

A
  • Make sure to obtain a health history
  • Think to ask and look for any chronic cardiac, renal, or endocrine diseases
  • Medications
  • Client’s food and fluid intake, fluid output, daily weights
    Physical assessment/VS
55
Q

What to look for in a physical assessment for Fluid deficit?
Manifestations of dehydration

A 
Hypotension
Tachycardia
Weak pulse
Tachypnea
Reduced urine output 
Dry mucous membranes 
Weight loss 
Poor skin turgor 
N/V
56
Q

What to MONITOR for fluid volume deficit?

A 
Daily weight 
I&O
Lab Values 
LOC
Mucous membranes 
Skin turgor 
Urinary output (less than 30mL/hr reported to doctor)
Vital signs
57
Q

CMP Lab

A

Complete Metabolic Panel

Measures electrolyte levels in the body and renal labs like BUN and Creatinine are measures of kidney function

58
Q

CBC Lab

A

Hematocrit measures volume of whole blood that is RBCs
Affected by changes in plasma volume
Normal between 40-50%

59
Q

What to monitor when giving hypotonic solutions?

A

Blood pressure

Risk of lowering

60
Q

Serum Osmolality

Normal Range?

A

Measures the solute concentration of the blood
Evaluates fluid balance
Normal: 280-300 mOsm/kg

61
Q

Urine Osmolality

Normal Range?

A

Measures the solute concentration of the urine
Consists of nitrogenous wastes (BUN, Creatinine Uric acid)
Normal 200-800 mOsm/kg

62
Q

Urine specific gravity

Normal range?

A

Indicator of urine concentration

Normal 1.005-1.030

63
Q

Causes of fluid volume deficit: Dehydration

A 
Excessive fluid loss
Insufficient intake 
Failure of regulatory mechanisms 
Pediatric differences 
Older adults
64
Q

Causes of fluid volume deficit: Dehydration: Excessive Fluid Loss examples?

A 
Hemorrhage 
GI Suction 
Intestinal fistulas 
Vomiting 
Diarrhea
65
Q

Causes of fluid volume deficit: Dehydration: Insufficient intake examples?

A

Lack of fluid access
Oral trauma
Swallowing difficulty
Altered thirst mechanism

66
Q

Causes of fluid volume deficit: Dehydration: Failure of Regulatory Mechanisms

A

Burns: 1st barrier: evaporation

67
Q

Causes of fluid volume deficit: Dehydration: Pediatric Differences

A

Imbalances due to exercise
Heat stress
Increased respiratory rate
Fevere

68
Q

Causes of fluid volume deficit: Dehydration: Older adults

A

Fewer intracellular reserves leads to rapid dehydration

69
Q

Nursing Interventions for fluid volume deficit

A 
Encourage PO fluid intake 
Administer IVF per order
Initiate fall precautions
Reposition q 2 hrs
Teach prevention of orthostatic hypotension, prevention of fluid deficit, maintaining fluid intake
70
Q

Fluid Volume Deficit: Nursing Diagnosis

A

Deficient fluid volume
Ineffective peripheral tissue
Confusion
Activity intolerance

71
Q

Fluid Volume Overload: Interstitial Fluid

A
  • Increased blood hydrostatic pressure
  • Decreased blood osmotic pressure
  • Increased interstitial fluid osmotic pressure
  • Blocked lymphatic drainage
72
Q

Fluid Volume Overload: Interstitial Fluid: Causes of Increased blood hydrostatic pressure

A

Inflammation
Local infection
Right sided heart failure
Venous thrombosis

73
Q

Fluid Volume Overload: Interstitial Fluid: Causes of Decreased blood osmotic pressure

A

Albumin-Nephrotic syndrome
Kwashiorkor
Liver disease

74
Q

Fluid Volume Overload: Interstitial Fluid: Causes of increased interstitial fluid osmotic pressure

A

Increased capillary permeability caused by inflammation
Toxins
Burns
Hypersensitivity reactions

75
Q

Fluid Volume Overload: Interstitial Fluid: Blocked lymphatic drainage

A

Tumors
Goiters
Parasites
Surgery

76
Q

Clinical manifestations of fluid volume overload

A 
Weight gain >5% over a short period of time 
Edema (anasarca)/Ascites 
Increased blood pressure
Full/bounding pulse 
Distended neck/peripheral veins
Cough/Dyspnea/Orthopnea 
Moist crackles and rhonchi in lungs **
Polyuria 
Possible cerebral edema 
Decreased hematocrit and BUN (diluted)
77
Q

All diagnostic tests (labs) for Fluid Volume Overload will be what?

A 
Decreased 
CBC: Hematocrit 
Serum osmolality 
Specific gravity 
Renal labs (BUN and Creatinine)
78
Q

Nursing interventions for Fluid Volume Overload

A

Weigh daily
Monitor labs
Position in Fowler position
Elevate HOB
Monitor I&O, SaO2, Cardiorespiratory
Educate and encourage Na+ restriction diet
Administer meds: i.e. diuretics
Teach med safety
Oral hygiene q 2 hrs
Reposition q 2 hrs— elevate area with edema

79
Q

Electrolytes function is to?

A
  • Facilitate enzyme reactions
  • Transmits neuromuscular reactions
  • Maintain fluid balance
  • Contributing to acid-base regulation
80
Q

Na+

Normal range?
Chief electrolyte of ___ ?

A

Sodium

135-145 mEq/L
ECF

81
Q

What should you think when thinking about Na+

A

Neuro: confusion: cerebral edema

82
Q

What regulates Na+ ?

A

Kidneys and hormones

Aldosterone is the primary mineralocorticoid in regulating Na+

83
Q

Where Na+ goes ____ and _____ follows

A

Cl- and H2O

84
Q

Na+ is required for _____ _____ and ______ _______ transmission through the ____ / ____ pump

A

Nerve impulse
Muscle fiber transmission
Na+ / K+

85
Q

Regulates volume of body fluids through which pressure

A

Osmotic pressure

86
Q

Hyponatremia:

Below what range?
Critical?

A
87
Q

What does hyponatremia result from?

A

Excess of water intake or loss of Na+

88
Q

Water shifts from ____ to ____

A

ECF to ICF

89
Q

Hyponatremia S/S

A 
Abdominal cramps 
Muscle cramps 
Weakness
Fatigue 
Confusion 
N/V
Edema 
Convulsions (if critically low) (cerebral edema)
90
Q

Hyponatremia Tx

A

Diet
IV Therapy
Fluid Restrictions

91
Q

Hypernatremia

Above what range?
Critical?

A

> 145 mEq/L

> 160 mEq/L (Critical)

92
Q

Hypernatremia results from?

A

Excess of water loss or increase Na+ intake

93
Q

Water shifts from ____ to ____

A

ICF to ECF

94
Q

Hypernatremia: Clinical Manifestations

A
  • ECF hyperosmolality
  • Cellular dehydration
  • Thirst
  • Dry mucous membranes
  • Oliguria
  • Increased temp and pulse
  • Flushed skin
  • Restlessness
95
Q

Hypernatremia: Tx

A

Diet (Low Na+)

IVF (D5W or 0.45% NS)

96
Q

K+

Normal Range?
Chief electrolyte of ____ ?

A

5.5 - 5 mEq/L

ICF

Major mineral in all cellular fluids

97
Q

What does K+ aid in?

A
  • Muscle contraction: i.e. cardiac and skeletal muscles
  • Nerve & electrical impulse conduction
  • Regulates enzyme activity
  • Regulates ICF H2O content
  • Assists in acid-base balance
98
Q

K+ is regulated by ____ and _____

A

Kidneys and hormones

99
Q

Hypokalemia

Below what range?
Critical?

A
100
Q

Hypokalemia results from?

Affects what body systems?

A

Decreased intake of K+
Increased excretion via GI/Renal
K+ depleting diuretics

All body systems and life threatening

101
Q

Hypokalemia: S/S

A

Muscle weakness
Leg cramps
Decreased GI motility
Cardiac arrhythmias

102
Q

What should the nurse monitor when administering IV K+ ?

A 
Place on cardiac monitor >10 mEq/L K+
Monitor IV site for phlebitis 
Assure of adequate mixing of K+ in solution 
Monitor elevated K+ levels 
Monitor decreased Na+ levels 
NEVER administer K+ by IV push
103
Q

How much K+ can be administered through peripheral IV?

Central IV?

A

10 mEq/hr

20 mEq/hr

104
Q

Hyperkalemia

Above what range?
Critical?

A

> 5 mEq/L

> 7 mEq/L (Critical)

105
Q

Hyperkalemia: S/S

A

Muscle weakness
Cardiac changes
N/V
Paresthesia of face/fingers/tongue

106
Q

Hyperkalemia results from?

A 
Excessive intake of K+
Trauma 
Crush injuries 
Burns
Renal failure
Adrenal insufficiency 
Acidosis
107
Q

Hyperkalemia: Tx

A

Diet
Meds: Kayaxelate (GI tract absorbs K+, explosive diarrhea), insulin, D50, Ca++ gluconate (protect heart)
IV Therapy- dilute
Possible dialysis

108
Q

Ca++
Normal range ?
Ionized Ca++ ?

A

9 - 11 mg/dL

4.25 - 5.25 mg/dL

109
Q

Ca++ is found where?

And needed for?

A 
98-99% in teeth and bones 
Needed for:
nerve transmission
Vitamin B12
Muscle contraction 
Blood clotting 
Absorption of Vitamin D in gut
Absorption of Mg- bones
110
Q

Hypocalcemia

Below range?
Results from?

A
111
Q

Hypocalcemia: Manifestations

A 
Osteomalacia 
EKG changes
Numbness/tingling in fingers
Muscle cramps/tetany 
Siezures
Chovstek sign 
Trousseau sign
112
Q

Hypercalcemia

Above range?
Results from?

A

> 11 mg/dL

Hyperparathyroidism
Bone malignancies
Prolonged immobilization
Drug toxicity (Lithium, thiazides, Vitamins A and D)

113
Q

Hypercalcemia: S/S

A 
Muscle weakness
Renal calculi 
Fatigue 
Altered LOC 
Decreased GI motility 
N/V
Cardiac change
Constipation 
Polyuria
114
Q

Hypercalcemia: Tx

A

PO4-

IVF

115
Q

Mg++

Normal range?
Located?

A

1.5-2.5 mEq/L

Located within ICF

116
Q

Mg++ is needed for ?

A 
Activating enzymes 
Electrical activity 
Metabolism of carbs/proteins 
DNA synthesis 
Production and use of ATP
117
Q

Mg++ regulated by?

A

Intestinal absorption and kidneys

118
Q

Hypomagnesemia

Below range?
Results from?

A
119
Q

Hypomagnesemia: S/S

A 
Muscles weakness 
Cardiac changes
Mental changes
Hyperactive reflexes 
Other hypocalcemia S/S
120
Q

Hypomagnesemia: Tx

A

Replacement IV Therapy
Restore normal Ca levels (Mg mimics Ca)
Seizure precautions

121
Q

Hypomagnesemia is common in what type of patients and does what with the heart?

A

Common in critically ill patients

Increases cardiac irritability and ventricular dysrhythmias: especially with patient with recent MI
Torsade de Pointe **

122
Q

Hypermagnesemia

Normal range?
Results from ?

A

> 2.5 mEq/L

Renal failure
Increased Mg intake

123
Q

Hypermagnesemia: S/S

A 
Flushing 
Lethargy 
Cardiac changes (decreased HR)
Decreased resp
Loss of deep tendon reflexes
124
Q

Hypermagnesemia: Tx

A

Restrict intake

Diuretic Rx

125
Q

Cl-

Normal range?
Most abundant anion in the ____

A

95-105 mEq/L

ECF

126
Q

Cl- maintains what?

A

Osmotic pressure
Acid-base balance
Aids in digestion (forming hydrochloric acid in the stomach)

127
Q

Hypochloremia

Below range?
Results from?

A
128
Q

Hypochloremia: S/S

A

Paresthesia of face and extremities
Muscle spasm
Tetany

129
Q

Hypochloremia: Tx

A

Diet

IV Therapy

130
Q

Hyperchloremia

Above range?
Results from?

A

> 105 mEq/L

Renal failure
Overactive parathyroid glands
Metabolic acidosis
Respiratory alkalosis

131
Q

Hyperchloremia: S/S

A

Muscle weakness
Increased thirst
Kussmauls’s resp. (rapid, short resp)

132
Q

Hyperchloremia: Tx

A

IVF
Diuretics
Treat underlying cause

Med/Surg 1 Exam 1 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions