Fluid & Electrolytes Flashcards
(60 cards)
Infusion therapy
fluid and electrolyte replacement
medication administration
blood product administration
and nutritional support
intracellular fluid
ICF 70%
is within cells and accounts for majority of the total body weight
Extracellular fluid
ECF 30%
Outside cells
interstitial fluid and plasma
Rapid changes of fluid compartments
risk highest for infants & elderly
Healthy person body water
total body water is 50% to 60% of body weight
infants compared to adults
More body fluid and extracellular fluid than an adult so they are more susceptible to fluid volume deficits
Things that affect body water
gender and amount of fat cells
women and obese people have less body water
Sodium (Na+)
Controls and regulates volume of body fluids
Potassium (K+)
chief regulator of cellular enzyme activity and water content
Calcium (Ca++)
b12 absorption, nerve impulse, blood clotting, and muscle contraction
Magnesium (Mg++)
Metabolism of carbohydrates and proteins, vital actions involving enzymes
Chloride (Cl-)
maintains osmotic pressure in blood, produces hydrochloric acid
Bicarbonate (HCO3-)
body’s primary buffer system
Phosphate (HPO4-)
involved in important chemical reactions in the body, cell division, and hereditary traits
Hyponatremia
a sodium deficit in ECF (<135mEq) caused by a loss of sodium or a gain of water
sodium may be lost through vomitting, diarrhea, fistulas, swearing, or as the results of the use of diuretics
the decrease in sodium causes fluid to move by osmosis from the less concentrated ECF compartment to the ICF space (swelling, confusion, hypotension, edema, muscle cramps and weakness and dry skin)
Severe hyponatremia
manifested by signs of increasing intracranial pressure (lethargy, muscle twitching, focal weakness, seizures and death may occur)
Hypernatremia
surplus of sodium in ECF (sodium >145) caused by excess water loss or an overall excess of sodium
fluid deprivation, lack of fluid consumption, diarrhea, and excess of insensible water loss (hyperventilation, burns) leads to excess sodium
fluids move from the cells because of the increased extracellular osmotic pressure, causing them to shrink and leaving them without sufficient fluid
results in neurologic impairment such as restlessness, weakness, disorientation, delusion, and hallucinations
permanent brain damage, especially in children can occur
Hypokalemia
refers to a potassium deficit in ECF (<3.5mEq) and is common electrolyte abnormality
potassium may be lost through vomiting, gastric suction, alkalosis, or diarrhea, or as the result of the use of diuretic
when the extracellular potassium level falls, potassium moves from the cell, creating an intracellular potassium deficiency and sodium and hydrogen ions are retained by the cells to maintain isotonic fluids.
Muscle weakness and leg cramps, fatigue, paresthesias, and dysrhythmias
Hyperkalemia
refers to an excess of potassium in ECF (serum potassium >5mEq/L)
excess potassium may result from renal failure, hypoaldosteronism, or the use of certain medications
less frequent than hypokalemia, but is more dangerous
nerve conduction as well as muscle contractility can be affected
skeletal muscle weakness and paralysis may occur and cardiac irregularities
Hypocalcemia
calcium deficit in ECF (serum calcium < 8.9mg/dl, ionized calcium <4.5mg/dL)
common causes involve inadequate calcium intake, impaired calcium absorption, and excessive calcium loss
numbness and tingling of fingers, mouth, or feet. Tetany, muscle cramps and seizures come about.
Hypercalcemia
refers to an excess of calcium in ECF
two major causes are cancer and hyperparathyroidism
nausea, vomitting, constiation, bone pain, excessive urination, thirst, confusion, lethargy, and slurred speech
severe hypercalcemia can lead to cardiac arrest
Hypomagnesemia
magnesium is the most abundant intracellular cation after potassium
magnesium loss may occur with nasogastric suction, diarrhea, withdrawal from alcohol, administration of tube feedings or parental nutrition, sepsis or burns
leads to muscle weakness, tremors, tetany, seizures, heart block, change in mental status, hyperactive DTRs, and respiratory paralysis
HYpermagnesemia
refers to magnesium excess in the ECF
usually occurs with renal failure when the kidneys fail to excrete magnesium or from excessive magnesium intake
includes nausea, vomitting, weakness, flushing, lethargy, loss of DTRs, respiratory depression, coma, and cardiac arrest
Hypophosphatemia
refers to a below normal concentration of phosphorus in the ECF
can result from administration of calories to malnourished patients, alcohol withdrawal, diabetic keto acidosis, hyperventilation, insulin release, absorption problems, and diuretic use
irritability, fatigue, weakness, paresthesias, confusion, seizures, and coma
