Fluids and Electrolytes Flashcards
How much of an adult’s total body weight is water?
50-60%
How much of an infant’s total body weight is water?
75-80%
How much body fluid is intracellular?
2/3
How much body fluid is extracellular
1/3
Isotonic fluids indication
- Treat vascular system fluid deficit
Isotonic fluid characteristics
- Concentration equal to plasma
- Prevent fluid shift between compartments
Isotonic solutions (3)
- Normal saline (0.9% NS)
- Lactated ringers
- 5% dextrose in water (D5W)
Hypotonic fluid indication
Treat intracellular dehydration
Hypotonic characteristics
- Osmolality higher than ECF
- Shift fluid from ECF to ICF
Hypotonic solutions (2)
- 0.45% normal saline (0.45% NS)
- 2.5% dextrose in 0.45% saline (D2.545% NS)
Hypertonic fluid indication
- Used only when serum osmolality is critically low
Hypertonic fluid characteristics
- Osmolality higher than ECF
- Shift fluid from ICF to ECF
Hypertonic solutions (5)
- 10% dextrose in water (D10W)
- 50% dextrose in water (D50W)
- 5% dextrose in 0.9% saline (D5NS)
- 5% dextrose in 0.45% saline (D5W in 0.45% NaCl)
- 5% dextrose in lactated ringers (D5LR)
Hypokalemia risk factors adverse effects of medications (4)
- Corticosteroids
- Diuretics
- Digitalis
- Laxatives abuse
Hypokalemia risk factors body fluid loss (4)
- Vomiting
- Diarrhea
- Wound drainage
- NG suction
Hypokalemia other risk factors (4)
- Excessive diaphoresis
- Kidney disease
- Dietary deficiency
- Alkalosis
Hypokalemia manifestations (8)
- Muscle weakness, cramping
- Fatigue
- N/V
- Irritability, confusion
- Decreased bowel motility
- Paresthesia
- Dysrhythmias
- Flat and/or inverted T waves
Hyperkalemia risk factors (4)
- Renal failure
- Adrenal insufficiency
- Acidosis
- Excessive potassium intake
Hyperkalemia medication risk factors (2)
- Potassium sparing diuretics
- ACE inhibitors
Hyperkalemia manifestations (5)
- Peaked T waves
- Ventricular dysrhythmias
- Muscle twitching, paresthesia (early)
- Ascending muscle weakness (late)
- Increased bowel motility
Hyperkalemia medication interventions (5)
- Kayexalate
- 50% glucose with insulin
- Calcium gluconate
- Bicarbonate
- Loop diuretics
Hyponatremia risk factors (7)
- GI loss
- SIADH
- Adrenal insufficiency
- NPO
- Restricted sodium diet
- Water intoxication
- Excessive diaphoresis
Hyponatremia medication risk factors (5)
- Diuretics
- Anticonvulsants
- SSRIs
- Lithium
- Demeclocycline
Hyponatremia manifestations (10)
- Weakness
- Lethargy
- Confusion
- Seizures
- Headache
- Anorexia, N/V
- Muscle cramps, twitching
- Hypotension
- Tachycardia
- Weight gain, edema
Hyponatremia medication intervention
Conivaaptan hydrochloride
Hypernatremia risk factors (9)
- Dehydration
- GI loss
- Hyperaldosteronism
- Hypertonic tube feedings
- Diabetes insipidus
- Kidney failure
- Burns
- Heatstroke
- Corticosteroids
Hypernatremia manifestations (13)
- Fever
- Swollen, dry tongue
- Hallucinations
- Lethargy
- Restlessness
- Irritability
- Seizures
- Tachycardia
- HTN
- Hyperreflexia
- Twitching
- Pulmonary edema
- Sticky mucous membranes
Hypocalcemia risk factors (6)
- Hypoparathyroidism
- Hypomagnesemia
- Kidney failure
- Vitamin D deficiency
- Inadequate intake
- GI loss
Hypocalcemia disease process risk factors (4)
- Celiac disease
- Lactose intolerance
- Crohn’s disease
- Alcohol use disorder
Hypocalcemia manifestations (9)
- Tetany
- Cramps
- Paresthesia
- Dysrhythmias
- Trousseau’s sign
- Chvostek’s sign
- Seizures
- Hyperreflexia
- Impaired clotting time
Hypercalcemia risk factors (12)
- Hyperparathyroidism
- Malignant disease
- Prolonged immobilization
- Dehydration
- Vitamin D excess
- Thiazide diuretics
- Lithium
- Glucocorticoids
- Digoxin toxicity
- Over use of calcium supplements
- Hyperthyroidism
Hypercalcemia manifestations (14)
- Muscle weakness
- Kidney stones
- Dysrhythmias
- Lethargy
- Coma
- Hyporeflexia
- Pathological fractures
- Flank pain
- Deep bone pain
- Polyuria
- Polydipsia
- Dehydration
- HTN
- N/V
Hypercalcemia medication interventions (5)
- Furosemide
- Calcitonin
- Glucocorticoids
- Bisphosphonates
- Calcium chelators
Hypomagnesemia risk factors (10)
- GI loss
- Alcoholism
- Hypocalcemia
- Hypokalemia
- DKA
- Hyperparathyroidism
- Malabsorption
- TPN
- Laxative abuse
- Acute MI
Hypomagnesemia medication risk factors (5)
- Cisplatin
- Cyclosporine
- Aminoglycoside antibiotics
- Diuretics
- Amphotericin B
Hypomagnesemia manifestations (13)
- Paresthesias
- Dysrhythmias
- Trousseau’s sign
- Chvostek’s sign
- Agitation
- Confusion
- Hyperreflexia
- HTN
- Insomnia
- Irritability
- Anorexia
- N/V
- Dysphagia
Hypomagnesemia medication interventions (2)
- IV magnesium sulfate
- PO magnesium salts
Hypermagnesemia risk factors (6)
- Renal failure
- Excessive Mg therapy
- Adrenal insufficiency
- Laxative over use
- Lithium toxicity
- Excessive soft tissue injury/necrosis
Hypermagnesemia manifestations (9)
- Hypotension
- Drowsiness
- Bradycardia
- Bradypnea
- Coma
- Cardiac arrest
- Hyporeflexia
- N/V
- Facial flushing
Hypermagnesemia medication interventions (3)
- IV lactated ringers, NS
- IV calcium gluconate
- Loop diuretics
Hypophosphatemia risk factors (9)
- Vitamin D deficiency
- Re-feeding after starvation
- Alcohol use disorder
- DKA
- Alkalosis
- Hypomagnesemia
- Hypokalemia
- Burns
- TPN
- Overuse of antacids
Hyphosphatemia excessive loss of body fluids risk factors (4)
- Sweat
- Diarrhea
- Vomiting
- Hyperventilation
Hypophosphatemia manifestations (6)
- Paresthesia
- Muscle weakness
- Bone pain, deformities
- Chest pain
- Confusion
- Seizures
- Nystagmus
Hyperphosphatemia risk factors (8)
- Renal failure
- Chemo
- Acute pancreatitis
- High vitamin D
- High phosphorus intake
- Hypoparathyroidism
- Excessive enema use
- Acidosis
Hyperphosphatemia manifestations (10)
- Tetany
- Cramps
- Paresthesias
- Dysrhythmias
- Trousseau’s sign
- Chvostek’s sign
- Hyperreflexia
- Anorexia
- N/V
- Soft tissue calcifications
Hyperphosphatemia medication interventions (4)
- Vitamin D
- Aluminum hydroxide
- Diuretics
- IV NSc x
