Fluid & Electrolytes Flashcards
Fluid Intake
2500 ml/day
Fluid Output
1400-1500 ml/day
Anasarca
associated w/ FVE
extreme generalized edema
swelling of skin/tissue
leading of cellular fluid
Lymphedema
chronic swelling collection of protein rich fluid
Hypernatremia neuro
restlessness irritability lethargy seizures confusion to coma dyspnea tachycardia orthostatic hypotension dryness flushed skin low urine muscle weakness
Chlorine to Sodium
attracted to each other (directionally proportional)
Hypokalemia s/s
skeletal muscle weakness legs to diaphragm
constipation
PVCs/heart blocks
fatigue
Hyperkalemia s/s
v-fib/cardiac arrest
hyperactivity
Fluid/Electrolyte Imbalances Assessment
PMH, RF, Meds Age/lifestyle i&O weight changes renal function/endocrine disease loc capillary refill jugular vein distention skinn color/temp
FVD Teaching
prevention of orthostatic hypotension
maintaing fluid intake
prevntion of fluid deficet
FVE Teaching
Sodium restriction provide alternative mattress/heel protectors fowler's position monitor o2/labs elevate areas of edema
ARF common causes
hypoperfusion r/t
prerenal (most common from conditions that lower GFR)
postrenal (obstructive ex BPH)
Intrinsic (r/t ATN kidney diseas, acute glomerulonephritis)
ATN
acute tubular necrosis
severe irreversible damage to kidney tubules
caused by prolonged ischemia (ex hypovolemia, dehydration, sepsis, burns, trauma, surgery)
ARF Etiology
5% of all hospitalized clients
high mortality
can occur any time of life
ARF RF
trauma/surgery infection hemorrhage severe heart failure severe liver disease lower urinary tract obstruction older adults child w/ renal insufficiency
ARF Prevention
counteract vasoconstriction
enhance blood flow via nephron
preempt risks like IV contrast
ARF Phases
Initiation
Maintenance
Recovery
ARF Initiation s/s
lasts hours to days
begins with event
ends w/ tubular injury
often asymptomatic
ARF Maintenance s/s
fall in GFR tubular necrosis oliguria edema muscle weakness n/d EKG changes possible cardiac arrest hyperphosphatemia hypocalcemia metabolic acidosis anemia confusion/agitation/lethargy seizures/coma hyperreflexia anorexia uremic syndrome
ARF REcovery s/s
tubule cell repair gradual return of GFR to normal diuresis creatinine, BUN higher potassium/phosphate levels high may take up to a year
Chronic Kidney Disease causes
diabetic nephropathy hypertension chronic glomerulonephritis chronic pyelonephritis polycystic kidney disease systemic lupus erythematosus infection dehydration hypertension
CKD Prevention
aggressive management of chronic disease low-sodium diet regular exercise avoid smoking limit alcohol intake
CKD s/s
impaired regulation of F/E
increased potassium and phosphate
decreased calcium
metabolic acidosis
CKD Children s/s
gross hematuria
paleness/lethargy
