Fluids and Electrolytes ch 10

Question 1

what kind of fluid contains soluble mineral ions and water?

Answer 1

Crystalloid

Question 2

____________ is the process by which solutes move from an area of HIGHER concentration to LOWER concentration

Answer 2

diffusion

Question 3

__________________ fluid = fluid in blood vessels; make up approx 1/3 of extra cellular fluid

Answer 3

intravascular

Question 4

_______________ fluid = fluid that surround cell like lymph; makes approx 2/3 extra cellular fluid

Answer 4

interstitial

Question 5

Osmosis: when two different solutions are separated by a semi-permeable membrane fluids shift from the region of ________ concentrated solution to a _________ concentrated solution, until the solutions are of _______ concentration

Answer 5

low
high
equal

Question 6

Why do fluids shift?
* Changes in __________
* ____________ leaks allowing water to escape into tissues, organs, or body cavities (burns, sepsis, snake bites
* ________ spacing

Answer 6

osmolarity
capillary
third

Question 7

what happens to a pt’s urine output who has third spacing

Answer 7

decreases
increased concentration

Question 8

complications of fluid shifts
* out of vessels =
* out of cells =
* Into tissues =
* Into brain =

Answer 8

hypotension
cellular dehydration
edema
cerebral edema

Question 9

How does the skin impact fluid status?

Answer 9

Perspiration

Question 10

How do the lungs impact fluid status?

Answer 10

respiration

Question 11

what is the MAJOR function of the kidneys?

Answer 11

to maintain FLUID BALANCE

Question 12

how much urine /hr should a healthy person excrete?

Answer 12

30ml/hr

Question 13

Hydrostatic pressure is the pressure that ___________ water out of the cell

Answer 13

FORCES

Question 14

Specific gravity compares density of __________ compared to ________

Answer 14

urine
water

Question 15

the lower the specific gravity, the more _________ the urine will be

Answer 15

dilute

Question 16

a specific gravity of 1.005 means that the urine is ___________

Answer 16

dilute

Question 17

a specific gravity of 1.030 means that the urine is __________

Answer 17

concentrated

Question 18

the specific gravity is a very good indicator of how ________________ a patient is

Answer 18

hydrated

Question 19

what is a normal urine osmolality?

Answer 19

(275-290)

Question 20

A high osmolality would indicate that the urine is :

Answer 20

more concentrated

Question 21

A low osmolality would indicate that the urine is :

Answer 21

more dilute

Question 22

BUN measures the amount of ________ in the blood

Answer 22

urea

Question 23

what is a normal BUN?

Answer 23

10-20mg/dl

Question 24

What is a normal creatinine?

Answer 24

0.7-1.4mg/dl

Question 25

Creatinine levels ____________ as renal function __________

Answer 25

increases decreases

Question 26

Hematocrit and Hemoglobin labs are good indicators for _____________ volume

Answer 26

fluid

Question 27

If hematocrit and hemoglobin labs are HIGH, the patient is ___________

Answer 27

hydrated

Question 28

If hematocrit and hemoglobin labs are LOW, the patient is

Answer 28

dehydrated

Question 29

Signs and symptoms of HYPOvolemia

Answer 29

lethargy tachy dry skin poor skin turgor confusion dizziness

Question 30

What are some indicators of HYPERvolemia?

Answer 30

third spacing edema very clear urine low sodium confusion CRACKLES IN LOWER LOBES HTN weight gain

Question 31

Nursing management of HYPOvolemic pts Record __________ encourage PO ________ daily ____________ trend ________ ________ assess skin __________ assess _________ color

Answer 31

I&Os fluids weights vital signs turgor urine

Question 32

Nursing management for HYPERvolemic record _____ _______ fluids Daily ________ assess ___________ sounds assess for _________

Answer 32

I&Os restrict weights breath edema

Question 33

tonicity compares the __________ of 2 solutions

Answer 33

osmolarity

Question 34

what are some examples of hypotonic solutions

Answer 34

0.45% saline (half normal)

Question 35

Hypotonic fluids hydrate ________

Answer 35

cells

Question 36

hypotonic fluids dilute blood osmolarity causing h2o to shift ______ ______

Answer 36

into cells

Question 37

Hypotonic fluids create a risk for pts with :

Answer 37

Hypovolemia Hypotension HA Decreased LOC

Question 38

hypotonic fluids can cause fluid _____________

Answer 38

overload

Question 39

Hypertonic fluids cause cells to __________

Answer 39

shrink

Question 40

Indications for hypertonic fluids:

Answer 40

severe hyponatremia cerebral edema

Question 41

Hypertonic fluids are contraindicated in pts with

Answer 41

heart failure renal failure

Question 42

__________ is the cation in the BLOOD

Answer 42

sodium

Question 43

what electrolyte is known as the fluid shift controller?

Answer 43

sodium

Question 44

___________ controls fluid distribution between intracellular fluid and extra cellular fluid

Answer 44

sodium

Question 45

Hyponatremia is defined by a serum level less than _____

Answer 45

135

Question 46

Hyponatremia is usually due to in balance of _____

Answer 46

water

Question 47

Causes of HYPOnatremia * diuretics * too much ______ * Neuro / _______ * Psychogenic ______________ * __________ insufficiency * Excessive __________ * Vomiting and __________

Answer 47

IV fluids SIADH polydipsia adrenal sweating diarrhea

Question 48

What are the most common signs and symptoms of HYPOnatremia? * _________ cramps * _________ edema * Confusion * Seizures

Answer 48

muscle cerebral

Question 49

Hyponatremia is an overlooked cause of confusion in the __________ population

Answer 49

elderly

Question 50

ways fluids shit and what they cause OUT of vessels —> ___________ OUT of cells —> __________ _____________ INTO tissues —> _______ INTO brain —> ___________ _________

Answer 50

hypotension cellular dehydration edema cerebral edema

Question 51

What are some factors that would INCREASE serum osm?

Answer 51

hypernatremia , hyperglycemia, alcoholism, burns, dehydration

Question 52

what are some factors that would decrease serum osm?

Answer 52

fluid volume excess, SIADH, AKI, hyponatremia

Question 53

What are some clinical indicators of HYPOvolemia?

Answer 53

hyperthermia tachycardia weak pulse hypotension weight loss dry mucous membranes exhaustion low UOP hypernatremia headache confusion poor skin turgor

Question 54

Causes of HYPOvolemia

Answer 54

GI infection Poor diet incontinence No air conditioning unable to reach fluid unable to walk to bathroom cannot afford adult diapers cannot remember when last fluid intake was

Question 55

Causes of HYPERvolemia * _________ failure * _______ failure * ____________ fluid intake * Cirrhosis

Answer 55

Kidney heart excessive

Question 56

Medical management of HYPERvolemia *kidney failure —> __________ * heart failure —> ____________, fluid restriction, sodium restriction * Excessive fluid intake —> __________ _________, diuretics *Cirrhosis —> __________

Answer 56

dialysis diuretics fluid restriction diuretics

Question 57

Tonicity compares the _______________ of 2 solutions

Answer 57

osmolality ** in the case of IV fluids,it means comparing the osmolarity of the IVF to the osmolarity of blood

Question 58

Hypotonic solutions can create a risk for : ______volemia _______tension HA ___________ LOC

Answer 58

hypo hypo decreased ** due to these fluids being pushed into the CELLS instead of the BLOOD

Question 59

Isotonic is contraindicated in patients that have…

Answer 59

heart failure kidney failure

Question 60

Hypertonic solutions are contraindicated in pts who have …

Answer 60

heart failure renal failure

Question 61

Colloids stay in the _________ space much longer that ____________ crystalloids

Answer 61

vascular isotonic