Fluids & Electrolytes Flashcards
Body fluid function
transports nutrients and waste to ans from cells
acts as solvent
maintains body temp, digestion, elimination, acid-base balance and lubrication of joints
Fluid
WATER that contains dissolved or suspended substances
Intracellular
inside cell
Extracellular
outside cell
Intravasvular fluid
plasma in blood
Interstitial fluid
fluid between cells
Osmosis
movement of water down concentration gradient
low to high solute by semipermeable membrane
Diffusion
movement of molecules from high to low concentration gradient
Colloid function
moves fluid from in between cells to blood
interstitial to intravascular
What labs are used to measure total protein levels?
albumin
globulin
fibrinogen
What trend does osmotic pressure have with age?
decreases with age and malnutrition
hydrostatic pressure
force of fluid pushing AGAINST cell membrane or vessel wall
pushing fluid OUT of capillary
What is hydrostatic pressure generated by?
blood pressure
Oncotic pressure
pulls fluid INTO capillary
caused by plasma colloids in solution
Electrolyte
substances that are electrically charged within a solution
What does electrolyte concentration depend on?
electrolyte intake, absorption, distribution, and excretion
Anions
Cl
Bicarb
P
Cations
K
Na
Ca
Mg
Intracellular ions
K
Mg
P
Extracellular ions
Na
Cl
Bicarb
Normal Sodium lab levels
136-145 meq/L
Normal Potassium lab level
3.5-5.0 meq/L
Normal magnesium lab level
1.7-2.2 mg/dL
Normal calcium lab level
9-11 mg/dL
Normal phosphate lab level
3.2-4.3 mg/dL
Water follows ___
salt
salt sucks
Hyponatremia
low sodium
<136
Hypernatremia
high sodium
> 145
Sodium function
activates nerve and muscle cells for ion movement for action potential
Causes of hyponatremia
GI losses-diarrhea, vomit, NG suction, fistulas
Renal losses-diuretics, adrenal insufficiency
Skin losses-wounds drainage, burns
Fasting diets-polydipsia
Excess hypotonic fluid
S/Sx of hyponatremia
confusion
altered LOC
anorexia
muscle weakness
seizures/coma
Dilutional hyponatremia
too much fluid- hypervolemia
increased BP
weight gain
bounding rapid pulse
Depletional hyponatremia
not enough fluid-hypovolemia
decreased BP
tachycardia
dry skin
weight loss
Hyponatremia treatment
IV normal saline
oral or IV (slow)
fluid restriction
Causes of Hypernatremia
IV fluids
tube feedings
excess sodium intake
not enough water
diarrhea
heat stroke
profound diuresis
S/Sx of hypernatremia
altered LOC
confusion
seizure/coma
extreme thirst (hyperosmolality)
dry, sticky mucous
muscle cramps
Hypernatremia Treatment
if water loss- add water and fluid
if sodium excess- remove sodium
over 48 hours
slow
Hypokalemia
low potassium - <3.5
Hyperkalemia
high potassium - >5.0
Potassium Function
helps regulate cell excitability and electrical status
What is the main source of potassium?
our diet
What is the main source of potassium loss?
Kidneys
Causes of hypokalemia
renal or GI losses
diarrhea
diuresis**
acid base disorders
S/Sx of hypokalemia
cardiac rhythm disturbances
muscle weakness
legs cramps
decreased bowel motility
Do we ever IV push potassium?
never
Causes of hyperkalemia
decreased potassium output (renal failure-not peeing)
burns, crash injuries, sepsis
drugs-potassium sparing diuretics (ACE, ARBs, NSAIDs)
S/Sx of hyperkalemia
cardiac rhythm disturbances
muscle weakness, cramps
abdominal cramping
D/V
Magnesium function
helps stabilize cardiac and smooth muscles
Causes of hypomagnesemia
diuresis
GI or renal losses
limited intake-fasting/ starvation
alcohol abuse
hyperglycemia
pancreatitis
S/Sx of hypomagnesemia
hyperactive reflexes
confusion
cramps
tremors
seizures
nystagmus
Causes of Hypermagnesemia
increased intake of magnesium with renal failure
precamplsia - OB patients
S/Sx of hypermagnesemia
lethargy
floppiness
muscle weakness
decreased reflexes
warm temp
decreased pulse and BP
Calcium function
stability and strength in bones
contraction of smooth, cardiac and skeletal muscles
nerve and muscle cells
Causes of Hypocalcemia
hypoparathyroidism
hypomagnesemia
increased renal failure
acute pancreatitis
thyroid and parathyroid surgery
Parasthesia
numbness, tingling
S/Sx of hypocalcemia
Chrosteks- twitching of cheek
Trousseaus-carpal spasm in hand
Causes of hypercalcemia
hyperparathyroidism
cancers
S/Sx hypercalcemia
sedation
fatigue
lethargy
confusion
weakness
kidney stones
Hypercalcemia Treatment
adequate hydration
increased urine output
diuretics and NaCl
dialysis
What relationship does calcium and phosphorous have?
indirect: as Ca lowers, P increases
as P lowers, Ca increased
Phosphorous function
bone formation
essential for ATP formation and enzymes
Causes of hypophospatemia
decreased absorption oh phosphate
antacids overdose
severe diarrhea
increased kidney elimination
malnutrition
alcoholism
S/Sx hypophosphatemia
tremors
parasthesias
confusion
seizure
muscle weakness
joint stiffness
bone pain
Causes of hyperphospatemia
kidney failure
laxatives
heat stroke, massive trauma
hypoparathyroidism
S/Sx of hyperphospatemia
usually asymptomatic
muscle spasms, parasthesia, tetany
Hypophospatemia treatment
IV or oral replacement
Hyperphospatemia treatment
treat cause
hemodialysis for renal failure
Hypocalcemia Treatment
IV calcium
calcium chloride
calcium gluconate
oral calcium