Fluid & Electrolytes Flashcards
Fluid Volume Excess = ________
Too much _____ in the ___________
Hypervolemia
fluid, vascular space
Causes of FVE HF: heart is \_\_\_\_\_\_, CO is \_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_\_ perfusion decreased, urinary output \_\_\_\_\_\_\_ The volume stays in the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ RF: kidneys aren't \_\_\_\_\_\_\_\_\_\_\_ Three things with a lot of sodium:
weak, decreased, kidney, decreased
vascular space
working
1. effervescent meds 2. canned foods 3. IVF c Na
Hormones r/t FV ALDOSTERONE found in \_\_\_\_\_\_\_\_\_\_\_ blood volume gets \_\_\_ so aldosterone secretion \_\_\_\_\_\_, retain \_\_\_\_\_\_ & \_\_\_\_\_\_, so blood volume goes \_\_\_ Too much aldosterone = Too little aldosterone =
ANP found in _______ of _______, released when atria ______
it is the ________ of aldosterone
ANP causes _____ of _____ & _____, which ________ blood volume
ADH found in _________
ADH makes you ________
retain _______
adrenal glands
low, increases, sodium & water, up
Cushing’s, hyperaldosterone (Conn’s)
Addision’s
atria, heart, stretch
opposite
excretion, sodium & water, decreases
pituitary
retain
water
Three Letters/Three Characters
ADH & H2O: ADH = think WATER
ADH Problems TOO MUCH ADH =\_\_\_\_\_\_ too many \_\_\_\_\_\_, too much \_\_\_\_\_\_\_ \_\_\_\_\_\_\_ water = Fluid volume \_\_\_\_\_\_\_ Urine \_\_\_\_\_\_\_\_ Blood \_\_\_\_\_\_\_\_ UOP \_\_\_\_\_\_\_\_\_
TOO LITTLE ADH = \_\_\_\_\_\_\_\_ DI = \_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_ water = Fluid Volume \_\_\_\_\_\_ Urine \_\_\_\_\_\_\_ Blood \_\_\_\_\_\_\_ UOP \_\_\_\_\_\_\_\_
SIADH letters, water retain = FVE concentrated dilute decreases
DI diuresis lose = FVD dilute concentrated increases
CONCENTRATED makes #’s go ______
DILUTE makes #’s go _______
Urine specific gravity, sodium, hematocrit
Drug utilized in DI
Desmopressin, DDAVP – ADH replacement for DI
________ ICP can lead to a ________ problem
increased, ADH
Fluid Volume Excess S/S
vessels are ______ = _______ veins
vessels _____ = ______ or third spacing
CVP goes ______: MORE _______ MORE ________
Lungs sound _______
________, kidneys are trying to _________
HR _________ –wants to push fluid ________
if fluid goes ______, leads to _____ & _____ edema
BP _______, MORE _____ MORE _______
weight _______ — NOT _____, BUT ________
full, distended leak, edema UP; volume, pressure wet POLYURIA, diurese increases, forward backward, HF & PULMONARY increases; volume, pressure increases; fat, fluid
Fluid Volume Excess Treatment
low _______ diet/restrict _______
I & O and daily _______
Diuretics
Protect the ______; ______ skin is about to ________
Bed rest induces ________ by releasing _____ and _______ ADH which will cause loss of ______ & _____
PUSH _____ for ______ unless contraindicated
Assess/Evaluate = ______ & _______
give IVF ______ to the very ______ & very _____ (& those with _____ & ______ problems)
sodium/fluids
weights
furosemide, bumex, hydrochlorthiazide, sprionolactone
skin; edematous, breakdown
diuresis, ANP, decreasing, sodium and water
fluids, bedrest
signs & symptoms
slowly, old, young, heart, kidney
Fluid Retention? Think _________ problems FIRST
heart
NORMAL CVP
2-6 mmHg/5-10 cmH2O
Fluid Volume Deficit = _________
POLYURIA, THINK _______ FIRST
hypovolemia
SHOCK
Fluid Volume Deficit Causes
loss of ______ from anywhere
_____ spacing (fluid is not in the ________, as in ascites or burns)
diseases with _______ (diabetes)
fluid
third, vascular space
polyuria
Fluid Volume Deficit S/S
weight _______
skin turgor _______
______ mucous membranes
________ urine output because kidneys are not being _______ or they’re holding on to ______
BP: ______ LESS ______, LESS ________
HR: _______ trying to pump the fluid left around
Pulse will be ______, _______
RR: _______ in an effort to improve ________
CVP: ________ LESS ______, LESS ________
Veins _________; cool extremities d/t _________
Urine Spec Grav: _________ d/t concentration
Orthostatic Hypotension: do not ________
decreases decreases dry decreased perfused, volume decreases, volume, pressure increases thready, weak increases, hypoxia decreases, volume, pressure constricted; vasoconstriction increases
delegate to UAP
Fluid Volume Deficit Treatment
prevent further ________
replace volume: mild _______; severe _______
safety precautions: high risk for _______
monitor for _________
losses
PO, IV
falls d/t mental status changes
overload
Isotonic Solutions AKA _______ solutions
Stay in _____________
use for client that has lost ______ through nausea, vomiting, burns, hemorrhage, sweating, trauma
________ is the basic solution for blood admin
Do NOT use _________ solutions in clients with _______, _______ disease or ________ disease as they cause _________, fluid volume ______ or hypernatremia
balanced
vascular space
fluid
NS
isotonic
hypertension, cardiac, renal
hypertension, excess
Isotonic Examples
NS, LR, D5W, D5 1/4 NS
Hypotonic Solutions
______ but do not cause _________
watch for cellular _______, which could lead to fluid volume ______ and ______ blood pressure
replenish, hypertension
edema
deficit, decreased
Hypotonic Examples
D2.5W, 1/2 NS, 0.33% NS
Hypertonic Solutions
_______ with ________
volume expanders that draw fluid into _________
_______ burns, edema, ascites, clients with _________
watch for fluid volume _______ with frequent ______
packed, particles
vascular space
severe, hyponatremia
excess, VS
Hypertonic Examples
D10W, 3% NS, 5% NS, D5LR, D5 1/2 NS, D5NS, TPN and Albumin
Two electrolytes act as sedatives: _____ & _____
HYPER = too ______ sedative
HYPO = not ______ sedative
Magnesium and Calcium
much
enough
Hypermagnesemia
caused by ________ failure, antacids
S/S include flushing, warmth d/t _________
Treatment: ventilator, dialysis, IV _________, ______ precautions
renal
vasodilation
Calcium gluconate, safety
Hypercalcemia
caused by too much _____; hyper_______, ________, _________
S/S include brittle _____ and _____ stones
Treatment: get _______, _______ to prevent kidney stones, add _______ to diet via _______, steroids, _______ precautions,
Meds: bisphosphates, ________
Need vitamin ______ to use _______
PTH, hyperparathyroidism, immobilization, thiazides
bones, kidney
moving!, fluids, phosphorus, protein, safety
phosphate, calcitonin
D, Ca
See Mg or Ca? THINK _______ FIRST
MUSCLES
Hypermag & Hypercal have these in common: DTRs: \_\_\_\_\_\_\_ Muscle tone: \_\_\_\_\_\_\_, \_\_\_\_\_\_\_ potential for \_\_\_\_\_\_\_\_ LOC \_\_\_\_\_\_\_ Pulse \_\_\_\_\_\_\_ Respirations \_\_\_\_\_\_\_ THINK \_\_\_\_\_\_\_
decreased flaccid, weak arrhythmias decreases decreases decrease SEDATED
Normal Magnesium
1.3 - 2.1
Normal Calcium
9.0 - 10.5
Hypomagnesemia
Causes: _______ d/t lots of Mg in intestines, ________ because ALCOHOL suppresses ADH and is hypertonic
Treatment: Give or eat _____, check ______ function, _______ precautions
diarrhea, ALCOHOL
Mag, kidney, seizure
Hypocalcemia
Causes: ______ parathyroidism, ______ectomy = not enough _______
Treatment: Vitamin _____, _______ binders, IV ______
HYPO, thyroid, PTH
D, phosphate, Ca
IV Mag: Flushing & Sweating? __________ the infusion
STOP
IV Ca: give ______, _______ monitor
slowly, cardiac
Hypomag & Hypocal have these in common:
Muscle tone _____, ______
potential for _______
airway is a smooth ______ –> ______/laryngospasm
+_____, +______
heart is a ______ –> ________
DTRs _______
______ changes
esophagus is a smooth ______ –> _____ problems
rigid, tight SEIZURE muscle --> stridor Chvostek's & Trousseau's muscle, arrhythmias increase MIND muscle --> swallowing
SODIUM THINK _______ CHANGES
NEURO
_____ is only electrolyte that cares about ______
sodium, water
Normal Sodium
135 - 145
Hypernatremia = ________
Too much ____; Not enough _____
causes: ____ventilation, ____ stroke, diabetes ______
S/S: _____ mouth, _____, swollen ______
Treatment: restrict ________, dilute client with ______ to decrease ______
DAILY ______, I&O, Labs
DEHYDRATION
sodium, water
hyper, heat, insipidus
dry, THIRST, tongue
sodium, fluids, sodium
WEIGHTS
Feeding tube clients tend to get ________
DEHYDRATED
IF YOU HAVE A ______ PROBLEM, YOU HAVE A _______ PROBLEM
Sodium, Fluid
Hyponatremia = ______
Too much _______; Not enough ______
causes: ________ replacement, psychogenic _______, D5W, SIADH d/t retaining _____
S/S: CNS 3 _______, _______, ______
Treatment: client needs _______, client DOESN’T need _______, ________ saline if ______ problems
Dilution
water, sodium
fluid, polydipsia, water
- headache 2. seizure 3. coma
sodium, water, hypertonic, neuro
Potassium ______ by the _______
If _____ are not ______, ________ will go ___
excreted, kidneys
kidneys, working, potassium, up
Normal Potassium
3.5 - 5.0
Hyperkalemia
Causes: _____ trouble, spironolactone d/t ______ of potassium
S/S: _____ twitching could lead to muscle ______, then ______ paralysis; LIFE-THREATENING ________
Treatment: dialysis for _____ not _____, Ca ______ for arrhythmias, ______ & _______; _________
Push ______ with Kayexalate (sodium polystyrene sulfonate)
kidney, retention
muscle, weakness, flaccid; ARRHYTHMIAS
kidneys, working, gluconate, glucose & insulin, Kayexalate
fluids
Hypokalemia
Causes: vomiting, _____ suction, _______, Not _____
S/S: _____ cramps, muscle ______, _________
Treatment: give __________, ________, eat more _________
NG, diuretics, eating
muscle, weakness, ARRHYTHMIAS
potassium, spironolactone, potassium
______ & _______ have an ______ relationship
Sodium, Potassium, Inverse
Give potassium with _______
Major side effect is _______
Food
GI upset
Always asses ________ BEFORE/DURING IV K
urine output
Always put potassium on a ______
NEVER give potassium via IV _____
pump
push
