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2.2 - ABSN NUR 334 Fluid & Electrolytes & Periop > Fluid & Electrolytes (Borrowed from Brainscape Library) > Flashcards

Fluid & Electrolytes (Borrowed from Brainscape Library) Flashcards

1
Q

<p>Where are fluids located within the body?</p>

A

<p>Intracellular Fluid (ICF)<br></br>Extracellular Fluid (ECF): Interstitial fluid, intravascular fluid</p>

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2
Q

<p>What organ/system does Antidiuretic Hormone (ADH) work on?</p>

A

<p>Kidneys/Renal System</p>

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3
Q

<p>What is the role of Antidiuretic Hormone (ADH) when it is released?</p>

A

<p>To conserve fluids through the kidneys - "KEY REGULATOR OF WATER SUPPLY IN BODY"</p>

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4
Q

<p>What organ/system does Aldosterone work on?</p>

A

<p>Kidneys/Renal System</p>

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5
Q

<p>What is the role of Aldosterone when is it released?</p>

A

<p>To conserve sodium through the kidneys.<br></br>When sodium is conserved, fluid follows, thus indirectly conserving fluid - "KEY REGULATOR OF SODIUM SUPPLY IN BODY"</p>

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6
Q

<p>What are examples of insensible fluid loss?</p>

A

<p>Perspiration<br></br>Respiration<br></br>Elimination of feces<br></br>Emesis</p>

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7
Q

<p>What mechanism is activated by the brain when the body losses fluid?</p>

A

<p>The thirst mechanism</p>

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8
Q

<p>What mechanism to aide in maintaining fluid balance is depressed in the older adult?</p>

A

<p>The thirst mechanism</p>

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9
Q

<p>What are causes of fluid loss/deficit?</p>

A

<p>Inadequate fluid intake<br></br>Hemorrhage (bleeding)<br></br>GI Losses (emesis, stool)<br></br>Fever<br></br>Diuretic Use</p>

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10
Q

<p>What are the clinical manifestations of fluid deficit?</p>

A

<p>Thirst<br></br>Acute weight loss<br></br>Urine changes: dark, concentrated, malodorous urine, decreased output<br></br>Constipation<br></br>Dry skin<br></br>Dry mucous membranes<br></br>Hypotension<br></br>Tachycardia<br></br>Orthostatic Hypotension<br></br>Mental status changes: lightheaded/dizzy, confusion, disorientation, weakness, lethargy</p>

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11
Q

<p>What is orthostatic hypotension?</p>

A

<p>Hypotension that occurs with position changes, such as going from lying to sitting, lying to standing, or sitting to standing</p>

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12
Q

<p>What is the best way to monitor fluid status in a patient?</p>

A

<p>Monitor weight daily</p>

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13
Q

<p>What are causes of fluid volume overload?</p>

A

<p>Excess fluid intake (either PO or IV)<br></br>Renal Failure<br></br>Heart Failure</p>

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14
Q

<p>What population is most at risk for developing fluid volume overload? Why?</p>

A

<p>Older adult population<br></br>More likely to have comorbidities such as chronic kidney disease (renal failure) and/or chronic heart failure</p>

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15
Q

<p>What are the clinical manifestations of fluid volume overload?</p>

A

<p>Acute, rapid weight gain (2 lbs or more over 24-28 hours)<br></br>Urine changes: polyuria (if kidneys and heart are functioning), light diluted non-concentrated urine<br></br>Bounding pulses (with normal heart rate)<br></br>Jugular Venous Distention (JVD)<br></br>Hypertension<br></br>Peripheral edema<br></br>Pulmonary Edema (ranging from mild to severe): crackles upon auscultation, tachypnea, dyspnea, labored breathing, decreased O2 saturation<br></br>Neurological Changes</p>

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16
Q

<p>What is the most concerning clinical manifestation with fluid volume overload?</p>

A

<p>Changes in respiratory status. Pulmonary edema can occur.<br></br><br></br>A.B.C's!</p>

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17
Q

<p>An individual has large, swollen lower extremities. When the nurse touches the area, there is no indentation. How would the nurse document this?</p>

A

<p>Non-pitting edema.</p>

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18
Q

<p>What is the priority nursing action when a patient is reporting difficulty breathing and has s/s of pulmonary edema?</p>

A

<p>Ensure head of bed is at 90 degrees (High Fowlers Position)</p>

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19
Q

<p>What interventions can the nurse implement to help improve edema in the lower extremities?</p>

A

<p>Elevate legs<br></br>Apply compression stockings</p>

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20
Q

<p>What is the role of sodium?</p>

A

<p>Helps to maintain serum osmolality<br></br>Important for optimal cell function (especially within the CNS)<br></br>Important for optimal nerve and muscle function</p>

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21
Q

<p>What are the clinical manifestations of hyponatremia?</p>

A

<p>Mental status changes!<br></br>Disorientation<br></br>Confusion<br></br>Agitation<br></br>Dizziness<br></br>Headaches<br></br>Lethargy<br></br>Muscle Weakness<br></br>Possible Seizures<br></br>Eventual Coma</p>

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22
Q

<p>What nursing interventions should be implemented when a patient is experiencing hyponatremia?</p>

A

<p>Safety is key! Seizure precautions, low bed, siderails up x 2, bed alarm on, room close to the nurse's station<br></br>Monitor weights daily<br></br>Monitor intake and output<br></br>Replace sodium<br></br>Restrict "free" water</p>

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23
Q

<p>What are the clinical manifestations of hypernatremia?</p>

A

<p>Thirst<br></br>Mental status changes: irritability, agitation, confusion<br></br>Muscle excitability causing twitching, tremors, possible seizures</p>

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24
Q

<p>What nursing interventions should be implemented when a patient is experiencing hypernatremia?</p>

A

<p>Safety is key! Seizure precautions, low bed, siderails up x 2, bed alarm on, room close to the nurse's station<br></br>Monitor weights daily<br></br>Monitor intake and output<br></br>Restrict sodium</p>

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25
Q

<p>What is the role of potassium?</p>

A

<p>Aides in the proper function of cardiac, skeletal and smooth muscle</p>

26
Q

<p>What is the most common potassium imbalance?</p>

A

<p>Hypokalemia</p>

27
Q

<p>What are the most common causes of hypokalemia?</p>

A

<p>Inadequate intake via the diet<br></br>Excessive loss via urine or through emesis/stool<br></br>Medication use; diuretics such as Furosemide (Lasix)</p>

28
Q

<p>How does hypokalemia affect the cardiovascular system?</p>

A

<p>Weak pulses<br></br>Can cause an arrhythmia<br></br>Potential cardiac arrest!</p>

29
Q

<p>How does hypokalemia affect the musculoskeletal system?</p>

A

<p>Decreases skeletal muscle activity<br></br>Causes muscle cramping<br></br>Causes weakness and fatigue of muscles<br></br><br></br>This leads to shallow, ineffective respirations (thus affecting the respiratory system)</p>

30
Q

<p>What nursing interventions should be implemented when a patient is experiencing hypokalemia?</p>

A

<p>Priority: Cardiac monitor (acute care setting only)<br></br>Give medications and/or foods to help increase potassium levels</p>

31
Q

<p>If a potassium level is < 3.5 mEq/L and the patient is scheduled to receive Furosemide (Lasix), should the nurse give it?<br></br>(Assume there are no orders for potassium replacement)</p>

A

<p>No, the nurse should hold the medication and call the doctor to notify and request further instructions.<br></br>Giving the Furosemide (Lasix) would further deplete the potassium level and cause hypokalemia.</p>

32
Q

<p>What are the most common causes of hyperkalemia?</p>

A

<p>Excessive potassium intake<br></br>Kidney Failure (the kidneys are not working, they cannot get rid of the potassium in the blood via the urine)<br></br>Medications</p>

33
Q

<p>How does hyperkalemia affect the cardiovascular system?</p>

A

<p>Can cause an arrhythmia<br></br>Possible cardiac arrest!</p>

34
Q

<p>How does hyperkalemia affect the musculoskeletal system?</p>

A

<p>Muscle twitching<br></br>Muscle cramps<br></br>Eventual muscle weakness</p>

35
Q

<p>What nursing interventions should be implemented when a patient is experiencing hyperkalemia?</p>

A

<p>Priority: Cardiac monitor (acute care setting only)<br></br>Administer medications to decrease potassium levels<br></br>Restrict potassium rich foods</p>

36
Q

<p>What is the role of calcium?</p>

A

<p>Essential for proper function of excitable muscle cells - cardiac muscle and smooth muscle<br></br>Helps to control blood pressure (smooth muscle cell control)</p>

37
Q

<p>What other substance is required in order for calcium to be absorbed?</p>

A

<p>Vitamin D<br></br>Vitamin D aides in the absorption of calcium, without it calcium will not be absorbed from our food</p>

38
Q

<p>What relationship to calcium and phosphorus have?</p>

A

<p>Inverse (opposite)</p>

39
Q

<p>What are common causes of hypocalcemia?</p>

A

<p>Vitamin D Deficiency<br></br>Renal Disease (the kidneys active vitamin D. Without active vitamin D the body cannot absorb calcium)<br></br>Medications<br></br>Hyperphosphatemia</p>

40
Q

<p>How does hypocalcemia affect the cardiovascular system?</p>

A

<p>Causes cardiac dysrhythmias<br></br>Can cause possible cardiac arrest<br></br>Causes hypotension</p>

41
Q

<p>How does hypocalcemia affect the musculoskeletal system?</p>

A

<p>Nerve hyperexcitability<br></br>Causes hyperactive deep tendon reflexes (this mean muscle twitching)<br></br>Numbness and tingling of the fingers and around the mouth<br></br>Positive Trousseau and Chvostek signs</p>

42
Q

<p>What nursing interventions should be implemented when a patient is experiencing hypocalcemia?</p>

A

<p>Priority: Cardiac Monitor<br></br>Administer calcium via medications<br></br>Administer calcium rich foods</p>

43
Q

<p>Explain a positive Chvostek Sign. What does it tell us?</p>

A

<p>When the face is tapped just below the eye and in front of the ear the eye and face muscles will twitch<br></br><br></br>This tells us there is nerve hyperexcitability</p>

44
Q

<p>Explain a positive Trousseau Sign. What does it show us?</p>

A

<p>The hand spasms when a blood pressure cuff is inflated on the upper arm for > 3 minutes.<br></br><br></br>This shows us tetany.</p>

45
Q

<p>In what electrolyte imbalance is there a positive Chvostek and Trousseau Sign?</p>

A

<p>Hypocalcemia</p>

46
Q

<p>What are common causes of hypercalcemia?</p>

A

<p>Excessive intake of calcium<br></br>Excessive intake of vitamin D<br></br>Medications<br></br>Hypophosphatemia <br></br>Paraneoplastic disorders (such as lung cancer)</p>

47
Q

<p>How does hypyercalcemia affect the cardiovascular system?</p>

A

<p>Causes cardiac dysrhythmias<br></br>Can cause cardiac arrest<br></br>Causes hypertension</p>

48
Q

<p>How does hypyercalcemia affect the musculoskeletal system?</p>

A

<p>Causes skeletal muscle weakness</p>

49
Q

<p>How does hypyercalcemia affect the genitourinary system?</p>

A

<p>Can cause kidney stones</p>

50
Q

<p>What nursing interventions should be implemented when a patient is experiencing hypercalcemia</p>

A

<p>Priority: Cardiac monitor<br></br>Decrease calcium levels<br></br>Avoid foods high in calcium</p>

51
Q

<p>What is the relationship between magnesium and calcium?</p>

A

<p>They work together</p>

52
Q

<p>What is the role of magnesium in the body?</p>

A

<p>Function of excitable cells (cardiac muscle, nerve cells)</p>

53
Q

<p>What are common causes of hypomagnesemia?</p>

A

<p>Decreased intake, usually related to malnutrition<br></br>Excessive loss (diarrhea)<br></br><br></br>Most commonly seen in alcoholics</p>

54
Q

<p>How does hypomagnesemia affect the cardiovascular system?</p>

A

<p>Causes cardiac dysrhythmias<br></br>Can lead to cardiac arrest</p>

55
Q

<p>How does hypomagnesemia affect the musculoskeletal system?</p>

A

<p>Hyperactive deep tendon reflexes<br></br>Can lead to tetany<br></br><br></br>(Just like hypocalcemia)</p>

56
Q

<p>What nursing interventions should be implemented when a patient is experiencing hypomagnesemia?</p>

A

<p>Priority: Cardiac monitor<br></br>Replace Magnesium via medications and/or food</p>

57
Q

<p>If a patient has a low calcium level, what other electrolyte would be low?</p>

A

<p>Magnesium</p>

58
Q

<p>What are common causes of hypermagnesemia?</p>

A

<p>Excessive intake<br></br>Renal Failure</p>

59
Q

<p>How does hypermagnesemia affect the cardiovascular system?</p>

A

<p>Can cause dysrhythmias<br></br>Possible cardiac arrest</p>

60
Q

<p>How does hypermagnesemia affect the musculoskeletal system?</p>

A

<p>Skeletal muscle weakness<br></br><br></br>(Just like hypercalcemia)</p>

61
Q

<p>Sodium (Na)</p>

<p>Expected Range?</p>

<p>Causes, symptoms of higher/lower levels?</p>

A

<p>Na: Electrolyte important for nerve/muscle function, maintaining fluid balance</p>

<p><br></br>Expected range: 135-145 mEq/L<br></br><br></br>Hyponatremia (<135)</p>

<ul> <li>Causes: GI losses, diuretics, skin losses, SIADH</li> <li>Symptoms: Confusion (common in elderly), fatigue</li></ul>

<p>Hypernatremia (>145)</p>

<ul> <li>Causes: Water deprivation (elderly who don't/are offered a drink), excess sodium intake, Cushing's syndrome</li> <li>Symptoms: Confusion, muscle twitching/weakness</li></ul>

2.2 - ABSN NUR 334 Fluid & Electrolytes & Periop (11 decks)

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