fluids and electrolytes Flashcards
internal stability despite environmental changes
homeostasis
fluid out side of cell
extracellular fluid
fluid inside the cell
intracellular fluid
2 ecf
interstitial fluid and intravascular fluid
fluid surrounding cells in tissues
interstitial fluid
plasma and fluid in blood vessels
inter vascular fluid
molecules and solvent move across a semi permeable membrane, low concentration to high concentration
osmosis
dilution of a solution
osmolarity
mass of a solvent
osmolality
LARGE molecules, intravascular space LONGER
coLLoids
Small CRYSTALS, immediate fluid replacement (Iso/hyper/hypotonic solutions)
CRYSTALloids
0.9%NaCl
Lactated ringers
5% dextrose in water (D5W)
Isotonic fluid
3-5%NaCl
5% dextrose in 0.9% saline (D5NS)
hypertonic
0.45%NaCl
hypotonic
used for:
hyponatremia
metabolic alkalosis
hypertonic fluid
used for:
fluid matenince
blood loss
dehydration
DKA
isotonic fluid
used for:
hypernatremia
kidneys excrete fluid
hypotonic fluid
salt<water
causes cells to swell
Out of vessel intO cell
hypOtOnic
salt=water
cell stays same
stays where I put It
Isotonic
salt>water
cells shrink
EntErs the vessel from cell
hypErtonic
potassium(K)
magnesium(Mg)
phosphorus(Po4)
ICF
sodium(Na)
calcium(Ca)
chloride(Cl)
ECF
low volume in blood
incr. HR
dear. BP
decr. urine
dry mucous membranes
hypovolemia
high volume in blood
incr. HR
incr. BP
incr. urine
cradles
hypervolemia
most abundant ECF electrolyte
maintains fluid balance
Sodium
levels<135mEq/L
S(stupor)
A(anorexia)
L(lethargic)
T(tachycardia)
L(limp muscle)
O(orthostatic hypertension)
S(seizures)
S(stomach cramping)
hyponatremia
levels>145mEq/L
F(flushed)
R(restlessness)
I(irritability)
E(edema)
D(decr. urine output)
S(skin flushed)
A(agitation)
L(low-grade fever)
T(shirts)
hypernatremia
causes of hypernatremia
M(meds)
O(osmotic diuretics)
D(diabetes)
E(excessive H2O loss)
L(low H2O intake)
causes of hyponatremia
GI suctioning
diarrhea
N/V
fluid shift
diuretics
inadequate salt intake
where salt goes
water follows
2 types of hyponatremia
hyponatremia hypovolemia
hyponatremia hypervolemia
incr. fluid
decr. sodium
hyponatremia hypervolemia
decr. fluid
decr. sodium
hyponatremia hypovolemia
foods high in sodium
pork
pickles
canned food
dried fruit
bread
sardines
most abundant ICF
regulated by aldosterone
necessary for cardiac function
potassium
levels<3.5mEq/L
S(skeletal muscle weak)
U(u wave depressed)
C(constipation)
T(toxicity)
I(irregular pulse)
O(orthostatic hypotension)
N(numbness)
hypokalemia
level>5.0mEq/L
M(muscle cramp)
U(urine abnormal)
R(respiratory distress)
D(decr. cardiac contractibility)
E(ekg changes)
R(reflexes)
hyperkalemia
causes of hypokalemia
Ng suctioning
N/V
meds
respiratory alkalosis
causes of hyperkalemia
F(failure renal)
R(rhabdomyolysis)
A(Addisons)
M(metabolic acidosis)
E(excess meds)
S(spironolactone diuretics)
ECF
circulates in blood stream
bones, teeth, muscle
regulated by PTH
calcium
levels<8.9mg.dL
C(convulsions)
A(arrhythmias)
T(tetany)
S(spasm)
hypocalcemia
levels>10.1mg/dL
B(bone pain)
A(arrhythmias)
C(cardiac arrest)
K(kidney stones)
M(muscle weak)
E(excessive urination)
hypercalcemia
carpal spasm due to inflation of blood pressure cuff
positive trousseau’s
contraction of facial muscles when facial nerve is tapped (cheeky smile)
chvostek’s sign
causes of hypercalcemia
Diuretics
Drainage
Diarrhea
causes of hypocalcemia
diuretics
ACE inhibitor
kidney disease
hyperparathyroidism
PTH
ICF
function of cardiac, nerve, muscle, and immune
goes together with ca+
magnesium
levels<1.5
not sedated
everything incr.
hypomagnesemia
levels>2.6
sedated
everything decr.
coma
hypermagnesemia
Mg emergent
D5W 1-2g in 2 min (push)
Mg non emergent
D5W 1-2g in 2hr (pump)
dehydration in chloride
hyperchloremia
hypotension in chloride
hypochloremia
Cl- (ECF) is besties with who
Na+
phosphate(ICF), fluid loss or anything contributing to it
hypophosphatemia
3 types of diuretics
Loop
Thiazide
Spironolactone
Potassium wasting (losing)
hypokalemia
loop
potassium wasting (throwing away)
hypokalemia
thiazide
potassium Sparing
hyperkalemia
spironolactone
example of loop diuretic
furosemide
(lasix)
example of thiazide diuretic
HCTZ
(hydrochlorothalside)
(Controls BP)
excessive fluid volume
integumentary
edema
skin tight
shiny
excessive fluid volume
vitals
incr. bp
incr. hr
incr. rr
decr. O2 stats
excessive fluid volume
weight
gain more than 1 kilo (5lbs) in 24 hr
excessive fluid volume
neurological
headache
excessive fluid volume
cardiac
bounding pulse
S3
jugular distended vein (JDV)
excessive fluid volume
respiratory
wet cough
crackles
SOB
incr. rr
pink frothy sputum
excessive fluid volume
gastrointestinal
excessive fluid volume
urinary
decr urination (<30ml/hr)
dilute or concentrated
deficient fluid volume
integumentary
tenting
dry skin
dry sticky mucous membrane
deficient fluid volume
weight
lose more than 1 kilo (5lbs) in 24 hr
deficient fluid volume
vitals
decr. bp
incr. hr (trying to push fluids)
deficient fluid volume
neurological
headache
confusion
dizzy
r/f
weak
deficient fluid volume
cardiac
weak thread pulse
decr capillary refill
deficient fluid volume
respiratory
SOB
deficient fluid volume
gastrointestinal
constipation
deficient fluid volume
urinary
dark concentrated urine
specific gravity
D5W
don’t give to diabetics
starts of iso catalyses loses water D5 and hypo
