Fluid & Electrolytes Flashcards

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1
Q

What is Aldosterone?

A

Steroid

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2
Q

Where is Aldosterone secreted?

A

Adrenal gland

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3
Q

Where is the adrenal gland?

A

Above kidneys

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4
Q

What does Aldosterone do?

A

Retain Na & water, Lose K

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5
Q

What diseases have too much Aldosterone?

A
  1. Cushing’s

2. Conns Syndrome (Hyperaldosteronism)

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6
Q

Disease with not enough Aldosterone?

A

Addison’s

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7
Q

What does ANP do?

A

Excretes Na & water

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8
Q

How does ANP work?

A

When preload increases (laying down) the atria secretes ANP

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9
Q

Disease with too much ADH

A

Syndrome of Inappropriate ADH Secretion (SIADH)

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10
Q

Disease with not enough ADH

A

Diabetes Insipidus

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11
Q

What do you worry about with Diabetes Insipidus?

A

Shock, bc decreased blood volume

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12
Q

Where is ADH found?

A

Pituitary gland

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13
Q

What drug is similar to ADH?

A

Vasopressin, Desmopressin acetate

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14
Q

In SIADH, does Na follow water?

A

No, Na levels increase

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15
Q

Where is the pituitary gland?

A

Behind the eyes

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16
Q

ADH problems are associated with what?

A

Head surgeries, increased ICP

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17
Q

CVP levels

A

2-6

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18
Q

Pulses in hypervolemia

A

Full, bounding

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19
Q

NS

A

Isotonic

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20
Q

LR

A

Isotonic

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21
Q

D5W

A

Isotonic

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22
Q

D51/4NS

A

Isotonic

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23
Q

Don’t use isotonic solutions with who?

A

HTN, cardiac dz, renal dz

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24
Q

Another name for isotonic fluids?

A

Balanced solutions

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25
Q

Best fluid for shock pts

A

LR

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26
Q

Hypotonic fluids do what?

A

Rehydrate, move into cells. Don’t raise BP bc they don’t stay in vascular space

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27
Q

0.5 NS

A

Hypotonic

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28
Q

0.33 NS

A

Hypotonic

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29
Q

D 2.5 W

A

Hypotonic

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30
Q

Besides heart and renal dz, what are hypotonic solutions for?

A

Hypernatremia to dilute, and for rehydrating

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31
Q

Hypertonic fluids, think what?

A

Packed with particles

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32
Q

D10W

A

Hypertonic

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33
Q

3%NS

A

Hypertonic

34
Q

D5LR

A

Hypertonic

35
Q

TPN

A

Hypertonic

36
Q

Albumin

A

Hypertonic

37
Q

Hypertonic fluids are for what?

A

Hyponatremia, 3rd space w burns, ascites

38
Q

How is magnesium excreted?

A

Kidneys, also lost in GI tract

39
Q

Mg and Ca act like what?

A

Sedatives

40
Q

Causes of hypermagnesemia

A

Renal dz, antacids

41
Q

First signs of hypermagnesemia and why

A

Flushing, warmth, vasodilate

42
Q

S/S of hypermag

A

Decreased LOC, DTR, RR, HR, flaccid, arrhythmia

43
Q

Tx of hypermag

A

Vent, safety precautions

44
Q

Antidote of mag

A

Calcium Gluconate

45
Q

Cause of hypercalcemia

A

Too much PTH

Immobilization

46
Q

What does PTH do?

A

Pulls Ca from bone and puts it in the blood when blood levels are low

47
Q

S/S of hypercalcemia

A

Kidney stones, brittle bones, decreased LOC, DTR, RR, HR, flaccid, arrhythmia

48
Q

Tx of hypercalcemia

A

Move, bear weight, fluids to prevent kidney stone, fleets enema (lots of phos), phos soda, foods with protein has phos, safety precautions bc sedate, vitamin D to use calcuim

49
Q

Ca and Ph are what?

A

Inverse relationship

50
Q

What can decrease serum calcium?

A

Steroids, calcitonin (treats osteoporosis)

51
Q

Causes of hypomag

A

Alcohol, diarrhea

52
Q

Why does alcohol cause hypomag?

A

Suppresses release of ADH, hypertonic, not eating

53
Q

S/S of hypomag and hypocalcemia?

A

Rigid/tight muscles, seizures, stridor/laryngospasm, positive Chostevicks, positive trousseaus, arrhythmias, increase DTR, mind changes, swallowing problems/aspiration

54
Q

Tx of hypomag

A

Give IV mag, check kidney function first, seizure precautions

55
Q

Foods w/ mag

A

Green veggies, seeds, peppermint

56
Q

Causes of hypocalcemia

A

Hypoparathyroidism, radical neck, thyroidectomy

57
Q

Tx of hypocalcemia

A

Vitamin D, phos binders (Ca acetate), IV Ca

58
Q

How to give IV Ca

A

Give slowly, keep pt on heart monitor

59
Q

Causes of hypernatremia

A

Dehydration, hyperventilation, heat stroke, DI

60
Q

S/S of hypernatremia

A

Dry mouth, thirsty, swollen tongue

61
Q

Tx of hypernatremia

A

Restrict Na, dilute with fluids

62
Q

Clients on feeding tubes tend to get what?

A

Dehydrated, the tube feedings have all the electrolytes they need but no water. Ask the doc if you can give them more water.

63
Q

Causes of hyponatremia

A

Drinking water, D5W (sugar and water), SIADH

64
Q

S/S of hyponatremia

A

HA, seizure, coma

65
Q

Tx of hyponatremia

A

Give Na, not water, if neuro problems: give hypertonic saline (packed w/ particles)

66
Q

K is excreted how?

A

Kidneys

67
Q

Causes of hyperkalemia

A

Kidney dz, spironolactone

68
Q

S/S of hyperkalemia

A

Muscle twitching, then weakness, then flaccid paralysis. Also arrhythmias.

69
Q

ECG changes with hyperkalemia

A

Bradycardia, tall/peaked T waves, prolonged PR intervals, flat/absent P waves, widened QRS complex, conduction blocks, v fib

70
Q

Tx of hyperkalemia

A

Dialysis, calcium gluconate to decrease arrhythmias, glucose and insulin (insulin carries glucose and K into cell), sodium sulfonate (gives sodium ions which will bring K down, inverse relationship)

71
Q

Any time you give IV insulin, worry about what?

A

Hypokalemia and hypoglycemia

72
Q

Causes of hypokalemia

A

Vomiting, NG suction (lots of K in stomach), diuretics, not eating

73
Q

S/S of hypokalemia

A

Muscle cramps, weakness, arrhythmias

74
Q

ECG changes with hypokalemia

A

U waves, PVCs, v tach

75
Q

Tx of hypokalemia

A

Give K, spironolactone, eat K

76
Q

Major problem with oral K

A

GI upset, so give with food

77
Q

How to give IV K

A

Assess urinary output before and during, put on a pump, mix well, never give as a push

78
Q

What relationship do Na and K have?

A

Inverse

79
Q

Does K burn during infusion?

A

Yes, eats up peripheral veins

80
Q

Foods high in K

A

Green veggies, oranges, any potatoes ginger, apricots, strawberries, avocado, banana, tuna, cantaloupe, tomatoes, lima beans, parsley