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Nurse 158 > Fluid's > Flashcards

Fluid's Flashcards

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1
Q

What are the major electrolytes of the ICG?

A

Potassium

Phosphates

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2
Q

What are the major electrolytes of the ECF?

A

Sodium

Chloride

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3
Q

What is the major force of IV fluid therapy?

A

Osmosis

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4
Q

What are the 6 main elements that require active transport?

A

K, Na, H, Fe, Cl, I

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5
Q

What is the key assessment in fluid balance?

A

Weight

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6
Q

What is the major solute in plasma?

A

Sodium

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7
Q

Increased BUN is a major indicator of what?

A

Dehydration

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8
Q

What is Hydrostatic pressure?

A

Pushing force of fluid against the walls of the space it occupies

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9
Q

What is oncotic pressure?

Where does it occur?

A

The pulling force of proteins in the vascular space.

In the capillary beds

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10
Q

How much do kidney’s filter a day? This amount is called?

A

150-180L

The GFR

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11
Q

Water conservation begins after the body loses ______% of body fluids?

A

1-2%

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12
Q

ADH is also known as ____

Why?

A

Vasopressin

Because it causes Vasoconstriction

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13
Q

The main goal of ADH is to _____

It does this by_____

A

Conserve Water

Targeting the Distal tubules of the nephron

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14
Q

ADH release is triggered by what three things? The opposite of these things _____ ADH

A

Drop in BP
Drop in Blood volume
Rise in Blood osmolarity

Inhibit

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15
Q

ADH is released from the ____

A

Posterior Hypothalamus

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16
Q

Aldosterones main goal is to____

It does this by _____

A

Save Sodium and Water

Initates resorption of sodium. Water follows

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17
Q

Aldosterone is released by the ____ in response to the ____system.

A

Adrenal gland

Renin-angiotensin-aldosteron system

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18
Q

What three things trigger the system that releases aldosterone?

A

Drop in BP
Drop in Blood volume
Drop in Na and increase in Potassium

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19
Q

Glucocorticoids are released by the ___ their main goal is to ___

A

Adrenal glands

cause the kidneys to conserve sodium and water

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20
Q

Glucocorticoids are released in response to ___

A

stress

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21
Q

ANP is relased when ______

A

The atria of the heart are stretched r/t increased BP or blood volume

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22
Q

The main goal of ANP is to ____

It does this by___ (4things)

A

Lower BP and Blood Volume

  • Vasodilation
  • Decreases Aldosterone
  • Decreases ADH
  • Increases GFR(more urine more water excreted)
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23
Q

When is BNP released?

A

When the ventricles are stretched r/t increased blood pressure and volume

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24
Q

What is the main goal of BNP

How is this goal achieved? (3 things)

A

To decrease Blood volume and pressure

  • Vasodilation
  • Decreased aldosterone
  • Causes Diuresis of water and Na
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25
Q

BNP is a key lab for ____

A

CHF

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26
Q

Small shifts in _____ cause thirst

A

Serum osmolarity

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27
Q

Receptors that trigger thirst are found in the ____

They can be triggered by as little as ___ mOsm/L change

A

Hypothalamus

1

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28
Q

When thirst is triggered so are these 2 hormones

A

ADH and Aldosterone

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29
Q

When you drink water, it takes _____ minutes to be absorbed and distributed

A

30-60

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30
Q

Water is absorbed in your _____

A

Colon

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31
Q

What is the minimum fluid intake?

A

30ml/kg/day

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32
Q

How do you calculate minimum fluid intake?

A

100 ml/kg for the first 10Kg
50 ml/kg for the next 10Kg
20ml/kg for the remaining Kg’s

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33
Q

Calculate the min. fluid intake of someone weighing 30kg

A

1000+500+200

1700ml

34
Q

What is an isotonic FVD

A

When equal amounts of fluid and solute are lost

35
Q

What is a Hypotonic FVD?

Plasma osmolarity ____

A

When more electrolytes are lost than water

Decreases

36
Q

What is a hypertonic FVD?

Plasma Osmolarity

A

When more water than electrolytes is lost

Increases

37
Q

Name some of the 7 general main risk factors for FVD’s

A 
Age, gender, Body fat
Acute illness
Chronic Illness
Environmental Factors
Diet and Lifestyle
Medications
Stress
38
Q

What are some causes of isotonic fluid volume loss?

A
  • Poor intake
  • Excessive Gi fluid loss
  • Excessive renal loss
  • Excessive skin loss
  • Third space loss
39
Q

What are some causes of hypertonic dehydration

A
  • Poor intake
  • Prolonged isotonic loss
  • Watery Diarrhea
  • Diabetes Insipidus
  • Increased solute intake
40
Q

What are some assesment findings in a FVD?

A 
Thirst
Changes in urine volume and concentration
Skin turgor
Sunken eyes and fontanels
Flat neck veins
Hypotension
Decreased CO
Mental status changes
Fever
Weight loss
41
Q

Mild FVD = __% of body weight lossed?

A

2

42
Q

Moderate FVD = __% of body weight lossed?

A

5

43
Q

Severe FVD = __% of body weight lossed?

A

8 or higher

44
Q

FVD will should a kidney output of less than ____ and hr and a urine specific gravit of greater than ___

A

30

1.030

45
Q

How will FVD effect BP?

A

It will cause orthostatic Hypotension

46
Q

What is a normal CVP?

A

2-8 cm of H2O

47
Q

What are the 5 types of diagnostic/lab findings that are used to detect FVD?

A 
Direct measurements
-ABG
-PA lines (CO2 measurements)
-CV lines(CVP)
HCT&BUN
Urine Specific Gravity
Urine Osmolarity
Plasma Concentration
-Osmolarity
-Sodium
-Glucose
48
Q

If BUN is increased and creatinine is normal what is the likely reason?

A

FVD

49
Q

What are the four types of interventions for FVD?

Which one is the first choice?

A

Oral replacement First choice
Parenteral replacement
Monitoring during therapy
Medication

50
Q

What is an example of an Oral replacement Therapy solution?

A

Pedialyte or Half strength Gatorade

51
Q

Isotonic Fluids fix _____ FVD

A

Isotonic

52
Q

What are the features of Isotonic fluids?

A

Same osmolarity as plasma
Replaces ECF and electrolytes
They expand volume quickly
No calories

53
Q

What are the 4 main isotonic solutions?

A

0.9% NaCl (normal saline solution)
Ringers solution
Lactated ringers solution (LR)
5% dextrose in water

54
Q

Hypotonic Solutions fix _____ FVD

A

Hypertonic

55
Q

What are the features of hypotonic solutions?

A

Lower osmolarity than Plasma

Prevent/Treat cellular dehydration

56
Q

Using hypotonic solutions is contraindicated in ____

Why?

A

Acute Brain injuries

The brain will suck up the solution and swell

57
Q

What are the frequent assessments required when administering hypotonic solutions?
Why?

A

VS
LOC
Circulation

Because of the risk of cerebral edema

58
Q

What are the two main Hypotonic solutions

A

1/2 NS solution

1/4 NS solution

59
Q

Hypertonic solutions fix ____ FVD

A

Hypotonic

60
Q

What are the features of Hypertonic fluids?

A

Higher osmolarity than plasma
Require close monitering
Used in limited doses
Require use of infusion pump

61
Q

What are the 5 main hypertonic fluids?

A 
3% NaCl solution
5% NaCl solution
D10W 
50% dextrose
D51/2NS, D5NS, D5LR, D51/4NS
62
Q

What is 50% dextrose used for?

A

DKA

63
Q

What is a crystaloid solution?

A

A solution that does not cause a fluid shift

64
Q

What is a colloid solution?

A

A solution that causes a fluid shift

65
Q

What is an Isotonic FVE?

A

(Hypervolemia and edema)

When there is a proportional gain in fluid and Solute

66
Q

In an isotonic FVE there is excess in which two fluid compartments?

A

Vascular and interstitial

67
Q

What are the 5 main causes of an isotonic FVE?

A 
Renal failure
Heart Failure
Excess intake
High Corticosteroid levels
High Aldosterone
68
Q

A hypotonic FVE is also know as ______

A

Water intoxication

69
Q

What are the characteristics of a hypotonic FVE?

A

More fluid than solute is gained

Serum Osmolality falls

70
Q

What are some causes of a hypotonic FVE?

A 
Plain water irrigation
Hypotonic IV fluids
Overzealous plain water intake
Diluted formula in infants
SIADH
Psychogenic Polydipsia
Severe prolonged FVE with existing diseases states
71
Q

What can cause SIADH?

A

Head/Brain trama

72
Q

What are some positive assessment findings in FVE?

A 
Bulging Fontanels
High CVP
JVD
Third Spacing
Bounding Pulse
INcreased BP
73
Q

What are three examples of third spacing?

A

Peripheral Edema
Pulmonary Edema
Ascities

74
Q

What are three signs of pulmonary edema?

A

Shortness of breath
Crackles
Clear white sputum

75
Q

What are four main causes of edema?

A

INcreases capillary Hydrostatic Pressure
Decreases Capillary onconic pressure
Lymphatic Obstruction or removal
Sodium Excess

76
Q

What causes increased capillary hydrostatic pressure?

A

Hypertension and hypervolemia

77
Q

What causes decreased Capillary Onconic Pressure?

A 
Decreased Albumin
Injury
Inflammation
Malnutrition
Liver dysfunction
78
Q

How will weight be affected by FVE?

A

it will increase

79
Q

What lab values will suggest a FVE?

A

Decreased sodium, bun, and HCT

80
Q

What are some interventions for FVE?

A 
Restrict fluid intake
Promote excretions
Monitor during therapy
Prevent more excess
Be alert for acute Pulmonary edema
Patient education
81
Q

What are four things that promote excretion of excess water in a FVE?

A

Diuretics
hBNP
Digoxin, ACE inhibitors
Protein intake

Nurse 158 (14 decks)

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