Fluid & Electrolytes Flashcards
What are the two main compartments that fluid is divided into in the body?
Extracellular fluid (ECF)
Intracellular fluid (ICF)
- interstitial fluid (fluid b/w cells, blood, plasma
- transcellular fluid (CSF)
Where is most of the body’s fluid located?
Intracellular space (25 liters)
Water-pushing pressure
The force that pushes water outward from a confined space through a membrane
Example: BP
Hydrostatic Pressure
Clinical significance of changes in normal hydrostatic pressure
Edema
Water-pulling pressure created by proteins (notably albumin) in the circulatory
Pulls water into the circulatory system
Oncotic pressure/colloid osmotic pressure
Measurable fluid intake
PO fluids, IV fluids, Enteral feedings, irrigation fluids
Measurable fluid output
urine, sweating, emesis, feces
The kidneys release ____ in response to a decreased BP
Renin
Explain the renin-angiotensin II pathway
- Kidneys release renin
- Renin converts angiotensinogen (released by the liver) into angiotensin I
- Angiotensin I converted to Angiotensin II in the lungs
- Angiotensin II causes vasoconstriction and increases BP
How do ACE Inhibitors work?
Prevents the conversion of angiotensin I to II
Helps the body vasodilator and decrease BP
1 L of water = ____ kg
1 kg
therefore weight change of 1 lb = fluid volume change of about 500 mL
Assessment findings of fluid overload
Pulmonary crackles, lower extremity edema, JVD
Normal K+
3.5 - 5
What is the impact of hypokalemia on ECG?
ST depression, shallow/depressed T wave, prominent U wave
S/S of hypokalemia
dysrhythmias, constipation, palpitations, excessive fatigue, muscle damage/spasms numbness/tingling
IV K+ should not exceed ____ mEq/liter
is best at ____ mEq/liter
rate max is ____ mEq/hr
60
40
10-20
Important to remember about hypokalemia tx
check urine output - should be at least .5 mL/kg
oral K+ replacement are big pills that can be difficult to swallow - don’t crush/break these
IV: tough on veins, monitor for pain at IV site
What is the impact of hyperkalemia on ECG?
Widened QRS, ST elevation, narrow/peaked T wave
Can also lead to V fib and ventricular standstill
S/S of hyperkalemia
irritability, abdominal cramping, diarrhea, weakness, irregular pulses, cardiac arrest if sudden/severe
Tx for hyperkalemia
Kayexalate (binds to K+ in the colon in exchange for Na) - causes diarrhea
IV Calcium Gluconate
IV insulin/dextrose - moves K+ into the cells
Lasix - K+ wasting diuretic
Normal Na
135 - 145
Causes of hyponatremia
Loss of Na- excessive sweating, GI, diuresis
Dilutional- polydipsia, renal disease, increased ADH
S/S of hyponatremia
Impact is mainly on the nervous system
muscle cramps, weakness, fatigue
below 125 - progressive neuro symptoms, seizures, coma
Tx of hyponatremia
Fluid restriction - monitor Na levels q 6 hr and adjust accordingly
IV fluids w/ Na
