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Foundations > Fluid/Electrolytes > Flashcards

Fluid/Electrolytes Flashcards

1
Q

Volume

A

Amount of a fluid

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2
Q

Osmolarity

A

concentration of fluid

the concentration of solutes creating pressure in body fluids

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3
Q

Fluid Composition

A

electrolyte concentration

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4
Q

PH

A

Degree of acidity

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5
Q

Intracellular fluids

A

fluid within cells;42 % of total body water , 2/3 of total body water

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6
Q

Extracellular fluids

A
  1. interstitial fluids
  2. Intravascular
    Transcellular

17% of body water

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7
Q

osmols

A

of particles of solute per kilogram of water

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8
Q

Isotonic

A

same concentration as blood

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9
Q

hypotonic

A

more dilute than blood

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10
Q

Hypertonic

A

More concentrated than blood

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11
Q

Electrolytes

A

mineral salts- compounds that separate into ions when dissolved in water

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12
Q

osmosis

A

movement of a pure solvent ( like water) from areas of lesser concentration to an area of high concentration

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13
Q

diffusion

A

passive process by which molecules of a solute move though a cell membrane from an area of higher concentration to lower concentration

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14
Q

Filtration

A

movement of water and small particles from an area of high pressure to one of low pressure

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15
Q

Active transport

A

when molecules move across cell membranes against a concentration gradient (area of low concentration to high concentration) requires energy.

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16
Q

Fluid Balance

A

fluid intake and absorption
fluid distribution
fluid output

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17
Q

fluid distribution

A

movement of fluid among its various compartments

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18
Q

Thirst Mechanism

A
  • increased plasma osmolarity
  • angiotensin II
  • Dry pharyngeal mucous membranes
  • psychological factors
  • angiotensin III
  • decreased plasma volume
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19
Q

Average adult intake of fluids recommended by IOM

A

2,700 mL for women
3,700 mL for men

80% from drinking fluids
20% intake from foods/ cellular metabolism of foods

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20
Q

insensible water loss

A

continuous, is not perceived by person, but can increase significantly with fever or burns

lost on a daily basis from the lungs, skin, respiratory tract, and water excreted in the feces.

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21
Q

Sensible water loss

A

occurs through excess perspiration and can be perceived by the patient or the nurse through inspection

urine excretion

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22
Q

Major electrolytes (6)

A
  1. Calcium ( Ca++) - bone health, neuromuscular function, cardiac function (insufficiency leads to osteoporosis)
  2. Magnesium ( Mg++) - Intracellular fluid, bone; many cellular functions ( insufficiency = alcoholism)
  3. Chloride( Cl-) - Extracellular fluid; bound to other ions
  4. Sodium ( Na +) extracellular fluid, regulates fluid volume
  5. Potassium ( K+) Muscle contraction and cardiac conduction
  6. Phosphate ( PO4) promoting muscle and nerve action/ assist with acid-base balance
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23
Q

Hypovolemia

A

Deficient fluid volume - occurs when there is a proportional loss of fluid and electrolytes from ECF

  • loss of blood volume from surgery or trauma
24
Q

Dehydration

A

state of negative fluid balance in which there is loss of water form ICD & ECF

Categorized by 3 causes

  • insufficient intake of fluid
  • excessive fluid loss
  • fluid shift (intravascular fluid may leak into body tissues, burns)

Early sign- THIRST
with continued fluid loss Hypovolemic Shock

25
Q

Signs of Dehydration

A 
dry skin
dry mucous membranes
poor skin turgor
decreased urine output 
hypotension
orthostatic hypotension
weak increase heart rate ( tachycardia)
rise in body temp
weight loss
26
Q

Assess for and preventing Fluid volume Deficit

A
  • sudden loss of 5% body weight = clinically significant
  • elevated blood urea nitrogen (BUN)
  • elevated Hematocrit
  • Urine specific Gravity
  • identify pt’s. at risk: older adults, children, infants, patients with conditions associated with fluid los; diabetes, vomiting, diarrhea, fever
27
Q

Hypervolemia

A

Excess fluid volume

excessive retention of sodium and water in extra cellular fluids

Could be caused by: excessive salt intake, diseases affecting kidney or liver function, poor pumping action of the heart

retained sodium increases osmotic pressure in the EXF
this pressure pulls fluid form cells into ECF

28
Q

Signs of Hypervolemia

A
  • Elevated Blood pressure, bounding pulse
  • respirations are increased and shallow
  • distended neck veins
  • edema in dependent areas
  • skin is pale and cool
  • urine becomes dilute and volume increases
  • weight gain
  • moist crackles, dyspnea, ascites in severe cases
  • decrease in BUN, hematocrit and urine specific gravity
29
Q

ascites

A

the accumulation of fluid in the peritoneal cavity, causing abdominal swelling.

30
Q

dyspnea

A

labored breathing

31
Q

Preventing Fluid overload

A
  • monitor intake and output

- Carefully regulate IV fluids

32
Q

Hypokalemia

A

low Potassium ( K+)

SXS:
Excessive

33
Q

Hyperkalemia

A

high potassium ( K+)

34
Q

Hypocalcemia

A

low calcium ( Ca++)

35
Q

Hypercalcemia

A

High Calcium ( Ca++)

36
Q

Hypomagnesemia

A

low magnesium ( Mg++)

37
Q

Hypermagnesemia

A

high magnesium ( Mg++)

38
Q

Acid

A

Compound that contains hydrogen Ions (H+) releases them

39
Q

base

A

Compound that accepts hydrogen Ions ( more alkaline)

40
Q

PH for blood, Normal range of ABG

A

7.35 - 7.45

41
Q

PH Scale

A

Lower the number the more acidic ( Acidosis) , the higher the number the more basic ( Alkalosis).

7 = neutral ( ex. water)

42
Q

ABGs

A

Arterial Blood Gas- Reflection of ht balance between carbon dioxide ( C02) Regulated by the lungs and Bicarbonate ( HC03-), a base regulated by the kidneys

43
Q

Three Major Mechanism that regulate Acid-Base in body

A
  1. Buffers ( Bicarbonate)
  2. Respiratory System ( increase/decrease rate & depth of breathing)
  3. Renal system ( Kidneys excrete H+ and reabsorbs bicarbonate OR Kidneys hold on to H+)
44
Q

PaCO2

A

is the partial pressure of carbon dioxide in arterial blood and is a reflection of the depth of pulmonary ventilation.

range: 35-45 mm Hg

45
Q

paO2

A

is the partial pressure of oxygen in arterial blood. Has no primary role in acid-base regulation if it is within normal limits

normal range- 80-100 mm Hg

46
Q

base excess

A

amount of blood buffer (hemoglobin and bicarbonate) that exists

47
Q

Respiratory Acidosis

A
  • Hypoventilation–> hypoxia
  • rapid, shallow respirations
  • decrease blood pressure with Vasodilation
  • dyspnea
  • headache
  • hyperkalemia
  • dysrhythmias ( increased K)
  • drowsiness, dizziness, disorientation
  • muscle weakness, hyperreflexia

CAUSES: Respiratory stimuli, anesthesia, drug overdoes, COPD, pneumonia, atelectasis

decreases in PH, increase in pCo2, Retention of CO2 by lungs

48
Q

Respiratory Alkalosis

A
  • Seizures
  • Deep, rapid breathing
  • hyperventilation
  • tachycardia
  • decrease or normal BP
  • Hypokalemia
  • Numbness and tingling of extremities
  • lethargy & confusion
  • Light headedness
  • nausea/ Vomiting

Causes: Hyperventilation, Anxiety, PE, Fear, Mechanical Ventilation

Increase PH, Decrease pCO2, increase loss of CO2 from lungs

49
Q

Metabolic Acidosis

A
  • Headache
  • Decreased BP
  • Hyperkalemia
  • Muscle Twitching
  • warm, flushed skin ( vasodilation)
  • Nausea, vomiting, diarrhea
  • Changes in Level of consciousness ( Confusion, Increased drowsiness)
  • Kussmaul respirations ( Compensatory Hyperventilation)

CAUSES: DKA, Severe diarrhea, Renal Failure, Shock

Decrease in PH and Decrease in HCO3

50
Q

Metabolic Alakalosis

A
  • Restlessness followed by lethargy
  • Dysrhythmias ( Tachycardia)
  • Compensatory hypoventilation
  • confusion ( Decreased level of consciousness, dizzy, irritable)
  • nausea, vomiting, diarrhea
  • tremors, muscle cramps, tingling of fingers and toes
  • hypokelemia

CAUSES: Severe vomiting, excessive GI suctioning, Diuretics, Excessive NaHCO3

decrease acid or increase base
increased PH and Increase HCO3

51
Q

Nursing Diagnosis: Assessment

A

Gather and accurately cluster data

  • focused assessment
  • look for patterns/emerging trends

hx

52
Q

IV solutions

A

Hypotonic: moves fluid into the cells, causing them to enlarge( 0.45% NS)- Oh NO the cells gonna blow

Hypertonic: Pulls fluid from the cells ( D5%/0.9%NS)
(D5%/0.45%NS)

Isotonic: expands bodies fluid volume; same osmolarity as blood
( lactated ringers, 0.9% NS, D5%/Water)

53
Q

Diaphoretic

A

Sweating

54
Q

D.A.R ( Focused charting)

A

Data
Action
Response

55
Q

P.I.E ( Problem oriented charting)

A

Problem
Interventions
Evaluation

56
Q

SOAP( IER)

A 
Subjective
objective
assess
plan
( intervention
evaluation
reassess)
57
Q

ISBARR

A 
introduction
situation
background
assessment
Recommendation
read back

Foundations (7 decks)

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