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Nursing 1st Fall Semester > Fluids And Electrolytes > Flashcards

Fluids And Electrolytes Flashcards

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1
Q

How much body fluids do adults have

A

women= 55%
men=65%
Located inside the cell and outside the cell

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2
Q

What are the two main solutes in urine

A

sodium ions and chloride ions

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3
Q

What are the 3 major hormones that control renal NA and CI

A

Angiotensin II
Aldosterone
ANP

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4
Q

What is the main factor determining body fluid volume

A

The amount of urinary salt loss

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5
Q

What is the major hormone that regulates water loss

A

antidiuretic hormone

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6
Q

What is Angiotensin II

A

stimulates secretion of aldosterone, reduces water loss in urine

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7
Q

What is Aldosterone

A

Key hormone in regulating sodium= reabsorbing water

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8
Q

What is ANP

A

Atrial natriuretic peptide
Released from the heart when the blood volume increases, causing urination and salt loss increase

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9
Q

What is NA+

A

Sodium
136-142 plasma level range
Creates osmotic pressure of ECF, most abundant cation
Essential for electrical activity in neurons and muscle cells

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10
Q

What is K+

A

Potassium
3.8-5.0 plasma level range
Creates osmotiic pressure in ICF, most abundant cation in ICF
Essential for electrical activity in neurons and muscle cells

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11
Q

What is hypernatremia

A

Excessive Sodium in ECF
Loss of water through diarrhea, insensible water loss and water deprivation
Gain of sodium through diabetes or heat stroke

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12
Q

Deficiency and Excess of Potassium

A

D=Hypokalemia
E=Hyperkalemia

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13
Q

How would you manage hypernatremia

A

24 hours of I&O
Make sure urine gravity is above 5.025
Check for thready pulse and flat neck veins
Check for tachycardia and tachypnea
Check for changes in sensorium
Check and compare daily weights
Check skin and mucus membrane

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14
Q

What is Hyponatremia & its symptoms

A

Occurs when serum sodium levels are less then 135
Decreased sodium is caused by dilution ( excess H2o or increased sodium loss)
Signs = Lethargy, headache, confusion, apprehension, seizures, coma

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15
Q

What does Hyponatremia cause

A

diarrhea, inadequate salt intake, gastrointestinal suctioning, diuretics, vomiting

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16
Q

What is Hyperkalemia & symptoms

A

Too much potassium in your blood.
Caused by renal failure, acidosis, and massive tissue damage
Causes muscle cramps that can lead to weakness and paralysis, drowsiness, Low BP, Dysrythmias, Abdominal cramping, diarrhea and oliguria

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17
Q

Nursing interventions for hyperkalemia

A

SAY NO TO POTASSIUM
Give diuretics, monitor renal function and respiratory function, Increase fluid intake provide a potassium restricted diet!

18
Q

What is severe hyperkalemia

A

Causes changes in cardiac conduction, can be life threatening
Will give Insulin to pull potassium out of the blood

19
Q

What is hypokalemia

A

Potassium deficit, known as Alkalosis
Presents shallow respirations, irritability, confusion, weakness, arrhythmia, thready pulse, lethargy, low intestinal mobility

20
Q

Nursing interventions for hypokalemia

A

Provide IV potassium replacement at a rate of 10-20 meq/hr(KCL) or oral potassium replacments(KCI)
Eat foods high in potassium, bananas, prunes, squash, potatoes

21
Q

What is Hypovolemia

A

Isotonic dehydration
Results in decreases perfusion and activation of RAAS
Happens when water and salts are lost in equal amounts ( vomiting and diarrhea)
Commonly caused by hemmorhage, vomiting, diarrhea, burns, diuretic therapy, fever

22
Q

What are the types of fluid volume deficits

A

Isotonic fluid loss, hypertonic dehydration and third spacing

23
Q

What is Isotonic Fluid Loss

A

When fluids and solutes are lost equally
Intracellular water is not disturbed
Fluid loss is extracellular fluid
Can quickly lead to shock, requires extracellular fluid replacement and the emphasis is on increasing vascular volume
Caused by impaired intake, excessive losses of body fluids from vomitting, diarrhea or hemmorage, osmotic diuresis, excessive sweating

24
Q

What is Hypertonic dehydration

A

proportionally lose more water then sodium.
results from end stage renal disease, diabetes, insulipids, IV fluid or tube feedings with high electrolyte levels, keto acidosis, hyperventilation, prolonged fever, diarrhea

25
Q

What is Isotonic Fluid Excess

A

Caused by increased sodium intake, decrease in sodium and water elimination by the kidney and heart failure

26
Q

What is Fluid Intake Excess aka Hypervolemia

A

Too much fluid going in with failure to eliminate it
Causes changes in LOC, confusion, headache, seizures, pulmonary congestion, bounding pulses, increased BP and JVD, Tachycardia, Anorexia and nausea

27
Q

What are signs of Hypovolemia

A

Poor skin turgor, dry mucus membrane, dry axila, flat neck veins, tachycardia, hypotension, weightless and sunken eyes

28
Q

What are signs of Hypervolemia

A

Shortness of breath at rest and exertion, Ascites, Pitting edema, Weight gain

29
Q

What role does stress play in fluid

A

Can increase the production of ADH, which will promote fluid retention and decrease urine output

30
Q

Overall assessment of fluid and electrolytes, what do you look for the observation process

A

Edema of lower extremities or hands and feet ( swelling of feet)
Flushed face, neck or arms
Dry and cracked lips ( dehydration)
dry mucous membrane
Sunken eyes ( general sign of illness)
tenting on skin

31
Q

General assessment of F+E, nursing history

A

Current and past medical history
Medications
Age
Lifestyle
Food and fluid intake, and fluid output

32
Q

Diagnostic tests in F+E

A

Serum electrolytes
Complete blood count
Osmolality
Urine specific gravity

33
Q

What are some lifespan considerations to take into thought for older adults

A

Normal aging process will affect fluid balance and increase the risk of dehydration due to:
diminished thirst, reduced fluid reserve, decline in kidney function, increased levels of ANF, increased sensitivity to salt

34
Q

What are some nursing management for FVE

A

Do frequent respiratory assessments and check LOC and cardiovascular checks
Watch for edema
Restrict fluids and weigh daily

35
Q

What are FVE risk factors

A

Heart disease, kidney dysfunctions, Hypertension, diabetes

36
Q

What are some collaborative interventions to FVE

A

calculate alllll fluid ( at meals, when meds are administered, any fluid content in food )
Provide loop diuretics, potassium sparing diuretics
Dietary management: sodium-restricted diet
Run tests: serum electrolyte

37
Q

How can you prevent Fluid loss

A

Drink at least 1500 mL of fluid
Achieve fluid and electrolyte balance
Replace fluids when needed

38
Q

What is FVD

A

Fluid volume deficit
Dehydration
Loss of electrolytes along with fluid

39
Q

Hypotonic dehydration

A

porpotionaly more sodium loss then water loss results from severe prolonged vommiting and diarrhea, burns or renal disease

40
Q

Signs and symptoms of FVD

A

weight loss over short period of time
Thirst
narrowed pulse pressure
weak, rapid pulse
low BP and turgor
dry mucous membrane
oliguria
postural hypotension
generalized weakness

41
Q

How would you manage FVD

A

measure all fluids that enter and leave the body
Check electrolytes, CBC and urine gravity
Assess for hypotension and weak pulses
Assess respiratory system and tissue perfusion
Check oritntation, vision, hearing, reflexes and muscle strengths
Check for weight changes
Check for skin breakdown and good oral care

Nursing 1st Fall Semester (41 decks)

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