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NCLEX > Fluid & Electrolytes > Flashcards

Fluid & Electrolytes Flashcards

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1
Q

Too much fluid in the vascular space

A

hypervolemia

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2
Q

causes of hypervolemia

A

HF
RF
things with lots of sodium

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3
Q

in ___ ___ the heart is weak, decreased CO, decreased UO, decreased kidney perfusion,

volume stays in the vascular space

A

heart failure

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4
Q

3 things with lots of sodium

A

efferescent soluble meds (aklaseltzer)
canned foods
IVF with sodium

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5
Q

3 hormones that regulate fluid volume

A

adolsterone
ANP
ADH

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6
Q

where is aldosterone found?

A

adrenal glands

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7
Q

normal action of aldosterone

A

retain sodium AND water

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8
Q

aldosterone makes the blood volume go ____

A

up

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9
Q

diseases with too much aldosterone

A

cushing’s dx

hyperaldosteronism

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10
Q

dx with too little aldosterone

A

addison’s disease

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11
Q

where is Atrial Natriuretic Peptide (ANP) found

A

atria of the heart

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12
Q

how does ANP work?

A

opposite of aldosterone

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13
Q

ANP causes excretion of ??

A

water and sodium

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14
Q

ANP is released for ___ ___ patients

A

heart failure

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15
Q

anti-diuretic hormone (ADH) makes you ____ water

A

retain

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16
Q

too much ADH aka?

A

SIADH

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17
Q

with SIADH they are in fluid volume ____

A

excess

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18
Q

urine and blood with SIADH

A

concentrated urine

dilute blood

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19
Q

not enough ADH aka??

A

DI

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20
Q

DI patients are in fluid volume ____

A

deficit

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21
Q

urine and blood with DI

A

dilute urine

concentrated blood

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22
Q

PC with DI

A

SHOCK….DIE

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23
Q

Concentrated makes the #s go ____

A

up

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24
Q

dilute makes the #s go ____

A

down

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25
Q

which 3 things can go up or down with dilute vs. concentrated?

A

urine specific gravity
sodium
Hct

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26
Q

ADH is found where?

A

pituitary gland

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27
Q

key words to make you think potential ADH problems?

A 
craniotomy
head injury
sinus surgery
trassphenoidal hypophysectomy
or any condition that can lead to increased ICP
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28
Q

another name for ADH =

A

vasopressin

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29
Q

with hypervolemia the vessels can’t hold anymore fluids so they start to

A

3rd space

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30
Q

central venous pressure is measured where?

A

right atrium

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31
Q

with hypervolemia….CVP goes ___

A

up

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32
Q

sx of hypervolemia

A

wet lung sounds
polyuria
increased BP
increased weight

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33
Q

hypervolemia can lead to

A

heart failure then pulmonary edema

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34
Q

normal CVP

A

2-6

or 5-10

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35
Q

fluid retention: think ____ problems first

A

HEART

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36
Q

treatment for hypervolemia

A 
low Na+ diet
fluid restriction
I/Os and daily weights
diuretics
bed rest
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37
Q

loop diuretic

A

furosemide

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38
Q

thiazide diuretic

A

hydrochlorothiazide

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39
Q

potassium sparing diuretic

A

sprionolactone

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40
Q

bed rest induces ____ by the release of ___ and decreased production of ____

A

diuresis

ANP

ADH

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41
Q

fluid volume deficit AKA

A

hypovolemia

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42
Q

causes of hypovolemia

A

loss of fluid from anywhere
third spacing
diseases with polyuria

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43
Q

examples of fluid loss from anywhere

A 
thoracentesis
paracentesis
vomiting
diarrhea
hemorrhage
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44
Q

when fluid is in a place that does you no good

A

3rd spacing

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45
Q

examples of 3rd spacing

A

burns

ascites

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46
Q

diseases with polyuria

A

polyuria
oliguria
anuria

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47
Q

sx of hypovolemia

A 
decreased weight,
decreased skin turgor
dry MM
decreased UO
low BP
increased HR
increased RR
decreased CVP
increased urine specific gravity
48
Q

treatment for hypovolemia

A

prevent further losses

replace volume

49
Q

fluid that goes into the vascular space and stays there!

A

isotonic solution

50
Q

exs of isotonic solution

A

NS
LR
D5W
D5 1/4 NS

51
Q

uses for isotonic solutions

A

N/V
burns
sweating
trauma

52
Q

when is isotonic solutions C/I

A

HTN
cardiac disease
renal dx

53
Q

goes into the vascular space and then shifts out into the cells to replace cellular fluid

A

hypotonic solutions

54
Q

hypotonic solutions rehydrate without causing ____

A

HTN

55
Q

examples of hypotonic solutions

A

D2.5W
1/2 NS
0.33% NS

56
Q

uses for hypotonic solutions

A

client who has HTN

renal or cardiac disease

57
Q

watch for cellular edema with hypotonic solutions because this fluid is moving out to the cells, which could lead to fluid volume ____ and decreased BP

A

deficit

58
Q

volume expanders that will draw fluid into the vascular from the cells

A

hypertonic solutions

59
Q

examples of hypertonic solutions

A 
D10W 
3% NS
5% NS
D5LR
D5 1/2
D5
TPN
Albumin
60
Q

uses for hypertonic

A

hyponatremia
3rd spacing clients
clients with severe edema, burns, or ascites

61
Q

watch for fluid volume ____with hypertonic solutions

A

excess

62
Q

ISOTONIC

A

“stay where I put it”

63
Q

HYPOTONIC

A

go Out of the vessel

64
Q

HYPERTONIC

A

Enter the vessel

65
Q

Mg and Ca act like

A

sedatives

66
Q

Mg is excreted by the ____ or can be lost in the ___ ___

A

kidneys

GI tract

67
Q

causes of hypermagnesemia

A

renal failure

antacids

68
Q

sx of hypermagnesemia

A

flushing
warmth
vasodilation

69
Q

treatment for hypermagesemia

A

ventilator
dialysis
CALCIUM GLUCONATE

70
Q

causes of hypercalcemia

A

hyperparathyroidism
thiazides
immobilization

71
Q

sx of hypercalcemia

A

bones are brittle

kidney stones

72
Q

treatment for hypercalcemia

A 
move!!!!!
fluids
add phosphorus to diet
steroids
vitamin D
73
Q

sx common with hypermagnesemia and hypercalcemia

A 
decreased DTRs
weak muscle tone
arrhythmias
decreased LOC
decreased pulse and RR
74
Q

if you want to get Mg and Ca questions right, think ____ first

A

muscles

75
Q

calcium has an inverse relationship with _____

A

phosphorus

76
Q

Mg level

A

1.3-2.1

77
Q

calcium level

A

9.0-10.5

78
Q

causes of hypomamagnesemia

A

diarrhea

alcoholism

79
Q

causes of hypocalcemia

A

hypoparathyroidism
radical neck
thyroidectomy
(not enough PTH)

80
Q

sx of hypomagnesema and hypocalcemia

A 
rigid muscle tone
seizure risk
stridor
positive trousseau's sign and chovestek's sign
arrhythmias
increased DTRs
swallowing problems
mind changes
81
Q

treatment of hypomamagnesemia

A

give some Mg
seizure precautions
eat Mg

82
Q

what to checking before and during Mg infusion?

A

kidney function

83
Q

what do you do if your client reports flushing and sweating when you start IV Mg?

A

STOP IT

84
Q

treatment for hypocalcemia

A

vitamin D
phosphate binders
IV Ca

85
Q

what to make sure to do before administering IV Ca

A

put patient on the heart monitor

86
Q

foods high in Mg

A 
spinach
mustard greens
summer squash
broccoli
halibut
turnip greens
pumpkin seeds
peppermint
cucumber
green beans
celery
kale
sunflower seeds
sesame seeds
flax seeds
87
Q

sodium level in your blood is totally dependent on how much ____ you have in the blood

A

water

88
Q

sodium level

A

135-145

89
Q

Hypernatremia AKA

A

dehydration

90
Q

hyponatremia AKA

A

dilution

91
Q

causes of hypernatremia

A

hyperventilation
heat stroke
DI
V/D

92
Q

sx of hypernatremia

A

dry mouth
swollen tongue
thirsty

93
Q

treatment of hypernatremia

A 
restrict Na+
dilute client with fluids
daily weights
I/Os
lab work
94
Q

causes of hyponatremia

A

drinking H20 for fluid replacement
psychogenic polydipsia
D5W
SIADH

95
Q

psychogenic polydipsia

A

loves to drink water

96
Q

sx of hyponatremia

A

HA
seizure
coma

97
Q

treatment for hyponatremia

A

client needs Na+

client doesn’t need water

98
Q

if having neuro problems with hypocalcemia they need ______ saline

A

hypertonic

99
Q

K+ levels

A

3.5-5.0

100
Q

K+ is excreted by the ____

A

kidneys

101
Q

causes of hyperkalemia

A

kidney trouble

spironolactone

102
Q

spironolactone makes you retain ____

A

K+

103
Q

sx of hyperkalemia

A

muscle twitching
then muscle weakness
then flaccid paralysis
arrhythmias

104
Q

treatment for hyperkalemia

A

dialysis
calcium gluconate
glucose and insulin
sodium polystyrene sulfonate (kayexelate)

105
Q

calcium gluconate decreases _____

A

arrhythmias

106
Q

insulin carries ____ and ___ into the cell.

A

glucose and K+

107
Q

anytime you give IV insulin, worry about _____ and ____

A

hypoglycemia and hypokalemia

108
Q

causes of hypokalemia

A

vomiting
NG suctioning
diuretics
not eating

109
Q

sx of hypokalemia

A

muscle cramps
muscle weakness
arrhythmias

110
Q

treatment for hypokalemia

A

give K+
Spironolactone
eat more K+

111
Q

spironolactone makes you retain ____

A

K+

112
Q

sodium and ___ have an inverse relationship

A

K+

113
Q

major problem with oral potassium

A

GI upset

give with food

114
Q

assess ___ ____ before and during IV potassium

A

urinary output

115
Q

always put IV ____ on a pump

A

K+

NCLEX (10 decks)

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