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NCM 112 MIDTERMS > Fluids and Electrolytes > Flashcards

Fluids and Electrolytes Flashcards

1
Q

Normal Sodium (Na) Level

A

135-145 mmol/L

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2
Q

Normal Chloride (Cl) Level

A

98-106

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3
Q

Normal Calcium (Ca) Level

A

9.0-10.5 mg/dL

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4
Q

Normal Bicarbonate (HCl3) Level

A

22-29 mEq/L

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5
Q

Normal Potassium (K) Level

A

3.5-5.0 mmol/L

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6
Q

Normal Phosphorus/Phosphate (P) Level

A

3.0-4.5 mg/dL

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7
Q

Normal Magnesium (Mg) Level

A

1.3-2.1 mEq/L

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8
Q

What is maintained by the fluids and electrolytes?

A

blood volume and normal body temperature

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9
Q

What does fluids and electrolytes transports?

A

gases, nutrients, and other substances

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10
Q

What does fluids and electrolytes promote?

A

cellular chemical function

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11
Q

What does fluids and electrolytes eliminates?

A

waste products from the cell

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12
Q

Type of loss that can’t be measured or seen?

A

insensible loss

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13
Q

Type of loss that can be measured?

A

sensible loss

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14
Q

Daily output

A

2600

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15
Q

Output from the skin

A

600

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16
Q

Output from the lungs

A

400

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17
Q

Output from the kidneys

A

1500

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18
Q

Output from the intestines

A

100

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19
Q

Daily intake

A

2600

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20
Q

Intake from liquids

A

1500

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21
Q

Intake from solid foods

A

800

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22
Q

Intake from water from oxidation

A

300

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23
Q

Fluid compartments

A

ICF and ECF

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24
Q

Compartment where all fluids are inside the cell

A

Intracellular Fluid (ICF)

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25
Q

Compartment where fluids are outside the cell

A

Extracellular Fluid (ECF)

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26
Q

Fluids between cell (third space) blood, lymph node, bone, connective tissue, water

A

interstitial fluid

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27
Q

Accumulation and sequestration of trapped extracellular fluid in actual or potential body space as a result of disease or injury

A

third space

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28
Q

Refers to fluid inside blood vessel

A

intravascular

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29
Q

Body of fluid that is not inside the cell but is separated from plasma and interstitial fluid by cellular barriers.

A

transcellular

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30
Q

Excess accumulation of fluid in the interstitial space; occurs as a result of alterations in oncotic pressure, hydrostatic pressure, capillary permeability, and lymphatic obstruction.

A

edema

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31
Q

Generalized edema, excessive accumulation of fluid in ther interstitial space throughout the body occurs as a result of conditions such as cardiac, renal, or liver failure.

A

anasarca

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32
Q

Factors that affect water distribution

A

age, sex, fluid type, fluid movements, balancing fluids

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33
Q

Fluid type that has the same osmolarity to body fluid.

A

isotonic solution

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34
Q

Fluid type that has the same salt concentration as cells and blood

A

isotonic solution

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35
Q

Fluid type that has lower concentration of salt or solute than another, more concentrated solution

A

hypotonic solution

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36
Q

A solution that contains fewer dissolved particles (salt and other electrolytes) than is found in normal cells and blood

A

hypotonic solution

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37
Q

This solution is commonly used to give fluids intravenously to hospitalized patients in order to treat and avoid dehydration.

A

hypotonic solution

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38
Q

Fluid type that has higher concentration of solutes than other, less concentrated solution, higher osmolarity than fluid

A

hypertonic solution

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39
Q

A solution that contains more dissolved particles (such as salt and other electrolytes) than is found in normal cells and blood.

A

hypertonic solution

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40
Q

Solute (substance dissolved) may spread through a solution/solvent (solution where solute is dissolved)

A

diffusion

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41
Q

Movement where solute spreads higher to lower concentration

A

diffusion

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42
Q

It is the process of moving molecules across a cellular membrane through the use of cellular energy

A

active transport

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43
Q

It is the pressure in the force that draws solvent in less concentrated solute through a high concentrated.

A

osmosis

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44
Q

It is where fluid generally moves out of the capillary and into the interstitial fluid

A

capillary filtration

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45
Q

Ways to balance fluids

A

thirst, kidneys, ADH, RAAS, Anti-natriuretic peptide

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46
Q

What works with fluids to maintain health and well being?

A

electrolytes

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47
Q

What is crucial for nearly all reactions and functions of the cell?

A

electrolytes

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48
Q

It is an electrically charged atom or group of atoms formed by the loss or gain of one or more electrons

A

ion

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49
Q

Generates a negative charge

A

anion

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50
Q

Generates a positive charge

A

cation

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51
Q

Positive and negative ions balance each other out, achieving neutral electrical charge

A

electroneutrality

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52
Q

Functions of electrolytes:
Regulate ______
Govern _____
Transmit _____
Contributes _____

A

Regulate water distribution
Govern acid-base balance
Transmit nerve impulses
Contributes on energy generation and blood clotting

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53
Q

Major EC Electrolytes

A

Sodium, Chloride, Calcium, Bicarbonate

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54
Q

This helps maintain normal blood pressure, supports the work of your nerves and muscles, and regulates the body’s fluid balance.

A

sodium

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55
Q

What are the food sources of sodium?

A

Bacon, frankfurters, lunch meat, butter, cheese, canned food, ketchup, mustard, milk, processed food, snack food, soy sauce, table salt

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56
Q

Causes of HYPONATREMIA

A

Increased Na excretion
Inadequate Na intake
Dilution of serum Na

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57
Q

Factors that affects increased Na excretion

A

Excessive diaphoresis, Diuretics, Vomiting, Diarrhea, wound drainage especially GI, Kidney disease, decreased secretion of aldosterone

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58
Q

Factors that affect inadequate Na intake

A

NPO-fasting, L Na diet

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59
Q

Factors that affect dilution of serum Na

A

Excessive ingestion of hypotonic fluid or irrigation with hypotonic fluid, kidney disease, freshwater drowning, SIADH secretion, Hyperglycemia, Heart failure

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60
Q

What is needed to monitor in HYPONATREMIA?

A

Cardiovascular, RR, Neuromuscular, cerebral, renal, GI

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61
Q

HYPONATREMIA is accompanied by _____

A

fluid volume deficit (hypovolemia)

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62
Q

What is administered to restore Na content of fluid?

A

IV Na Cl

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63
Q

What is prescribed to promote the excretion of water rather than Na?

A

osmotic diuretics

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64
Q

What is administered if HYPONATREMIA is caused by inappropriate or excessive secretion of antidiuretic hormone?

A

medications that antagonize antidiuretic hormone

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65
Q

What happens if client is taking lithium and has HYPONATREMIA?

A

Client may have diminished lithium excretion resulting to toxicity

66
Q

Causes of HYPERNATREMIA?

A

decreased Na excretion
Increase Na intake, Na containing IVF
Decreased H2O intake, fasting, NPO
Increase H2O loss

67
Q

Factors that affects decreased Na excretion?

A

Corticosteroids, Cushing’s syndrome, kidney disease, Hyperaldosteronism

68
Q

Factors that affects increased H2O loss

A

Increased rate of metabolism, fever, hyperventilation, infection, excessive diaphoresis, watery diarrhea, diabetes insipidus

69
Q

What is needed to monitor in HYPERNATREMIA?

A

Cardiovascular, RR, neuromuscular, cerebral, renal, and Integumentary status.

70
Q

What to do if there’s fluid loss in HYPERNATREMIA?

A

prepare to administer IV infusions

71
Q

What to do if there’s inadequate renal excretion of Na in HYPERNATREMIA?

A

prepare to administer diuretics that promote sodium loss.

72
Q

This electrolyte helps keep the amount of fluid inside and outside of the cells in balance. It also helps maintain proper blood volume, blood pressure, and pH of your body fluids.

A

chloride

73
Q

This electrolyte is needed in the body to build and maintain strong bones.

A

calcium

74
Q

Some studies suggest that this electrolyte, along with vitamin D, may have benefits beyond bone health: perhaps protecting against cancer, diabetes and high blood pressure. What electrolyte is this?

A

calcium

75
Q

Food sources of calcium?

A

Cheese, Collard greens, kale, milk and soy milk, rhubarb, sardines, tofu, yogurt

76
Q

Causes of HYPOCALCEMIA

A

Inhibition of Ca absorption from GIT
Increased Ca excretion
Conditions that decreases the ionized fraction of Ca

77
Q

Factors that affects inhibition of Ca absorption from GIT

A

Adequate intake of Ca
Lactose Intolerance
Malabsorption syndromes such as celiac sprue or Crohn’s disease

78
Q

Factors that affect increased Ca excretion

A

Kidney disease, polyuric phase
Diarrhea, steatorrhea, wound drainage in GI

79
Q

What are the conditions that decreases the ionized fraction of Ca?

A

Hyperproteinemia, Alkalosis, medications such as Ca chelators or binders, acute pancreatitis, hyperphosphatemia, immobility, removal or destruction of the parathyroid glands.

80
Q

What is needed to monitor in HYPOCALCEMIA?

A

CV, RR, NM, and GI status

81
Q

If the patient has HYPOCALCEMIA, HYPERCALCEMIA, HYPOKALEMIA, HYPOPHOSPHATEMIA, and HYPOMAGNESEMIA the patient should be placed in _____ to monitor its _____

A

cardiac monitor - cardiac activity

82
Q

How should Ca supplements be administered?

A

orally or IV

83
Q

Nursing interventions if Ca supplements are given IV in HYPOCALCEMIA

A

warm injection solution to body temp before administer and administer slowly
monitor for ECG changes
observe for infiltration
monitor for hypercalcemia

84
Q

What is Aluminum hydroxide?

A

medication that reduces phosphorus level but causes countereffect of increasing Ca level

85
Q

This aids in absorption of Ca from GIT

A

vitamin D

86
Q

What treatment should be kept available for acute Ca deficit or in acute HYPOCALCEMIA?

A

10% Ca Gluconate

87
Q

What precaution to be initiated in HYPOCALCEMIA?

A

Initiate seizure precaution

88
Q

What should be monitored if client has HYPOCALCEMIA and HYPERCALCEMIA and he/she is to be moved?

A

Monitor for signs of pathologic fracture

89
Q

Causes of HYPERCALCEMIA?

A

Increased Ca absorption
Decreased Ca excretion
Increased bone reabsorption of Ca
Hemoconcentration

90
Q

Factors that affects increased Ca absorprtion?

A

Excessive oral intake of Ca
Excessive oral intake of vit. D

91
Q

Factors that affects decreased Ca excretion?

A

Kidney diseases, use of thiazide diuretics

92
Q

Factors that affects the increase of bone reabsorption of Ca

A

Hyperparathyroidism, Hyperthyroidism, Malignancy (bone destruction from metastatic tumor), immobility, use of glucocorticoids (corticosteroid)

93
Q

Factors that affects hemoconcentration

A

Dehydration, use of lithium, adrenal insufficiency

94
Q

What is needed to monitor in HYPERCALCEMIA?

A

CV, RR, NM, Renal, and GI status

95
Q

If the patient that has HYPERCALCEMIA has an IV infusion that contains Ca or Vit. D, what should be done?

A

Discontinue

96
Q

In HYPERCALCEMIA, what medication in discontinued and replaced?

A

Thiazide diuretics may discontinued & replaced with diuretics that enhance excretion of Ca

97
Q

Medications used in HYPERCALCEMIA that inhibit Ca reabsorption from the bone

A

phosphorus, calcitonin, bisphosphonates, and prostaglandin synthesis inhibitors (acetylsalicylic acid, NSAID)

98
Q

What should be done if patient has severe HYPERCALCEMIA and if medications are failed to reduce serum Ca level?

A

dialysis

99
Q

What should the nurse check for presence of urinary stones?

A

Flank or abdominal pain and strain in the urine

100
Q

This electrolyte is an essential component of the physiological pH buffering system of the human body.

A

Bicarbonate

101
Q

This is an alkali, so it helps to keep the acid-base balance of the body stable.

A

bicarbonate

102
Q

Process of bicarbonate

A

3/4 of carbon dioxide > carbonic acid > bicarbonate

103
Q

Major IC Electrolytes

A

potassium, phosphorus, magnesium

104
Q

This is a mineral that the body needs to work properly. It helps the nerves to function and muscles to contract. It helps the heartbeat stay regular. Also helps move nutrients into cells and waste products out of cells.

A

potassium

105
Q

Food sources of potassium

A

Avocado, bananas, cantaloupe, oranges, strawberries, tomatoes, carrots, mushrooms, spinach, fish, pork, beef, potatoes, raisins

106
Q

Functions of potassium

A

Regulates cell excitability
Nerve impulse conduction
Resting membrane potential

107
Q

Causes of HYPOKALEMIA

A

Excessive use of diuretics or corticosteroids
Increased secretion of aldosterone (Cushing’s Syndrome)
Vomiting, Diarrhea
Wound drainage; particularly gastrointestinal
Prolonged Nasogastric suction
Excessive diaphoresis
Kidney disease impairing reabsorption of K
NPO, Alkalosis, Hyperinsilunism

108
Q

What is needed to be monitored in HYPOKALEMIA?

A

Cardiovascular, RR, Neuromuscular, Gastrointestinal, and renal status, Electrolyte values

109
Q

How should be K supplements administered orally?

A

Oral K supplements should not be taken on an empty stomach: if pt. complaints of abdl pain, distention, nausea, vomiting, diarrhea, or GI bleeding - need to be discontinued.

110
Q

Nursing interventions in Liquid K Chloride

A

Liquid K chloride has an unpleasant taste and should be taken with juice or another liquid.

111
Q

IV K supplements should NEVER be administered by ____

A

IV push, IM, or SQ

112
Q

Nursing intervention in IV K supplements

A

IV is always diluted and administered using an infusion device.

113
Q

What kind of diuretics is discontinued and prescribed in HYPOKALEMIA?

A

K losing diuretic may be discontinued, K retaining should be prescribed.

114
Q

What does patient that has HYPOKALEMIA experiences that needs safety measures?

A

muscle weakness

115
Q

This occurs due to methods of blood specimen collection and cell lysis.

A

pseudo hyperkalemia

116
Q

Causes of HYPERKALEMIA

A

Excessive K intake of food high in K or medications, K chloride or salt substitute
Decreased K excretion
Movement of K from ICF - ECF

117
Q

Factors that decreases K excretion

A

K retaining diuretics
Kidney Disease
Adrenal Insufficiency, such as Addison’s disease

118
Q

Factors that affects movement of K from ICF - ECF

A

Tissue damage, Acidosis, Hyperurecimia, Hypercatabolism

119
Q

Why should K imbalances should be monitored carefully?

A

K imbalance may cause cardiac dysrhythmias that can be life threatening

120
Q

Precautions in administering IV K

A

✓ Dilution of no or more than 1mEq/10ml. 1mmol/10ml of solution is recommended.
✓ Rotate and invert the bag to ensure that K is distributed evenly throughout the IV solution.
✓ Ensure IV bag containing K is properly labeled

121
Q

Maximum recommended infusion of IV K in HYPERKALEMIA

A

5- 10 meq/hour (5-10mmol/hour) never to exceed 20mmol/hour under any circumstances.

122
Q

Nursing interventions for patients who has HYPERKALEMIA and receiving more than 10 mEq/hr of IV K

A

Client receiving more than 10meq/hr should be placed on a cardiac monitor and infused via infusion device.

123
Q

What complication can K infusion cause?

A

Phlebitis

124
Q

What should a nurse assess because K infusion can cause phlebitis?

A

nurse should assess the IV site frequently for signs of phlebitis, or infiltration, if occurs infusion should be stopped immediately.

125
Q

What should be monitored during administration of K and assess before administering K

A

Nurse should assess renal function before administering K, and monitor intake & output during administration.

126
Q

This electrolyte controls energy metabolism

A

Phosphorus / Phosphate

127
Q

It is needed by the body to build and repair bones and teeth, help nerves function, and make muscles contract.

A

phosphorus / phosphate

128
Q

Food sources of phosphorus

A

Dairy Products, fish, Nuts, Pork, beef, chicken, organ meats, pumpkin, squash, whole grain breads and cereals

129
Q

Relationship of phosphorus and calcium

A

RECIPROCAL RELATIONSHIP. Decrease in serum phosphorus is accompanied by an increased Ca level. Increase in serum phosphorus is accompanied by a decreased Ca level

130
Q

Causes of HYPOPHOSPHATEMIA

A

Insufficient P intake
Increased P secretion
IC shift

131
Q

Factors that affects insufficient Phos intake

A

malnutrition and starvation

132
Q

Factors that affects increased P secretion

A

Hyperparathyroidism, Malignancy, Use of Mg based or aluminum hydroxide based antacids

133
Q

Factors that affects IC shift

A

hyperglycemia, RR alkalosis

134
Q

What should be monitored in HYPOPHOSPHATEMIA?

A

CV, RR. NM, CNS and hematological status

135
Q

When to prepare to administer phosphate IV?

A

Serum phos level fall below 1mg/dl and patient shows s/sx.

136
Q

What should be assessed first before administering P in HYPOPHOSPHATEMIA?

A

Renal system

137
Q

What to instruct in HYPOPHOSPHATEMIA regarding foods?

A

Instruct high P containing food while decreasing intake of any Ca containing food

138
Q

Causes of HYPERPHOSPHATEMIA

A

Decreased Renal excretion resulting from renal insufficiency
Tumor lysis syndrome
Increased intake of phos
Hypoparathyroidism

139
Q

Specific in intaking phosphate

A

dietary intake or overuse of phos containing laxatives or enemas

140
Q

What does phophate-binding meds do?

A

Increased fecal excretion of phos by binding phos from food in GIT.

141
Q

What are phosphate-containing meds examples?

A

Laxatives and enema

142
Q

Food consideration in HYPERPHOSPHATEMIA

A

Take phosphate with meals or immediately after meals

143
Q

This helps to maintain normal nerve and muscle function, supports a healthy immune system, keeps the heartbeat steady, and helps bones remain strong. It also helps adjust blood glucose levels. It aids in the production of energy and protein.

A

magnesium

144
Q

Food sources of magnesium

A

Avocado, canned white tuna, cauliflower, green leafy veg. such as spinach and broccoli, milk, oatmeal, wheat bran, peanut butter, almonds, peas, pork, beef, chicken, soybeans, potatoes, raisins, yogurt

145
Q

Functions of magnesium

A

• Influence enzyme reaction
• Neuromuscular contraction
• Normal functioning of nervous and cardiovascular system
• Influences on electrolyte balance

146
Q

Causes of HYPOMAGNESEMIA

A

Insufficient Mg intake
Increased mg excretion
IC movement of Mg

147
Q

Factors that affects insufficient Mg intake

A

Malnutrition & starvation, vomiting or diarrhea, malabsorption syndrome, Celiac disease, Crohn’s disease

148
Q

Factors that affects increased mg excretion

A

meds such as diuretics, chronic alcoholism

149
Q

Factors that affect IC movement of Mg

A

Hyperglycemia, Insulin administration, sepsis

150
Q

What should be monitored in HYPOMAGNESEMIA?

A

CV, RR, GI, NM, CNS

151
Q

Relationship of calcium and magnesium

A

Hypocalcemia frequently accompanies hypomagnesemia, aim to restore normal Ca level.

152
Q

Oral preparation of mg in HYPOMAGNESEMIA may cause?

A

Diarrhea and increased Mg loss

153
Q

Nursing interventions during administration of Mg (IM can cause pain and tissue damage)

A

initiate seizure prec, monitor serum Mg level frequently, and monitor for diminished deep tendon reflexes, suggesting Hypermagnesemia

154
Q

Causes of HYPERMAGNESEMIA

A

Increased Mg intake
Decreased renal excretion of Mg as a result of renal insufficiency.

155
Q

Factors that affects increased Mg intake

A

Mg containing antacids & laxatives, excessive administration of Mg IV

156
Q

What should be monitored in HYPERMAGNESEMIA?

A

CV, RR, NM, CNS

157
Q

What is prescribed in HYPERMAGNESEMIA to increase renal excretion of Mg?

A

Diuretics

158
Q

Medication that may be prescribed to reverse the effect of Mg on cardiac muscle

A

IV Ca Cl or Ca Gluconate

159
Q

Antidote of magnesium overdose

A

Calcium gluconate

160
Q

Influences one electrolyte balance

A

• Normal cell function
• Fluid intake and output
• Acid-base balance
• Hormone secretion

161
Q

Organs that maintains electrolyte balances

A
  1. Kidneys:
  2. Lungs and Liver:
  3. Heart:
  4. Sweat Glands:
  5. GI Tract:
  6. Parathyroid glands:
  7. Thyroid gland

NCM 112 MIDTERMS (2 decks)

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