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Patient Centered Care 2 > Fluid & Electrolytes > Flashcards

Fluid & Electrolytes Flashcards

1
Q

Furosemide assessment priority…

A

I and O

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2
Q

SSA signs of dehydration

A

12 irregular HR, sunken eyes, dry mucosa

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3
Q

SSA chronic kidney disease excoriation skin…

A

Dry skin, sensory neuropathy, and calcium-phosphate skin

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4
Q

What is the normal range for sodium?

A

135-145

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5
Q

What is the normal range for potassium?

A

3.5-5.3

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6
Q

What is the normal range for calcium?

A

9-11

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7
Q

What is the normal range for magnesium?

A

1.5-2.5

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8
Q

What is the normal range for chloride?

A

95-105

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9
Q

What is the normal range for phosphate?

A

2.4-4.5

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10
Q

What is the acronym for HYPERcalcemia symptoms?

A

BACKME

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11
Q

What does BACKME stand for?

A 
Bone pain
Arrhythmias
Cardiac arrest
Kidney stones
Muscle weakness
Excessive urination
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12
Q

What is the acronym for HYPERcalcemia causes?

A

CHIMPAN

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13
Q

What does CHIMPAN stand for?

A 
Calcium supplements
Hyperparathyroidism
Iatrogenic, immobilization
Multiple myeloma
Parathyroid hyperplasia
Alcohol
Neoplasm
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14
Q

What is the acronym for HYPOcalcemia symptoms?

A

CATS

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15
Q

What does CATS stand for?

A

Convulsions
Arrhythias
Tetany
Strider and spasms

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16
Q

What is the acronym for HYPERkalemia symptoms?

A

MURDER

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17
Q

What does MURDER stand for?

A 
Muscle cramps
Urine abnormalities
Respiratory distress
Decreased cardiac contractions
EKG changes
Reflexes
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18
Q

What is the acronym for HYPOkalemia?

A

A SIC WALT

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19
Q

What does A SIC WALT stand for?

A 
Alkalosis
Shallow respirations
Irritability
Confusion and drowsiness
Weakness and fatigue
Arrhythmias
Lethargy
Thready pulse
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20
Q

What are the acronyms for HYPERnatremia?

A

FRIED or SALT

21
Q

What do FRIED and SALT mean?

A 
Flushed skin/low-grade fever
Restless, irritable, anxious, confused
Increased BP and fluid retention
Edema: peripheral pitting
Decreased urine output and dry mouth

Skin Flushed
Agitation
Low-grade fever
Thirst

22
Q

What is the acronym for HYPOnatremia?

A

SALTLOSS

23
Q

What does SALTLOSS stand for?

A 
Stupor/com
Anorexia
Lethargy
Tendon reflexes (decreased)
Limp muscles
Orthostatic hypotension
Seizures/headaches
Stomach cramping
24
Q

Are potassium and magnesium intracellular or extracellular?

A

Intracellular

25
Q

How many liters of fluids should adults take in/ day?

A

2 1/2 L/day

26
Q

Why are infants and children under the age of 2 risk factors for F&E imbalances?

A
  1. kids have a greater body surface area
  2. higher percentage of body water
  3. breathing and metabolic rate is faster
  4. kidneys are immature
27
Q

Why are older adults risk factors for F&E imbalances?

A
  1. kidney function declining
  2. loss of sensation
  3. meds that can cause electrolyte imbalances
  4. increased sensitivity to salt
28
Q

What ethnic group has a higher sensitivity to sodium?

A

African Americans

29
Q

What are some causes of dehydration?

A
  1. Diarrhea
  2. vomiting
  3. Severe weather
  4. burns
  5. trauma and crush injury (potassium can be shifted out of the cell at this time)
30
Q

What are some causes of HYPOkalemia?

A
  1. diuretics (with no supplement)
  2. Vomiting
  3. anorexia
  4. bulimia
  5. diarrhea
  6. excessive insulin
31
Q

What are some causes of HYPERkalemia?

A
  1. lack of insulin
  2. kidney issues
  3. overcorrection of IV infusions
  4. Potassium-sparing diuretics
  5. Massive sudden cell death
  6. Tumor Lysis syndrome
32
Q

What are some causes of HYPOcalcemia?

A
  1. poor absorption
  2. not enough in diet
  3. diuretics
  4. meds that help push calcium back into bones (takes it away from blood causing a deficit)
  5. hypoparathyroidism
33
Q

How do you assess for HYPOcalcemia?

A
  1. check for facial twitching
  2. check for other muscle twitching
  3. pump up a BP cuff on the arm and wait for 3-5 min and if the hand starts twitching, then they probably have hypocalcemia
34
Q

What are some causes of HYPOmagnesemia?

A
  1. chronic diarrhea

2. alcoholism

35
Q

What are some causes of HYPERmagnesemia?

A
  1. renal disease
36
Q

When should you take your pts weight?

A

First thing in the morning

37
Q

What is the normal range for urine specific gravity?

A

1.015-1.030

38
Q

What should you teach your pt to decrease their sodium intake?

A
  1. don’t eat processed foods
  2. no canned soups
  3. decrease fast foods
  4. be careful with salt substitutes because they can be high in potassium (make sure they are safe before taking)
39
Q

Should you give caffiene to a patient who has hypovolemia?

A

No because this constricts blood vessels and increases urination. If they are hypovolemic, then they have a fluid deficit.

40
Q

What interventions should a nurse take to decrease dry mouth if the pt is on fluid restriction?

A
  1. ice chips
  2. wet sponge (do not suck water out of sponge)
  3. Teach them what they should not do (drink out of the faucet)
41
Q

What interventions should a nurse take for someone with fluid deficit?

A
  1. replace fluids
  2. monitor electrolytes
  3. ice chips
  4. at least 2 L of fluid could be needed
  5. watch skin integrity
42
Q

What is the earliest sign of dehydration

A

Thirst

43
Q

What are components of dehydration in infants?

A
  1. sunken eyes
  2. sunken fontanels
  3. tachycardia
  4. weight loss
  5. lack of tears
44
Q

What are 3 serum lab tests for chronic renal failure?

A
  1. urinalysis
  2. BUN and creatinine
  3. GFR
45
Q

What should be listed on I & O sheet?

A

Intake: oral fluids, ice chips, food that is liquid at room temp
Tube feedings: Parenteral fluids, IV meds, Cath/tube irrigations
Output: urine, vomitus, liquid feces, GI tube drainage, wound drainage, draining fistulas

46
Q

What are 3 late symptoms for sodium imbalance?

A
  1. seizures
  2. coma
  3. death
47
Q

What are some some lifestyle risk factors for Fluid and electrolyte imbalance?

A
  1. stress: Increases your cellular metabolism and increases ADH
  2. Exercise: Overexcercising can deplete electrolytes. Weight baring affects calcemia
48
Q

What are some modifiable risk factors for fluid and electrolyte imbalance?

A
  1. head injuries: bleeding and altered cognitions

2. Heat-related injuries: Fatigue, weakness, GI (Ex: do slow rewarming with frost-bite)

49
Q

What are some health-related illnesses that are risk factors for fluid and electrolyte imbalance?

A
  1. panreotitis: loosing insulin, typically need to be NPO
  2. Liver disease
  3. cancers
  4. Heart failures

Patient Centered Care 2 (26 decks)

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