Fluids:Electrolytes Flashcards
SIADH-S/Sx
SG
Na+
Hct
Fluid volume excess–Edema, JVD, Wet, crackly lungs, Increased HR, BP, weight
Concentrated urine– Na+ >145 SG > 1.030 Hct > 47 female > 54 male
SIADH-Tx
Diuretics–
-ides + spirinolactone
Low Na+ diet
Bedrest- promotes diuresis
Hypervolemia-Causes
SIADH Heart failure (decreased cardiac output–> decreased kidney perfusion)
Kidney failure
Increased Na+ (alkaseltzer, fleets enema, high Na+ IVF)
Aldosterone
Aldosterone
Function
Malfunction- Too much? Too little?
Increases retention of Na+ and H2O
Too much= Conn’s and Cushings
Too little= Addison’s
Isotonic solutions3
NS, LR, D5W,
Do NOT use with kidney failure, heart failure or HTN
Hypotonic solutions3
D2.5W
1/2NS
0.33%NS
Fluid moves out of vascular space, into cells–> cellular edema! fluid volume deficit, hypotention.Used with pt. with HTN.
Hypertonic solutions5
D10W3 or 5% NS DNS TPN AlbuminMoves fluid from excels into the vascular space Severe burns, edema
Magnesium and Calcium-HyperMg
Think muscle first
Decreased tone, DTRs, HR, LOC, RR
Warmth, flush (vasodilation)
Magnesium and Calcium
HyperCa
Think muscle first
PTH
Immobilization
Hi-protein (added Phos) to diet–>Encourage Ca+ to go back into bones (move!)
Magnesium and Calcium
HYPO Mg
Think muscle first-
Increased rigidity, increased DTR, seizures, Chvostek/trousseau
Give Mg, but check kidney function before and during
Brassica
Magnesium and Calcium
HYPO-Ca
Think muscle first-
Increased rigidity, increased DTR, seizures, Chvostek/trousseau
Phosphate binders
Always heart monitor those with Ca supplementation
Sodium HYPER Na+ Causes Sx Tx
Causes-Heat stroke, DI
S/Sx-Dry mouth, thirsty, swollen tongue
Tx-restrict Na+, increase fluids to dilute
Sodium
HYPO Na+
Causes- Not supplying body with electrolytes, too much water, SIADH
S/Sx- headache, seizure, coma
Tx- reduce water, increase Na+, 3-5%NS
Potassium-HYPER K+
Causes
Sx
Tx
Causes- kidney problems, aldactone (retains K+)
S/Sx- arrhythmias, muscle twitching–>weakness–>flaccid paralysis
Tx- dialysis(broken kidneys), Sodium Polystyrene Sulfonate.
Potassium
HYPO K+
Causes- NG suction, vomit, diuretics, starving
S/Sx- arrhythmias, muscle cramps to weakness
Tx- give K+, aldactone (retains K+).
Pituitary is related to fluids how?
It controls ADH. Damage to the pituitary (craniotomy, tumor, sinus surgery, transphenoidalhypophsectomy, increased ICP) can trigger SIADH or decreased ADH
Fluid retention, think _____first
Heart failure
Hydrochlorithyazide
Loses K+
Eat more potassium
Furosimide
Loses K+
Eat more potassium
Aldactone
Potassium sparing
Eat less potassium
Bedrest induces_______
Diuresis Watch for: Kidney stones Constipation DVT SOB (secretions will be thicker, more difficult to cough up)
Acities often caused by?
Fluid excess or deficit?
Liver problems
Deficit due to the fluid being in the peritoneum, not the vascular system
Polyuria, think _____first
Hypovolemic shock
Mg and Ca act like ______
Sedatives
Ca has an inverse relationship with _________
Phosphorus
Dietary phosphorus?
Anything with protiens
Diarrhea means the loss of which mineral?
Magnesium
Sodium, think ______ changes
Neuro
Serum sodium levels
135-145
Serum Ca+
9-10.5
Serum Mg
1.2-2.1
Serum Potassium levels
3.5 - 5.0
Hct levels
Women?
Men?
38-47%
40-54%
Specific gravity levels
0.010 - 0.030
Causes of HYPERkalemia
Kidney problems
Insulin carries glucose and ______ into the cells
Potassium, can be used for HYPERkalemia
Sodium polystyrene
Exchanges sodium for potassium in GI tract. Sodium goes up, potassium goes down.
Kayexalate. Watch for dehydration as sodium increases.
If giving IV potassium, what do you watch for?
Must be diluted, and on a pump. Watch for urine output. If the output decrease, it means the pt. is retaining potassium.
ADH, where is it released?
Pituitary, so if there is head trauma/surgery, increased ICP = ADH problems
Diabetes insipidus
Cause
Not producing or metabolizing ADH.
Magnesium and calcium
Act like ___________
Sedatives
Common Sx of hyper or Hyponatremia?
Neuro changes
Fluid imbalances
