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Archer Review > Fluids and Electrolytes > Flashcards

Fluids and Electrolytes Flashcards

1
Q

Normal Range: Sodium (Na)

A

135-145 mEq/L

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2
Q

Uses of Sodium

A

Regulates water (water follows salt)
Important for brain, nerves, muscle cells
*Must be replaced/shifted slowly

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3
Q

Normal Range: Chloride (Cl)

A

90-108 mEq/L

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4
Q

Uses of Chloride

A

Works with Na to maintain fluid balance
Binds with H to form stomach acid (HCl)
Inversely related to bicarbonate
Directly related to Na and K

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5
Q

Normal Range: Potassium (K)

A

3.5-5.0

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6
Q

Uses of Potassium

A

Responsible for nerve conduction
Important in heart and skeletal muscle contraction
Important in acid-base balance (acidic indicates increased K)

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7
Q

Hypernatremia S/Sx

A

FRIED & SALTED

Fever (low grade)
Restlessness and Agitation
Increased fluid retention
Edema (peripheral and pitting)
Dry Mouth

Skin flushed
Altered LOC and Confusion
Thirst
Elevated blood pressure
Decreased energy

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8
Q

Hypernatremia Management

A

FLAG

Free water administration
Loop diuretics
Agent causing (remove)
Give fluids IV

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9
Q

Hyponatremia Causes

A

MOBS Fail

Meds (diuretics)
Oral gastric tube suctioning
Burns
SIADH

Failure (heart, kidney, liver)

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10
Q

Hyponatremia S/Sx

A

LOW SODIUM

LOC altered
Orthostatic hypotension
Weak muscles

Seizures
Osmolarity low (serum)
Diarrhea
Increased ICP
Urine osmolarity high
More bowel sounds

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11
Q

Euvolemic Hyponatremia Management
(Water in body increases, Na stay the same)

A

Restrict free water
Sodium tablets
Osmotic diuretics
Encourage high salt diet

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12
Q

Hypervolemic Hyponatremia Management
(Water increases and dilutes amount of Na in body)

A

Restrict free water
Sodiu tablets
Osmotic diuretics
Encourage high salt diet

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13
Q

Hpovolemic Hyponatremia Management
(Water and Na both lost)

A

Restore volume and sodium
-Mild: 0.9% NS
-Severe: 3% NS

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14
Q

High Salt Foods

A

Anything processed
Bacon
Butter
Canned food
Cheese
Hot dogs
Lunch meat
Processed food
Table salt

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15
Q

Causes of Hyperkalemia

A

MACHINE

Medication (ACE inhibitors, K-sparring diuretics)
Acidosis
Cellular destruction
Hypoaldosteronism
Intake
Nephrons-renal failure
Excretion impaired

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16
Q

Hyperkalemia S/Sx

A

Muscle cramps
Urine abnormalities
Respiratory distress
Decreased cardiac contractility
EKG changes
Reflexes (depressed/absent DTRs)

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17
Q

Hyperkalemia Management

A

CRIED

Calcium IV
Remove sources of K
Increase K excretion (diuretics, Kayexalate)
Enhance K uptake into cells (D5W + regular insulin, albuterol, sodium bicarb)
Dialysis

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18
Q

High Potassium Foods

A

Milk/Dairy
Oranges
Avocados
Dried beans
Salmon
Bananas

19
Q

Causes of Hypokalemia

A

DITCH

Drugs (Laxatives, diuretics, Corticosteroids)
Inadequate K intake
Too much water
Cushing’s Disease
Heavy fluid loss

20
Q

Hypokalemia S/Sx

A

6 L’s

Lethargy
Low/Shallow respirations
Limp mucles
Lethal dysrhythmias
Leg cramps
Lots of urine output

21
Q

Hypokalemia Management

A

POD

Potassium IV (NEVER push!)
Oral potassium
Diet rich in potassium

22
Q

Hyperkalemia ECG changes

A

Wide, flat P waves
Prolonged PR interval
Widened QRS complexes
Depressed ST segment
Tall, peaked T waves

Can lead to heart block or V fib, eventually to cardiac arrest

23
Q

Hypokalemia ECG changes

A

Slightly peaked P wave
Slightly prolonged PR interval
ST depression
Flat/shallow/inverted T waves
Prominent U wave

24
Q

Normal Range: Calcium (Ca)

A

9.0-10.5

25
Q

Uses of Calcium

A

Stored in bones, absorbed by GI system, excreted by kidneys
Important for bones, teeth, nerves, and muscles
Important for coagulation
Controlled by PTH and Vitamin D
Inverse relationship with Phosphorus

26
Q

Normal Value: Phosphorus

A

3.0-4.5 mg/dL

27
Q

Uses of Phosphorus

A

Major role in cellular metabolism and energy production
Makes up phospholipid layer of cell membranes
Large component of bones and teeth
Inverse relationship with Ca

28
Q

Normal value: Magnesium (Mg)

A

1.6-2.6 mg/dL

29
Q

Uses of Magnesium

A

Stored in bones and cartilage
Major role in skeletal muscle contraction
Important for ATP formation
Activates vitamins
Necessary for cellular growth
Directly related to Ca

30
Q

Causes of Hypercalcemia
(also Hypophosphatemia and Hypermagnesmia)

A

MD SPIED

Malignancy
Diuretics

Steroids
Parathyroid (hyperparathyroid)
Immobilization
Endocrine (Addison’s)
Deficient Vitamin D

31
Q

Hypercalcemia Management

A

Reduce dietary calcium intake
Cadiac monitoring
IV fluids (NS preferred)
Loop diuretics
Encourage oral hydration
Dialysis
Calcium binders

32
Q

Causes of Hypocalcemia
(also Hyperphosphatemia and Hypomagnesmia)

A

CHAMP

Celiac, Crohn’s disease
Hypoparathyroid/Hyperphosphatemia
Alcoholism
Malnutrition/Malabsorption
Pancreatitis

33
Q

Hypocalcemia S/Sx

A

CATS

Convulsions
Arryhythmias
Tetany
Spasms

34
Q

High Calcium and Vitamin D foods

A

Calcium:
Dairy
Soy/Tofu
Green vegetables
Almonds

Vitamin D:
Tuna
Cod liver oil
Egg yolk
Oily fish

Both:
Milk
Sardines
Salmon
Cereal

35
Q

Foods high in Phosphorus

A

Dairy
Ceans
Meat
Nuts
Seeds
Grains
Chocolate
Colas

36
Q

S/Sx of Fluid Volume Excess

A

Bounding pulses
Hypertension
Jugular vein distention
Edema
Good urine output
Pale, dilute urine
Wt gain (daily weights–> watch for gain of 2-3 lbs/day)

37
Q

S/Sx of Fluid Volume Deficit

A

Weak pulses
Hypotension
Poor skin turgor
Poor urine output
Dark, concentrated urine
Wt loss

38
Q

Isotonic Fluids?

A

Do not cause fluid shift

Normal saline, Lactated Ringers, D5 in Water

39
Q

Hypotonic Fluids?

A

Less tonicity than blood
Move fluid out of blood vessels and into cells

40
Q

Hypertonic Fluids?

A

More tonicity than blood
Move fluid from cells into blood vessels

41
Q

Uses for Isotonic fluids?

A

Increase intravascular volume
Blood loss
Surgery
Isotonic dehydration
Fluid loss
Maintenance fluid
NPO status

42
Q

Uses for Hypotonic fluids?

A

DKA
HHNS
Hypernatremia

43
Q

Uses for Hypertonic fluids?

A

Hyponatremia
Cerebral edema

Archer Review (6 decks)

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