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NCM 112: Quiz 2 (midterms) > FLUID VOLUME DISTURBANCES > Flashcards

FLUID VOLUME DISTURBANCES Flashcards

1
Q

loss of ECF volume exceeds the intake of fluid.

A

hypovolemia

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2
Q

isotonic volume expansion of the ECF

A

hypervolemia

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3
Q

Hyponatremia refers to a serum sodium level that is less than

A

135

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4
Q

Hypernatremia is a serum sodium level higher than

A

145 mEq/L.

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5
Q

sually indicates a deficit in total potassium stores.

A

hypokalemia

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6
Q

Hyperkalemia refers to a potassium level greater than

A

5.0 mEq/L.

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7
Q

Hypocalcemia are serum levels below

A

8.6 mg/di.

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8
Q

Hypercalcemia is a calcium level greater than

A

10.2 mg/dl.

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9
Q

refers to a below-normal serum magnesium concentration.

A

Hypomagnesemia

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10
Q

Hypermagnesemia are serum levels over

A

2.3 mg/di.

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11
Q

Hypophosphatemia is indicated by a value below

A

2.5

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12
Q

Hyperphosphatemia is a serum phosphorus level
that exceeds

A

4.5

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13
Q

SIADH

A

SYNDROME OF INAPPROPRIATE SECRETION OF ANTIDIURETIC
HORMONE

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14
Q

DISORDER OF IMPAIRED WATER EXCRETION CAUSED BY THE
INABILITY TO SUPPRESS THE SECRETION OF ANTIDIURETIC HORMONE (ADH).

A

SYNDROME OF INAPPROPRIATE SECRETION OF ANTIDIURETIC
HORMONE

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15
Q

Water is retained abnormally in

A

SIADH

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16
Q

give 6 diagnostic exams

A

BUN
Hematocrit
Physical exam
Serum Electrolyte
ECG
ABG

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17
Q

used to treat the hypotensive patient with FVD

A

Isotonic electrolyte solutions

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18
Q

performed to remove nitrogenous wastes and control
potassium and acid-base balance

A

Hemodialysis

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19
Q

treat hyponatremia by
stimulating free water excretion.

A

AVP receptor agonists

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20
Q

decrease fluid volume in FVE, diuretics
are administered

A

Diuretics.

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21
Q

serum potassium levels are
dangerously elevated, it may be necessary

A

IV Calcium gluconate

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22
Q

used to lower the
serum calcium level and is particularly useful for
patients with heart disease

A

Calcitonin.

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23
Q

enhance
conservation of water by increasing the
permeability of collecting ducts to wate

A

Avp/ Vasopressin is a vasopressin receptor
agonist.

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24
Q

also a potent
vasoconstrictor and exerts a direct constrictive
action on specific smooth muscle receptors

A

Vasopressin

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25
Q

when loss of extracellular
fluid exceeds the intake of fluid

A

hypovolemia

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26
Q

predisposing factors of hypovolemia

DAOHCT

A

Diabetes Insipidus
● Adrenal insufficiency
● Osmotic diuresis
● Hemorrhage
● Coma
● Third-space fluid shifts

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27
Q

movement of fluid from
the vascular system to other body space

A

third-space fluid shifts

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28
Q

signs and symptoms of hypovolemia

LTDOC

A

Low BP (Postural hypotension)
● Tachycardia: rapid weak & thready pulse
● Decreased skin turgor
● Oliguria
● Concentrated urine

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29
Q

SIGNS AND SYMPTOMS (INFANT AND YOUNG CHILDREN)

A

Crying without tears
● No wet diapers for three hours or more
● Being unusually sleepy or drowsy
● Irritability Eyes that look sunken
● Sunken fontanel

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30
Q

CBC results of hypovolemic px

A

increase hematocrit
Elevated BUN
Decreased plasma volume

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31
Q

Urine test for hypovolemic px

A

Increased BUN
Na concentration
Urine pH

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32
Q

factors caused by:

A

Diarrhea
Fistula
Wounds
Diabetes insipidus
DKA

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33
Q

Level of Conciousness (5)

A

Alert
Lethargy
Obstundation
Stupor
Coma

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34
Q

Appearance of wakefulness, awareness of the self
and environment

A

Alert

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35
Q

mild reduction in alertness

A

Lethargy

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36
Q

moderate reduction in alertness. Increased response
time to stimuli

A

obtundation

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37
Q

Deep sleep, patient can be aroused only by vigorous
and repetitive stimulation. Returns to deep sleep
when not continually stimulated.

A

stupor

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38
Q

Sleep lice appearance and behaviorally unresponsive
to all external stimuli (Unarousable unresponsiveness,
eyes closed)

A

COMA (UNCONSCIOUS)

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39
Q

measure of pressure in the vena cava,

A

CENTRAL VENOUS PRESSURE

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40
Q

often used as an assessment of hemodynamic
status

A

CENTRAL VENOUS PRESSURE

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41
Q

stage 1 of hypovolemic shock

A

: 15% blood loss
(750 mL or about 25 ounces).

42
Q

stage 2 of hypovolemic shock

A

15% to 30%
(750 mL to 1,500 mL or up to almost 51 ounces)

43
Q

stage 2 of hypovolemic shock

A

30% to 40% of your blood (1,500 to 2,000 mL or up to 68 oz.)

44
Q

isotonic volume
expansion of the extracellular fluid (ECF) caused by
the abnormal retention of water and sodium

A

● HYPERVOLEMIA r

45
Q

SIGNS & SYMPTOMS (PULMONARY)
for hypervol

A

Pulmonary Congestion: crackles, rales
● Change in respiratory pattern
● Shortness of breath; orthopnea/dyspnea
● Orthopnea, Paroxysmal nocturnal dyspnea
● Cough
● X-ray shows pulmonary edema

46
Q

SIGNS & SYMPTOMS (NEUROLOGIC)

for hypervol

A

Headache
● Restlessness, Anxiety
● Seizures
● Change in mental status (confusion), LOC

47
Q

SIGNS & SYMPTOMS (EDEMA/ASCITES
hypervol

A

Dependent Pitting Edema
● Ascites

48
Q

biochemical abnormality,
defined as elevation, or buildup of,
nitrogenous products

A

Azotemia

49
Q

(BUN-usually ranging 7
to 21 mg/dL)

A

Azotemia

50
Q

Normal urine specific gravity levels are
between

A

1.010 and 1.02

51
Q

Urine Specific gr.
increases IF

A

if concentrated.

52
Q

disorder that causes excess
excretion of protein in the urine

A

Nephrotic syndrome

53
Q

swelling that occurs prior to
a woman’s menstrual cycle

A

Premenstrual edema

54
Q

CBC for hypercolemia

A

Low hematocrit
Serum Na
High Na

55
Q

Urine test for hypervol

A

Increased BUN

56
Q

Administer drugs to release water like

A

lasix,
hydrochlorothiazide or aldactone

57
Q

OTHER TREATMENT OPTIONS FOR HYPERVOLEMIA INCLUDE:

A

Undergoing dialysis or paracentesis:

58
Q

1kg weight gain is to

A

!L of water

59
Q

Evidenced seen in hypervol

A

Ascites.
● Extra heart sounds S3
● Aphasia, muscle twitching, tremors, seizures
● Hypertension
● Productive cough.
● Bounding pulses.
● Shortness of breath.
● Changes in LOC (lethargy, disorientation, confusion to
coma)
● Sudden weight gain,

60
Q

major extracellular fluid cation.

A

Sodium (Na)

61
Q

facilitating impulse transmission in nerve
muscle fibers by participating in the
sodium-potassium pump.

A

Importance of NA

62
Q

HYPERNATREMIA

A

↑ serum Na+ >145 mEq/L

urine specific gravity >1.025

63
Q

s/s of hypernatremia

FRIED

A

● Fever-low grade , Flushed skin
● Restless (irritable)
● Increased fluid retention
● EDema ( peripheral and pitting)
● Decrease urine output, Dry mouth

64
Q

SIGNS AND SYMPTOMS (TOO MUCH SALT)

SALT

A

Skin flushed
● Agitation
● Low grade fever
● Thirst

65
Q

6mm deep pit for 10-12 secs grade of edema

A

3+

66
Q

4 mm deep pit

A

2+

67
Q

signs of circulatory overload

A

dyspnea, orthopnea, wheezing, tightness in
the chest, cough, cyanosis, tachypnea, rapid
increase in blood pressure, distended neck
veins..)

68
Q

HYPONATREMIA

A

↓ serum Na+ <135 mEq/L
● Urine specific gravity <1.005

69
Q

SIGNS AND SYMPTOMS of hyponat

SALT

A

Stupor/Coma
● Anorexia
● Lethargy
● Tendon reflexes ↓↓ - Depressed DTR

70
Q

very brisk, hyperactive, with
clonus

A

4+

71
Q

Average, expected response;
normal

A

2+

72
Q

Brisker than average, slightly
hyperreflexic

A

3=

73
Q

SIGNS AND SYMPTOMS (LOSS) for hyponat

A

Limp muscles
● Orthostatic hypotension
● Seizures
● Stomach crampingq

74
Q

. EUVOLEMIC HYPONATREMIA

A

Caused by SIADH antidiuretic hormone problems:
fluid restriction

75
Q

Euvolemia treated with antidiuretic hormone
antagonists called

A

Declomycin

76
Q

major cation in the intracellular
fluid (ICF).

A

Potassium

77
Q

K normal range

A

Normal Range: 3.5 - 5.0 mEq/L

78
Q

ICF AND ECF of potassium

A

98% ICF and 2% ECF

79
Q

5 functions of potassium

A

Aids in Heart & Muscle Contractility -Participates in Sodium - Potassium Pump
Maintains osmotic pressure in the intra and
extracellular environments -

80
Q

Hyperkalemia

A

> 5.0 meq/L

81
Q

mild hyperkalemia

A

5.1-6.0

82
Q

moderate hyperkalemia

A

6.1-7.0

83
Q

severe hyperkalemia

A

above 7.0

84
Q

S/S of hyperkal

MURDER

A

Muscle weakness/cramps
● Urine, oliguria, anuria
● Respiratory distress
● Decrease cardiac contractility
● EKG changes
● Reflexes ( hyper or areflexia)

85
Q

Peaked T waves, Prolonged PR segment

A

Mild hyperkal

86
Q

Loss of P wave, prolonged QRS. ST elevates

A

Moderate hyperkal

87
Q

progressive widening of QRS comples, Sine wave, Ventricular fibri

A

Severe hyperkal

88
Q

TREATMENT “C BIG K DROP”

A

Calcium gluconate (stabilizes cardiac membrane)
● Beta-2-agonist(albuterol neb q2-4hrs), Bicarb (shift
K+ to the cell)
● Insulin
● Glucose
● Kayexalate(Na polystyrene sulfonate)- to excrete K+
out
● Drop

89
Q

to excrete K+
out

A

Kayexalate(Na polystyrene sulfonate)-

90
Q

given to rapidly REVERSE
conduction abnormalities.

A

calcium infusion

91
Q

HYPOKALEMIA

A

↓ serum K+ = <3.5 mEq/L

92
Q

causes of hypokal

DITCH

A

DRUGS: loop diuretics, laxatives, glucocorticoids
(Hydrocortisone)
● INADEQUATE CONSUMPTION OF K+
● TOO MUCH WATER INTAKE
● CUSHING’S SYNDROME - causes kidneys to excrete
K+
● HEAVY FLUID LOSS - vomiting, diarrhea, wound
drainage, gastric lavage

93
Q

SIGNS & SYMPTOMS (7L’S) of hypokal

A

Lethargy
● Low, shallow breathing
● Lethal cardiac arrest
● Loss of urine
● Leg cramps
● Limp muscles
● Low BP & HR

94
Q

TREATMENT (STOP K+ LOSSES!)

A

no to lasix
Discontinue diuretics
Use potassium-sparing

95
Q

potassium-sparing diuretics

A

/Aldactone,
Dyazide, Maxide, Triamterene

96
Q

(for severe heart
failure

A

Triamterene

97
Q

alkalosis potassium deficiency

A

use potassium chloride

98
Q

acidosis potassium deficiency

A

use potassium acetate

99
Q

IV Potassium for levels less than

A

2.5 mEq.

100
Q

TREATMENT (NEVER EVER GIVE?

A

K+ VIA IV PUSH OR BY IM OR
SUBQ ROUTES!)

NCM 112: Quiz 2 (midterms) (1 decks)

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