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Fluids/Acid Base Balances > Fluids and Electrolytes > Flashcards

Fluids and Electrolytes Flashcards

1
Q

SODIUM LAB VALUE

A

135-145

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2
Q

POTASSIUM LAB VALUE

A

3.5-5

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3
Q

PHOSPHORUS LAB VALUE

A

2.5-4.5

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4
Q

CALICUM LAB VALUE

A

9-11

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5
Q

MAGNEISUM LAB VALUE

A

1.5-2.5

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6
Q

CHLORIDE

A

95-105

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7
Q

Potassium:

A

Priority: Pumps the heart and muscles

vital role in cell metabolism, nerve impulses, cardiac and muscle tissues, and acid base imbalances

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8
Q

Hyperkalemia S/S

A

Heart - TIGHT & CONTRACTED 1ST elevation and Peaked T waves
2 Severe = Vfib or Cardiac Standstill!
3 Hypotension, Bradycardia
GI TRACT - TIGHT & CONTRACTED
1 Diarrhea
2 Hyperactive bowel sounds NEUROMUSCULAR
- TIGHT & CONTRACTED Paralysis in Extremities Increased DTR
Profound Muscle Weakness, (General Feeling of heaviness)

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9
Q

Hypokalemia S/S

A

<3.5 mEq/L
weak, irregular pulse
orthostatic hypotension
shallow respirations
anxiety, lethargy

HEART - LOW & SLOW
1 Flat T waves, ST depression, & prominent U wave
MUSCULAR - LOW & SLOW
1 Decreased DTR
2 Muscle cramping
3 Flaccid paralysis (paralyzed limbs)
GI - LOW & SLOW
Decreased motility, hypoactive to absent bowel sounds, Constipation
Abdominal distention
Paralytic ileus, paralyzed intestines! PRIORITY for SB0 (small bowel obstruction)

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10
Q

Hypernatremia S/S

A

> 145 mEq/L
big and bloated
confused, irritable, restless
increase BP and fluid retention
pitting edema
decrease urine output
thirsty

  1. SKIN
    FLUSH ‘’Red & Rosy’’ EDEMA ‘’waterbed skin’’ LOW GRADE FEVER
  2. POLYDIPSIA EXCESS THIRST
  3. LATE SERIOUS SIGNS:
    SWOLLEN dry tongue-NCLEX
    GI = nausea & vomiting-NCLEX INCREASED muscle tone NCLEX
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11
Q

Hyponatremia S/S

A

SALT LOSS
stupor coma
anorexia
lethargy
tachycardia

limp muscles
orthostatic hypotension
seizures
stomach cramping

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12
Q

Hyperphosphatemia S/S

A

tetany, muscle cramps, numbness and tingling of extremities and around moth and hyperreflexia

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13
Q

Hypophosphatemia

A

decreased LOC, confusion, muscle weakness, pain, neuropathy

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14
Q

Sodium:

A

found in the ECF, essential for acid base, fluid balance, active and passive transport, irritability and conduction of nerve muscle tissues

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15
Q

Phosphorus:

A

mostly in bones and teach as calcium phosphate, function of muscle, red blood cells, and the nervous system. Excretion requires adequate kidney function

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16
Q

Chloride

A

Sodiums sidekick: maintains the blood pressure, blood volume and the PH balance

17
Q

Hyperchloremia S/S

A

> 105
nausea and vomiting, swollen dry tongue, confusion

18
Q

Hypochloremia

A

<95
excessive diarrhea, vomiting, and sweating and fever

19
Q

Magnesium

A

mag mellows the muscles

20
Q

Hypermagnesemia

A

> 2.5
Cardiac: calm and quiet
heart block, prolonged PR intervals
Vitals: bradycardia, hypotension
Deep tendon reflexes: calm+quiet
Lungs: calm and quiet as well, depressed shallow respirations
Gi: calm/quiet, hypoactive bowel sounds

21
Q

Hypomagnesemia

A
  1. CARDIAC - BUCK WILD!
    EKG: ST depression, T wave inversion
    SEVERE = V fib
    VITALS = Tachycardia
  2. DEEP TENDON REFLEXES - BUCK WILD
    Hyporeflexia - increased DTR
  3. EYES - BUCK WILD
    Abnormal eye movements (nystagmus)
  4. GI - BUCK WILD Diarrhea
22
Q

Calcium

A

keeps the bone, blood, and beats(heart) strong

23
Q

Hypercalcemia

A

> 11
SWOLLEN & SLOW -
MOANS, GROANS & STONES
1. CONSTIPATION
2. BONE PAIN
3. STONES Renal Calculi (kidney stones)
4. DEEP TENDON REFLEXES
-Decreased DTR
-Severe muscle weakness

24
Q

Hypocalcemia

A

<9
T - Trousseau’s
T - Twerking arm with BP cuff on C - Chvostek’s
C - Cheek smile when touched
-Diarrhea
-Circumoral tingling
-Weak bones

25
Q

NORMAL SALINE (NS) USES
-0.9 % NaCl in water
-crystalloid solution
-isotonic

A

-increases circulating plasma volume when red cells are adequate
-shock
-fluid replacement in patients with DKA
-hyponatremia
-blood transfusions
-resuscitation
-metabolic alkalosis
-hypercalcemia

26
Q

NORMAL SALINE (NS) SPECIAL CONSIDERATIONS

A
  • do not use patients with heart failure, edema, or hypernatremia
    -replaces losses without altering fluid concentrations
    -helpful for Na+ replacement
27
Q

1/2 Normal Saline
-0.45 % NaCl in water
-crystalloid solution
-Hypotonic (154 mOsm)

A

-water replacement
-raises TFV
-hypertonic dehydration
-sodium and chloride depletion
-gastric fluid loss from nasogastric suctioning or vomiting

28
Q

1/2 Normal Saline CONSIDERATIONS
-0.45 % NaCl in water
-crystalloid solution
-Hypotonic (154 mOsm)

A

USE CAUTIOUSLY may cause cardiovascular collapse or increase in intracranial pressure
-dont use in pts with liver disease, trauma, or burns
-useful for daily maintenance of body fluids
-establishing renal function
-fluid replacement for pts who dont need extra glucose (diabetics)

29
Q

Lactated Ringers (LR)
normal saline with electrolytes and buffers

A

replaces fluid and buffers PH
hypovolemia due to third shift spacing
dehydration
burns
lower GI tract fluid loss
acute blood loss

30
Q

Lactated Ringers (LR) CONSIDERTIONS
normal saline with electrolytes and buffers

A

-has similar electrolyte content with serum but does not contain magnesium
- has K+ therefore don’t use to patients with renal failure as it can cause hyperkalemia
-don’t use in liver disease because pt cant metabolize lactate; a functional liver converts it to bicarb
-don’t give to pts PH >75

31
Q

ISOTONIC

A

iso=equal
tonic=concentration of solution

meaning: equal concentration inside as well as outside of the cell

They are used to increase the extracellular fluid volume.
The extracellular fluid is lost through blood loss, dehydration (V/D), surgery,
and heat exposure (sweating).
Won’t cause a shift into the intracellular area and prevents the cell from shrinking or expanding.

32
Q

D5W
-dextrose 5% in the water crystalloid solution
-isotonic in the bag
-physiologically hypotonic

A

-replaces total fluid volume
-helpful in rehydrating and excretory purposes
-fluid loss and dehydration
-hypernatremia

33
Q

D5W CONSIDERATIONS
-dextrose 5% in the water crystalloid solution
-isotonic in the bag
-physiologically hypotonic

A

-it is isotonic and then becomes hypotonic when dextrose is metabolized
-do not use for resuscitation
-caution: pt with renal/cardiac disease can cause fluid overload

34
Q

HYPOTONIC

A

has a lower concentration of fluid, sugars, and salt than blood

35
Q

HYPERTONIC

A

HIGHER concentration of fluid, sugars, and salt than blood

36
Q

What is an acid base imbalance?

A

A blood pH imbalance can lead to two conditions: acidosis and alkalosis. Acidosis refers to having blood that’s too acidic, or a blood pH of less than 7.35. Alkalosis refers to having blood that’s too basic, or a blood pH of higher than 7.45

37
Q

Intracellular ICF

A

● Two thirds of body water
● Body fluids within the cell

38
Q

Extracellular ECF

A

● One third of body water
● Body fluids outside of the cell membrane
● Further divided into parts
-Intravascular fluid: The liquid part of blood or the plasma
-Interstitial fluid: Located between the cells and outside of the blood vessels
-Transcellular body fluids: Secreted by epithelial cells (cerebrospinal, pleural, peritoneal, synovial fluids)

Fluids/Acid Base Balances (4 decks)

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