Fluid & Electrolytes Flashcards
Furosemide assessment priority…
I and O
SSA signs of dehydration
12 irregular HR, sunken eyes, dry mucosa
SSA chronic kidney disease excoriation skin…
Dry skin, sensory neuropathy, and calcium-phosphate skin
What is the normal range for sodium?
135-145
What is the normal range for potassium?
3.5-5.3
What is the normal range for calcium?
9-11
What is the normal range for magnesium?
1.5-2.5
What is the normal range for chloride?
95-105
What is the normal range for phosphate?
2.4-4.5
What is the acronym for HYPERcalcemia symptoms?
BACKME
What does BACKME stand for?
Bone pain Arrhythmias Cardiac arrest Kidney stones Muscle weakness Excessive urination
What is the acronym for HYPERcalcemia causes?
CHIMPAN
What does CHIMPAN stand for?
Calcium supplements Hyperparathyroidism Iatrogenic, immobilization Multiple myeloma Parathyroid hyperplasia Alcohol Neoplasm
What is the acronym for HYPOcalcemia symptoms?
CATS
What does CATS stand for?
Convulsions
Arrhythias
Tetany
Strider and spasms
What is the acronym for HYPERkalemia symptoms?
MURDER
What does MURDER stand for?
Muscle cramps Urine abnormalities Respiratory distress Decreased cardiac contractions EKG changes Reflexes
What is the acronym for HYPOkalemia?
A SIC WALT
What does A SIC WALT stand for?
Alkalosis Shallow respirations Irritability Confusion and drowsiness Weakness and fatigue Arrhythmias Lethargy Thready pulse
What are the acronyms for HYPERnatremia?
FRIED or SALT
What do FRIED and SALT mean?
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
What is the acronym for HYPOnatremia?
SALTLOSS
What does SALTLOSS stand for?
Stupor/com Anorexia Lethargy Tendon reflexes (decreased) Limp muscles Orthostatic hypotension Seizures/headaches Stomach cramping
Are potassium and magnesium intracellular or extracellular?
Intracellular
How many liters of fluids should adults take in/ day?
2 1/2 L/day
Why are infants and children under the age of 2 risk factors for F&E imbalances?
- kids have a greater body surface area
- higher percentage of body water
- breathing and metabolic rate is faster
- kidneys are immature
Why are older adults risk factors for F&E imbalances?
- kidney function declining
- loss of sensation
- meds that can cause electrolyte imbalances
- increased sensitivity to salt
What ethnic group has a higher sensitivity to sodium?
African Americans
What are some causes of dehydration?
- Diarrhea
- vomiting
- Severe weather
- burns
- trauma and crush injury (potassium can be shifted out of the cell at this time)
What are some causes of HYPOkalemia?
- diuretics (with no supplement)
- Vomiting
- anorexia
- bulimia
- diarrhea
- excessive insulin
What are some causes of HYPERkalemia?
- lack of insulin
- kidney issues
- overcorrection of IV infusions
- Potassium-sparing diuretics
- Massive sudden cell death
- Tumor Lysis syndrome
What are some causes of HYPOcalcemia?
- poor absorption
- not enough in diet
- diuretics
- meds that help push calcium back into bones (takes it away from blood causing a deficit)
- hypoparathyroidism
How do you assess for HYPOcalcemia?
- check for facial twitching
- check for other muscle twitching
- 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
What are some causes of HYPOmagnesemia?
- chronic diarrhea
2. alcoholism
What are some causes of HYPERmagnesemia?
- renal disease
When should you take your pts weight?
First thing in the morning
What is the normal range for urine specific gravity?
1.015-1.030
What should you teach your pt to decrease their sodium intake?
- don’t eat processed foods
- no canned soups
- decrease fast foods
- be careful with salt substitutes because they can be high in potassium (make sure they are safe before taking)
Should you give caffiene to a patient who has hypovolemia?
No because this constricts blood vessels and increases urination. If they are hypovolemic, then they have a fluid deficit.
What interventions should a nurse take to decrease dry mouth if the pt is on fluid restriction?
- ice chips
- wet sponge (do not suck water out of sponge)
- Teach them what they should not do (drink out of the faucet)
What interventions should a nurse take for someone with fluid deficit?
- replace fluids
- monitor electrolytes
- ice chips
- at least 2 L of fluid could be needed
- watch skin integrity
What is the earliest sign of dehydration
Thirst
What are components of dehydration in infants?
- sunken eyes
- sunken fontanels
- tachycardia
- weight loss
- lack of tears
What are 3 serum lab tests for chronic renal failure?
- urinalysis
- BUN and creatinine
- GFR
What should be listed on I & O sheet?
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
What are 3 late symptoms for sodium imbalance?
- seizures
- coma
- death
What are some some lifestyle risk factors for Fluid and electrolyte imbalance?
- stress: Increases your cellular metabolism and increases ADH
- Exercise: Overexcercising can deplete electrolytes. Weight baring affects calcemia
What are some modifiable risk factors for fluid and electrolyte imbalance?
- head injuries: bleeding and altered cognitions
2. Heat-related injuries: Fatigue, weakness, GI (Ex: do slow rewarming with frost-bite)
What are some health-related illnesses that are risk factors for fluid and electrolyte imbalance?
- panreotitis: loosing insulin, typically need to be NPO
- Liver disease
- cancers
- Heart failures
