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Med Surg > Fluids and Electrolytes ch 10 > Flashcards

Fluids and Electrolytes ch 10 Flashcards

1
Q

what kind of fluid contains soluble mineral ions and water?

A

Crystalloid

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2
Q

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

A

diffusion

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3
Q

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

A

intravascular

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4
Q

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

A

interstitial

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5
Q

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

A

low
high
equal

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6
Q

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

A

osmolarity
capillary
third

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7
Q

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

A

decreases
increased concentration

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8
Q

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

A

hypotension
cellular dehydration
edema
cerebral edema

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9
Q

How does the skin impact fluid status?

A

Perspiration

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10
Q

How do the lungs impact fluid status?

A

respiration

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11
Q

what is the MAJOR function of the kidneys?

A

to maintain FLUID BALANCE

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12
Q

how much urine /hr should a healthy person excrete?

A

30ml/hr

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13
Q

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

A

FORCES

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14
Q

Specific gravity compares density of __________ compared to ________

A

urine
water

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15
Q

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

A

dilute

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16
Q

a specific gravity of 1.005 means that the urine is ___________

A

dilute

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17
Q

a specific gravity of 1.030 means that the urine is __________

A

concentrated

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18
Q

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

A

hydrated

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19
Q

what is a normal urine osmolality?

A

(275-290)

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20
Q

A high osmolality would indicate that the urine is :

A

more concentrated

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21
Q

A low osmolality would indicate that the urine is :

A

more dilute

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22
Q

BUN measures the amount of ________ in the blood

A

urea

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23
Q

what is a normal BUN?

A

10-20mg/dl

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24
Q

What is a normal creatinine?

A

0.7-1.4mg/dl

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25
Q

Creatinine levels ____________ as renal function __________

A

increases
decreases

26
Q

Hematocrit and Hemoglobin labs are good indicators for _____________ volume

A

fluid

27
Q

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

A

hydrated

28
Q

If hematocrit and hemoglobin labs are LOW, the patient is

A

dehydrated

29
Q

Signs and symptoms of HYPOvolemia

A

lethargy
tachy
dry skin
poor skin turgor
confusion
dizziness

30
Q

What are some indicators of HYPERvolemia?

A

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

31
Q

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

A

I&Os
fluids
weights
vital signs
turgor
urine

32
Q

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

A

I&Os
restrict
weights
breath
edema

33
Q

tonicity compares the __________ of 2 solutions

A

osmolarity

34
Q

what are some examples of hypotonic solutions

A

0.45% saline (half normal)

35
Q

Hypotonic fluids hydrate ________

A

cells

36
Q

hypotonic fluids dilute blood osmolarity causing h2o to shift ______ ______

A

into cells

37
Q

Hypotonic fluids create a risk for pts with :

A

Hypovolemia
Hypotension
HA
Decreased LOC

38
Q

hypotonic fluids can cause fluid _____________

A

overload

39
Q

Hypertonic fluids cause cells to __________

A

shrink

40
Q

Indications for hypertonic fluids:

A

severe hyponatremia
cerebral edema

41
Q

Hypertonic fluids are contraindicated in pts with

A

heart failure
renal failure

42
Q

__________ is the cation in the BLOOD

A

sodium

43
Q

what electrolyte is known as the fluid shift controller?

A

sodium

44
Q

___________ controls fluid distribution between intracellular fluid and extra cellular fluid

A

sodium

45
Q

Hyponatremia is defined by a serum level less than _____

A

135

46
Q

Hyponatremia is usually due to in balance of _____

A

water

47
Q

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

A

IV fluids
SIADH
polydipsia
adrenal
sweating
diarrhea

48
Q

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

A

muscle
cerebral

49
Q

Hyponatremia is an overlooked cause of confusion in the __________ population

A

elderly

50
Q

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

A

hypotension
cellular dehydration
edema
cerebral edema

51
Q

What are some factors that would INCREASE serum osm?

A

hypernatremia , hyperglycemia, alcoholism, burns, dehydration

52
Q

what are some factors that would decrease serum osm?

A

fluid volume excess, SIADH, AKI, hyponatremia

53
Q

What are some clinical indicators of HYPOvolemia?

A

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

54
Q

Causes of HYPOvolemia

A

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

55
Q

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

A

Kidney
heart
excessive

56
Q

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

A

dialysis
diuretics
fluid restriction
diuretics

57
Q

Tonicity compares the _______________ of 2 solutions

A

osmolality

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

58
Q

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

A

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

59
Q

Isotonic is contraindicated in patients that have…

A

heart failure
kidney failure

60
Q

Hypertonic solutions are contraindicated in pts who have …

A

heart failure
renal failure

61
Q

Colloids stay in the _________ space much longer that ____________ crystalloids

A

vascular
isotonic

Med Surg (20 decks)

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