Fluids And Electrolytes Flashcards by Megan Nitchals

What is the ability of all the salutes to cause an osmotic driving force that promotes water movement from one compartment to another?

Tonicity

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What is the movement of water caused by concentration gradient?

Osmosis

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The natural tendency of a substance to move from an area of higher concentration to one of lower concentration

Diffusion

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Hydrostatic pressure is used to filter fluid out of the intravascular compartment (high hydrostatic p) into the interstitial fluid (low hp)

Renal filtration

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Moves sodium from the cell into the ECF and potassium into the cell

Sodium-potassium pump

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What are the purpose of kidneys?

Filter plasma, excrete urine, regulate ECF :

volume, osmolaity, electrolytes, ph, and waste through SELECTIVE RETENSION AND EXCRETION

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Fx of lungs?

Breathing removes fluids for acid base balance

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What glands and their hormones, affect fluid electrolytes?

Pituitary- aldosterone
Adrenal- angiotensin
Parathyroid- renin

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What is FVD? And what populations are at risk for it?

When the loss of ECF volume exceeds fluid intake. 
Renal dysfunction 
Heart failure
Older adults-- thirst, fat,kidney weakness
Small children 
Dementia pt
Burns pt
N/d/v

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What is the best indicator for FVD?

Think assessment—> weight

Same t,clothes, and scale

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What are symptoms of FVD? Think cardiac, integumentary.

Weight loss
Poor turgor
Tachycardia
Decreased bp

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How often donee provide oral care for pt that are NPO?

Every 2 hrs

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What are some other symptoms for FVD? Think renal, neuro, psychosocial, cardio?

Decreased urine out put with high specific gravity, confusion and decreased in CNS activity, restless or anxious but fatigues easily

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What would the pt have wrong if they had a high specific gravity, and altered creatiene and BUN?

FVD

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What are some interventions for FVD?

Oral fluid replacement
Safety education
Drug therapy to treat CAUSE of fluid deficiency

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What are some causes of FVD?

Diarrhea, diuretic, meds, inadequate fluid intake in comparison to output

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What are some isotonic IV fluids?

Lacerated ringers and NS or normal saline

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What are some hypertonic solutions

D10W

3% 5% sodium chloride

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Give an example of a hypo fluid?

1/2 NS

D5W

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Isotonic FVD is treated with (blank) fluid

Isotonic- NS

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Hypertonic FVD is treated with (blank) fluid

Hypotonic- d5w in body, and 1/2ns or .45% sodium chloride

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Hypotonic solutions are treated with (blank) solutions

Hypertonic- 3% 5% NS and D5W

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What does it mean if there is edema around a IV site?

Not in vein… Remove immediately

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What solutions burn going in?

K+ causes tissue damage

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Heart failure and renal failure are notorious for what type of fluid volume (deficit or excess)?

Excess

An isotonic expansion of the ECF caused by the abnormal retention of water and sodium in approximately the same proportion in which they normally exist in the ECF

Hyperbole is/ fve

What are significant manifestations of hypervolemia? Think cardio, integumentary, respiratory, neuromuscular, gi?

``` Bounding pulse Increased bp and hr w/distended neck veins Weight gain*** Shallow/ slow respri, dyspraxia on excursion w/ crackles Pitting edema Pale cool skin All brain issues Increased motility gi ```

What would labs look like for hypervolemia?

Lower hmG, low concentration of cells bc of extra fluid

Elevating feet, fluid/ sodium restrictions, and assessing for increased fluid overload are interventions for what fluid disorder?

Fve hypervolemia

What diuretic is nondiscriminatory?

Lasix or furosemide

What do you monitor a pt that is hypervolemia for?

Bp, hr, o2, electrolyte imbalance

Skeletal and cardiac muscle contraction | Nerve impulse transmission maintaining ECF osmolarity and volume

Sodium fx

Name foods high in sodium

Cheese, bp, repackaged foods

What's the normal level for sodium?

135-145 mEq/L

Hypo or hyper natremia change in cell excitability result in slower membrane depolarization?

Hypo

Causes of hypo at

Sweating, diuretics, wound drainage, renal disease, low salt intake, SIADH

Hypo at causes cellular swelling or shrinking?

Swelling

What are top assessments for hypo nat?

Confusion**** Bilateral muscle weakness Diminished muscle tone and deep tendon reflexes Increased gi motility and cramps

List first line therapies for hypo natremia

Increase oral sodium intake Restrict fluids so we don't dilute an we have IV isotonic fluid with hypertonic saline (2,3,5% NS with lactated ringers) Osmotic diuretics!! Only takes h2o

Cells swell or shrink with hyper natremia?

Dehydrate--- shrink and are unable to respond to stimuli

Increase oral intake of sodium, saline solution with sodium, NPO, increase H2o loss with n d v swat or fever, and renal diseases.

Hyper natremia

Who is at risk for hyper natremia?

Elderly Kidney disease Diabetes insipidus*****

Symptoms and assessment for hyper natremia? | Neuro, nervous sys, skeletal, cardio

Increase CNS and agitation Prone to seizures and confusion Spontaneous muscle spasms severe weakness and deep tendon reflexes Decreased contractility and output

Interventions for hyper natremia

``` Admin hypotonic fluids (1/2 NS and d5w) Loop diuretics ( lasix ) ```

What are some potassium rich foods?

Bananas, cantaloupe, potato, broccoli, avocado, salmon, veil, raisin, oranges

What are the normal rates of K+?

3.5-5.0

What organ and hormone excrete the majority of K+?

Kidney and aldosterone

What electrolyte is in charge of marinating action potentials in excitable membranes, and regulation of protein synthesis and regulating glucose use and storage?

K+

What are the two causes of hypokalemia?

Actual | Relative

What does it mean when a cause is actual for hypokalemia?

Occurs with excessive k+ loss or inadequate k+ intake ( ie. diuretic, diarrhea, corticosteroids

What does it mean when hypokalemia is caused by relative?

K+ moves from ECF to ICF which causes an abnormal distribution of K+ ( alkalosis, hyperinsulinism

What's the most common cause of hypokalemia?

Gi suction

For hypokalemia, is nerve and muscle stimuli fast or slow?

Low

First line assessment for hypokalemia is?

Respiratory--->> ABCs airway, breath, and circulation | Shallow respri

Assessment for hypokalemia would include what? ( respi, musculoskeletal, cardio**, neuro, gi)

``` Shallow respri Hyporeflexia---> flaxis Slow hr, diff to palpate St depression or inversion Ortho htn Irritable and anxious Slowed gi, measure further bc paralytic ileus ```

What fluid volume can cause paralytic ileus?

Hypokalemia

List top interventions for hypokalemia

Oral k replacement | If severe then IV--hard on veins so monitor!

When does a pt need to be moved to a tele unit?

When k fluids are greater than 10 mEq/ hr

Does hyperkalemia increase or decrease cell excitability?

Increases

What organ is susceptible to tissue damage when dealing with k+ levels?

Heart

Causes of hyperkalemia include...

K deficits such as excess k intake or decreased k excretion RENAL FAILURE** main cause - others= blood transfusion, k sparing diuretic, Addison's disease

What would an EKG look like for hyperkalemia pts?

Tall tented t wave ***** A systole or cardiac death (too much stimuli can't respond bc weak and flaccid paralysis) Flat p-wave

Spastic colon, diarrhea, and hyper excitable bowls are dt what electrolyte imbalance?

Hyperkalemia

Labs for hyperkalemia would look like what?

Elevated hematocrite and hmG Elevated k if dehydrated If renal then BUN and creatiene

How would a nurse treat a pt w/ hyperkalemia permanently?

Increase k excretion with loop diuretics like lasix or kayexalate

What are temporary agents used to treat hyperkalemia?

Insulin Albuterol IV calcium glauconite

Maintenance of bone strength and density, activation of enzymes or reactions, skeletal and cardiac muscle contractions, nerve impulse transmission, cofactor in blood clotting all fall under what electrolyte?

Calcium, think musculoskeletal

Foods high in calcium?

Rhubarb ( vit d is needed to absorb the ca)

Absorption of ca occurs where?

Gi tract

Causes of hypocalcemia include what?

EVERYTHING GI as well as removal of parathyroid glands Inadequate intake Hyperphosphatemia

What are some key assessements for hypocalcemia?

Trousseau's and chvostek's signed Decreased hr Muscle twitch and hyperactive dtr's Increased motility, depolarizers quickly

Calcium glauconite and alumni numb hydroxide as well as vitamin d are all interventions to treat what electrolyte disorder?

Hypocalcemia

Excitable become more or less sensitive to normal stimuli with hypercalcemia?

Less

Too much calcium leads to heat issue for fluids and flow?

Excessive clotting

Name some causes of hypercalcemia.

Thiazides diuretics, hyperparathyroidism and hyperthyroidism

What is the most important thing to assess with hypercalcemia?

Cardiac bc starts as increase bp and hr but ends with clotting and cardiac arrest Monitor for DVT Others include Hypo active gi Renal stones!!