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NCLEX > Fluid & Electrolytes > Flashcards

Fluid & Electrolytes Flashcards

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1
Q

3 causes of hypervolemia

A

HF
RF
things with a lot of sodium

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2
Q

what are three things high in sodium

A

effervescent medications - (alka seltzer, fleet enema, IVF w Na)
Canned/processed food
IVF with sodium

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3
Q

what 3 hormones regulate fluid volume

A

aldosterone
atrial natriuretic peptide (ANP)
ADH

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4
Q

where is aldosterone found

A

adrenal glands

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5
Q

what is the role of aldosterone

A

retain sodium and water

increase blood volume

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6
Q

what diseases invovle too much aldosterone

A

cushing’s
hyperaldosteronism or Conn’s
(fluid overload)

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7
Q

what disease has too little aldosterone

A

addisons (losing sodium and water)

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8
Q

where is ANP found

A

atrium of heart (atrial natriuretic peptide)

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9
Q

How does ANP work

A

causes excretion of sodium and water

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10
Q

when is ANP released

A

when the heart stretches

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11
Q

how does Anti-diuretic hormone work (ADH)

A

retain water

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12
Q

what is the disease associated with too much ADH

A

Syndrome of Inappropriate ADH secretion (SIADH)

- retain H2O

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13
Q

What happens in SIADH

A

too many letters too much H2O
decreased urine output
increased blood volume

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14
Q

What disease is associated with not enough ADH

A

Diabetes Insipidus (DI)

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15
Q

what happens in DI

A

Diuresis!
fluid volume depletion
urine is dilute
blood concentrated

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16
Q

where is ADH found

A

pituitary gland between the eyes

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17
Q

when should you consider potential ADH problem

A

anytime there is a head injury or any condition that leads to increased ICP

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18
Q

when you see sphenoid think

A

sinus

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19
Q

when you see hypophysis

A

pituitary

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20
Q

what is another name for ADH (drug name)

A

vasopressin

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21
Q

what are signs and symptoms of ADH problems (8)

A 
distended veins
peripheral edema/third spacing
CVP goes up
lungs sound wet
polyuria
increased pulse
pulmonary edema
increased BP
weight increase
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22
Q

Where is CVP measured?

normal values

A

right atrium

2-6 mmHg

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23
Q

what is the treatment for hypervolemia or fluid excess

A 
low NA diet/fluid restriction
I & O 
daily weights 
diuretics 
bed rest 
fluid replacement
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24
Q

whne you see fluid retention what problems should you think first

A

heart problems

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25
Q

causes of fluid volume deficit or hypovolemia

A 
shock
anything that causes fluid loss
third spacing
burns
acites
polyruia diseases - RF or diabetes
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26
Q

what happens with CVP when a person is experiencing fluid volume deficit

A

decreases

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27
Q

what happens to urine specific gravity during hypovolemia

A

goes up - very concentrated

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28
Q

treatment of hypovolemia

A

prevent further losses
replace volume
falls precautions
monitor for overload

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29
Q

what do isotonic solutions do

A

stay where I put it

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30
Q

what do hypotonic solutions do

A

go Out of vessel

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31
Q

what do hypertonic solutions do

A

Enter the vessel

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32
Q

examples of isotonic solutions )4)

A

NS
lactated ringers
D5W
D5 1/2 NS

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33
Q

examples of hypotonic soltions (3)

A

D (2.5)W
0.5NS
.33NS

34
Q

examples of hypertonic solutions

A 
D10W
3%NS
5%NS
D5LR
D51/2NS, D5NS
TPN
Albumin
35
Q

magnesium and calcium act like

A

sedatives

36
Q

normal Mg levels

A

0.65-1.02

37
Q

normal calcium levles

A

2.25-2.62

38
Q

causes of hypermangesemia

A

RF

antacids

39
Q

symptoms of too much Mg

A

flushing
warmth
(makes you dilate)

40
Q

treatment for too much MG

A

ventilator
dialysis
calcium gluconate (IV slow adminster)

41
Q

what element has an inverse relationship with Ca

A

phosphorus

42
Q

what are the causes of hypercalcemia

A

hyperparathyroidism - too much PTH
thiazides - retain Ca
immobilization - have to bear weight to keep Ca in bones

43
Q

what regulates calcium

A

parathyormone (PTH) - kicks in when Ca gest low and pulls Ca from the bone

44
Q

what are signs and symptoms of too much calcium

A

brittle bones

kidney stones

45
Q

what are signs and symptoms common in clinets with too much calcium or mag

A 
decreased deep tendon reflex
weak and flacid or low muscle tone
arrhytmias
decreased LOC
decreased pulse
decreased respirations
46
Q

treatment for too much calcium

A 
move
fluids to prevent kidney stones 
add phosphorus to diet (inverse relationship)
steroids (decrease serum ca)
medications - biphosphates or calcitonin
47
Q

what are causes of hypomagnesmia

A

diarreha - lots of Mg in intestines

alcoholism - hypertonic, suppreses ADH and not eating or drinking

48
Q

signs and symptoms of too little Ca or Mg

A 
rigid and tight muscles 
seizures 
stridor (airway is smooth muscle_
\+'ve Chcosteks- "C" for cheek
Trousseaus - pump up BP cuff - hand tremors 
arrythmias - heart is a muscle 
increase in reflexes
mind changes
swallowing problems - esophagus is a smooth muscle
49
Q

treatment for too little Mg

A 
give Mg (check kidney function first)
seizure precations
50
Q

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

A

stop it

51
Q

what are foods high in MG

A

green leafy foods
seeds
peppermint
squash

52
Q

what are causes of hypocalcemia

A

hypoparathyroidsim

neck surgery - low PTH decrases serum calcium

53
Q

what is the treatment for too little calcium

A

give calcium (po or slow IV - heart monitor if IV)
vitamin D 0 help utilize Ca
phosphate binding medications

54
Q

what are you looking for in an ECG when giving IV calcium

A

wide QRS complexes

55
Q

what should you think of first with calcium and mag

A

MUSCLES

56
Q

what should you think of first with sodium changes

A

NEURO changes

57
Q

what is normal sodium lab voalues

A

135-145 mmol/L

58
Q

what is the level of sodium in your blood totally dependent on

A

how much water you have in your blood

59
Q

what is hypernatremia eqivalent to

A

dehydration - too much Na not enough H20

60
Q

causes of hypernatremia

A 
hyperventilation - you exhale H2O
heat stroke
DI
vomiting 
diarrhea
61
Q

what are the S&S of hypernatremia

A

dry mouth
thirsty
swollen tongue

62
Q

what is the treatment for hypernatremia

A 
restrict Na
dilute client with fluids 
daily weights
I& O
lab work
63
Q

what is hyponatremia

A

dilution; too much water not enough Na

64
Q

what is the causes of too little Na

A

drinking H2O for fluid replacement (vomiting, sweating)
psychogenic polydipsia - love to drink too much water
D5W (sugar and water)
SIADH

65
Q

signs and symptoms of hyponatremia

A

headache
seizure
coma

66
Q

treatment for hyponatremia

A

need sodium
no water
if having neuro problems need hypertonic saline 4%NS or 5%NS

67
Q

normal potassium levels

A

3.5-5

68
Q

what happens to potassium if the kidneys aren’t working well

A

potassium goes up

69
Q

what are the causes for too much K

A

kidney trouble

spironolactone

70
Q

S & S of too much potassium

A

muscle twitching –> muscle weakness –> flaccid paralysis

life threatening arrhytmias

71
Q

what are ECG changes with hyperkalemia

A 
brady
tall and peaked T waves
proloinged PR 
flat or absent P waves
widened QRS
conduction blocks 
Vfib
72
Q

what are ECG changes for hypokalemia

A

U waves
PVC’s
Vtach

73
Q

what is the treatment for too much potassium

A 
dialysis (kidneys aren't working)
calcium gluconate decreases arrythmias 
glucose and insulin
- inulin carries glucose and K into cell; give glucose to prevent hypoglycemia
sodium polystyrene (kayexalate)
74
Q

potassium has an inverse realtionship with which element

A

sodium

75
Q

what are causes of hypokalemia

A

vomiting
suction (lot of potassium in stomach)
diuretics
not eating

76
Q

signs and symptoms of too little K

A

muscle cramps
muscle weakness
life threatening arrhythmias

77
Q

treatment for too little K

A

give K
spironolactone
eat more K

78
Q

what is the major problem with giving oral K

A

GI upset

79
Q

always run IV K through waht

A

pump

80
Q

should you ever give K IV push

A

NEVER

81
Q

does IV K burn during infusion

A

yes - eats up peripheral vessels

NCLEX (10 decks)

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