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nurs 252 > Fluids and electrolytes > Flashcards

Fluids and electrolytes Flashcards

1
Q

Total body water percentage: intracellular

A

67%

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2
Q

Total body water percentage: interstitial

A

25%

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3
Q

Total body water percentage: plasma volume

A

8%

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4
Q

How much of an adult human is water

A

60%

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5
Q

What is intravascular fluid

A

Fluid inside blood vessels

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6
Q

What is extravascular fluid

A

Fluid outside of the blood vessels like lymph or cerebrospinal fluid

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7
Q

What comprises of extravascular volume

A

Plasma, interstitial fluid

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8
Q

Interstitial fluid

A

fluid in space between cells, tissue and organs(outside the blood vessel)

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9
Q

What comprises of Extracellular volume

A

interstitial fluid and intracellular fluid

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10
Q

Value of the osmotic pressure

A

24 mm Hg

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11
Q

How do the plasma proteins effect the osmotic pressure

A

The proteins cause a gradient in the blood to pull water into the blood

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12
Q

Osmotic pressure AKA…

A

colloid oncotic pressure

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13
Q

What kind of pressure does Interstitial fluid exert and why

A

Exerts hydrostatic pressure. Which is pressure exert onto the blood vessel by the volume outside the blood vessel

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14
Q

Value of interstitial fluid

A

17 mm Hg

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15
Q

What are crystalloids

A

Solutions (without protein) containing fluids and electrolytes normally not found in the body. Carries no risk for viral transmission, anaphylaxis or alteration in coagulation profile

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16
Q

Use of Crytalloids

A

To treat dehydration and maintenance for..
- Fluid loss
- replacement of fluids
- manage fluid and electrolyte disturbance
- Promote urinary flow

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17
Q

Examples of crystalloids (6)

A
  • Normal saline 0.9% isotonic or sodium chloride (0.45% hypotonic)
  • 3.3% dextrose with 0.3% normal saline (isotonic)
  • Hypertonic saline 3% sodium chloride
  • Lactated ringers solution(Isotonic)
  • Dextrose 5% in water (D5W)(Isotonic)
  • D5W and 0.45% normal saline (hypertonic)
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18
Q

Indications of crystalloids

A

Acute liver failure
Acute nephrosis
Adult respiratory distress syndrome
Burns
Cardiopulmonary bypass
Hypoproteinemia
Hemodialysis
Deep vein thrombosis (reduction of risk)
Shock

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19
Q

Adverse effects of crystalloids

A
  • May cause edema
  • May dilute plasma proteins reducing the colloid (osmotic) pressure
  • effects may be short lived and can cause alkalosis or acidosis
  • contraindicated in hypervolemia
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20
Q

What are Colloids

A

Protein substance. Adding these increase colloid (osmotic) pressure increasing the movement of fluid into the blood vessels

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21
Q

Examples of of colloids

A
  • Albumin 5% and 25% (from human donors)
  • Dextran 40 or 70 (available in sodium chloride and 5% dextrose
  • Hetastarch (synthetic)
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22
Q

Adverse effects of colloids

A
  • Often safe but may cause altered coagulation
  • Have no clotting factors or oxygen carrying capacity
  • Dextran may cause anaphylaxis or kidney failure (rarely)
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23
Q

What is albumin

A

Generates approximately 70% of colloid oncotic pressure.
pasteurized solution made from pooled blood, plasma, serum or placentas obtained from healthy human donors

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24
Q

What are blood products

A

Is the only class that increases tissue oxygenation, increase plasma volume and are most expensive and least available fluid because they require human donors

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25
Q

Types of blood products

A
  • Cryoprecipitate and plasma protein factors
  • Fresh frozen plasma
  • Packed red blood cells
  • Whole blood
26
Q

Indication of cryoprecipitate and plasma protein factors

A

Management of acute bleeding. For people with clotting issues

27
Q

Fresh frozen plasma indication

A

Increases clotting factor levels

28
Q

Packed red blood cells indication

A

To increase oxygen carrying capacity or those who have lost up to 25% of their total blood volume

29
Q

Whole blood indications

A

For those who have lost more than 25% of the total blood volume as it also contain proteins, drawing back fluid into the blood vessels from surrounding fluids

30
Q

Adverse effects of blood products

A

Incompatibility with recipients immune system, cross match testing, transfusion reaction, anaphylaxis, transmission of pathogens

31
Q

Electrolytes for extracellular fluid

A

Sodium

32
Q

Electrolytes for intracellular fluids

A

Potassium

33
Q

Potassium lab values

A

3.5-5.0 mmol/L

34
Q

Where is potassium excreted

A

Excreted in the kidneys

35
Q

Value of hyperkalemia

A

potassium over 5.5 mmol/L

36
Q

causes of hyperkalemia

A

Potassium supplements, ACE inhibitors, kidney failure, excessive loss from cells, potassium sparing diuretics, burns, trauma, metabolic acidosis and infections

37
Q

Hypokalemia value

A

potassium level of less than 3.5 mmol/L

38
Q

Causes of hypokalemia

A

Alkalosis, corticosteroids, diarrhea, ketoacidosis, hyperaldosteronism, increases secretion of mineralocorticoids, burns, thiazide and loop diuretics, vomiting, malabsorption

39
Q

When shouldnt one take digoxin

A

Taking digoxin when one has hypokalemia can cause digoxin toxicity resulting in ventricular dysrhythmias

40
Q

What is potassium responsible for?

A
  • Muscle contraction
  • Transmission of nerve impulses
  • Regulation of heartbeat
  • Maintenance of acid and base balance
  • Isotonicity
  • Electrodynamic characteristics of the cell
41
Q

Indication of potassium

A
  • Depletion of potassium
  • Stop irregular heartbeats
  • Management of tachydysrhythmias that may occur after cardiac surgery
42
Q

Adverse effects of oral preparations of potassium

A

Diarrhea, nausea, vomiting, gastrointestinal bleeding, ulceration

43
Q

Adverse effects of IV administration of potassium

A

Pain at injection site and phlebitis (inflammation of pain near the skin)

44
Q

What happens if one give too much potassium

A

Hyperkalemia, toxic effects, cardiac arrest

45
Q

Hyperkalemia manifestation

A

Muscle weakness, paresthesia, paralysis, cardiac rhythm irregularities

46
Q

Treatment of severe hyperkalemia

A
  • IV sodium bicarbonate ( to balance out the acidity of potassium)
  • Sodium polystyrene sulphonate or hemodialysis to remove the potassium
47
Q

Sodium values

A

135-145 mmol/L

48
Q

Causes of hyponatremia

A
  • Some conditions that cause hypokalemia
  • Excessive perspiration
49
Q

Symptoms of hyponatremia

A

Lethargy, stomach cramps, hypotension, vomiting, diarrhea, seizures

50
Q

Symptoms of hypernatremia

A
  • Water retention (edema), hypertension
  • Red, flushed skin; dry, sticky mucous membranes; increased thirst; elevated temperature; decreased or absent urinary output
51
Q

Causes of hypernatremia

A

Poor kidney excretion stemming from kidney malfunction/inadequate water consumption

52
Q

Treatment of mild hyponatremia

A
  • Oral sodium chloride
53
Q

Treatment of severe hyponatremia

A

IV normal saline or lactated ringer’s solution

54
Q

Adverse effects of oral sodium

A

nausea vomiting and cramp

55
Q

Adverse effects of IV administration sodium

A

Venous phlebitis (inflammation at the site)

56
Q

What should one assess before giving potassium

A

Electrocardiogram

57
Q

What rate should IV potassium be given (not on cardiac monitors)

A

10 mmol/hr

58
Q

What rate should IV potassium be given (on cardiac monitors)

A

20 mmol/her

59
Q

How should potassium not be given

A

IV bolus or undiluted

60
Q

0.9% IV NS is compatible with..

A

packed RBC

nurs 252 (23 decks)

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