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Medsurg > Fluids & Electrolytes Balance > Flashcards

Fluids & Electrolytes Balance Flashcards

Exam 2

1
Q

What do fluids and electrolytes maintain?

A

Fluids & Electrolytes maintain balance (homeostasis)

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2
Q

Fluids & Electrolytes Balance:

What are cations?

A

Cations are positive ions

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3
Q

Fluids & Electrolytes Balance:

What are anions?

A

Anions are negative ions

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4
Q

Fluids & Electrolytes Balance:

What is the primary constitute of cells?

A

Water is the primary constitute of cells

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5
Q

Fluids & Electrolytes Balance:

How much water on average are in women and in men?

A

55% of average female and 65% male

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6
Q

Fluids & Electrolytes Balance: How many compartments within a cell have fluid?

A

Four compartments

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7
Q

Four compartments of fluid include:

A

Intracellular

Extracellular

Plasma

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8
Q

Intracellular fluid

A

All the fluid within a cell

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9
Q

Extracellular fluid

A

All the fluid outside a cell

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10
Q

What percent of fluid does our plasma account for?

A

80%

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11
Q

FLUID AND ELECTROLYTE REGULATION

What are the four regulatory mechanisms?

A
  1. Renal system
  2. Endocrine system
  3. Respiratory system
  4. Insensible losses
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12
Q

FLUID AND ELECTROLYTE REGULATION:

Regulatory mechanisms: What are the primary organs involved in regulating fluid volumes and electrolyte balance?

A

Kidney are primary organs in regulating fluids volume and electrolyte balance.

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13
Q

FLUID AND ELECTROLYTE REGULATION:

Regulatory mechanisms: What occurs in the glomeruli?

A

Selective reabsorption of water and electrolytes occurs in the glomeruli.

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14
Q

FLUID AND ELECTROLYTE REGULATION:

How much urine output a day?

A

Urine output is 1 to 2 per day.

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15
Q

FLUID AND ELECTROLYTE REGULATION:
Endocrine system:

A

Maintain fluid and electrolytes by the Renin-Angiotensin-aldosterone system.

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16
Q

FLUID AND ELECTROLYTE REGULATION:
Endocrine system: What does it maintain?

A

The system maintains bloods pressure and intravascular fluids.

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17
Q

FLUID AND ELECTROLYTE REGULATION:

What responds to changes in blood osmolarity?

A

The Antidiuretic hormone and peptides respond to changes in blood osmolarity.

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18
Q

FLUID AND ELECTROLYTE REGULATION:

When are peptides released?

A

The peptides ae released due to increase blood volume and blood pressure

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19
Q

FLUID AND ELECTROLYTE REGULATION:

Respiratory system: How does fluid loss occur?

A

fluid loss occurs in the lungs through vaporization that occurs as a result of inspired air being warmed and humidified by the body.

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20
Q

FLUID AND ELECTROLYTE REGULATION:

What are insensible losses?

A

occurs through the skins, lungs and stool. Trauma, burns, fever , perspiration

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21
Q

FLUID AND ELECTROLYTE REGULATION:

Indicators of fluid status/ways that fluid status of a patient is evaluated includes:

A

Review of body weight

Osmolality

Blood urea nitrogen (BUN)

Creatinine

Urine specific gravity

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22
Q

FLUID AND ELECTROLYTE REGULATION:

Body weight- can assess what about hydration?

A

(dry oral mucous membranes and poor skin turgor, edema and weight gain

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23
Q

FLUID AND ELECTROLYTE REGULATION:

Osmolality

A

concentration of a solution as determined by the number of solutes in a kilogram of blood and urine.

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24
Q

FLUID AND ELECTROLYTE REGULATION:

Osmolality: What is the most effective way to measure osmolality?

A

Random urine specimen at the same time is the most effective means to evaluate.

25
Q

FLUID AND ELECTROLYTE REGULATION:

Osmolality: What is the normal ration between urine and blood osmolality?

A

Normal ratio between urine and blood osmolality 3:1.

26
Q

FLUID AND ELECTROLYTE REGULATION:

BUN- What does it measure?

A

Blood urea nitrogen measures the nitrogen portion of urea and serves as a measure of glomerular function.

Normal 8 to 21 mg/dL

27
Q

FLUID AND ELECTROLYTE REGULATION:

BUN- What are normal BUN values?

A

Normal 8 to 21 mg/dL

28
Q

FLUID AND ELECTROLYTE REGULATION:

Creatinine

A

by product of muscle creatinine phosphate metabolism.

29
Q

FLUID AND ELECTROLYTE REGULATION:

Creatinine: How is it constant?

A

Constant as long a muscle mass remains constant and serves as a better indication of kidney function. (Than BUN)

30
Q

FLUID AND ELECTROLYTE REGULATION:

Creatinine: What are normal values?

A

0.5 to 1.2 mg/dL

31
Q

FLUID AND ELECTROLYTE REGULATION:

Urine specific gravity-

A

measure of dissolved chemicals in urine and reflects the ability of the kidneys to concentrate urine.

32
Q

FLUID AND ELECTROLYTE REGULATION:

Urine specific gravity-What are normal values?

A

Range 1.005 to 1.030. High urine specific gravity.

33
Q

FLUID AND ELECTROLYTE REGULATION:

Urine specific gravity-Who would a high specific gravity be seen in?

A

Someone who is dehydrated or has decreased renal perfusion

34
Q

FLUID AND ELECTROLYTE REGULATION:

Urine specific gravity-Who would a low specific gravity be seen in?

A

the urine is more on the dilute side and it could indicate the use of diuretics or someone with DI.

35
Q

FLUID AND ELECTROLYTE REGULATION:

Age-related changes include:

A

Decreased taste, smell, and thirst

Health issues

Lack of financial resources

36
Q

FLUID AND ELECTROLYTE REGULATION:

Age-related changes: Why would a decline in olfactory function occur in older people?

A

Decline in olfactory function due to decrease in olfactory fibers or receptors

37
Q

FLUID AND ELECTROLYTE REGULATION:

What would loss of teeth/ill fitting dentures place old people at risk for?

A

Loss of teeth or ill fitting dentures placing them at risk for malnutrition, immunity , weight loss and deterioration of health status.

38
Q

FLUID AND ELECTROLYTE REGULATION:

Age-related changes: What may influence appetite, food selection and food absorption?

A

Older adults have arthritis, diabetes mellitus , heart failure and HTN that require meds that influence appetite, food selection and food absorption

39
Q

FLUID AND ELECTROLYTE REGULATION:

Age-related changes: Lack of financial resources leads to

A

Lack of financial resources- purchase and prepare nutritionally balance meals, lack of transportation, reduced income, healthcare expenses.

Loneliness and depression.

Cognitive changes dementia.

40
Q

FLUID IMBALANCESHypovolemia:

A

fluid volume deficit

41
Q

FLUID IMBALANCESHypovolemia: Causes?

A

Excessive loss of fluid

Insufficient intake of fluid

Fluid shifts

42
Q

FLUID IMBALANCESHypovolemia: fluid volume deficit:

Lab values effected?

A

Electrolytes

Hemoglobin and hematocrit

Serum osmolality

BUN and creatinine

Urine specific gravity

Urine osmolality

43
Q

FLUID IMBALANCESHypovolemia: fluid volume deficit:

Lab values effected: Electrolytes effected?

A

Electrolytes (potassium and sodium)

44
Q

FLUID IMBALANCESHypovolemia: fluid volume deficit:

Lab values effected: Hemoglobin and hematocrit can indicate?

A

Hemoglobin and hematocrit (hemorrhage)

45
Q

FLUID IMBALANCESHypovolemia: fluid volume deficit:

Lab values : Serum osmolality - what occurs?

A

(with a loss of water serum sodium increased)

46
Q

FLUID IMBALANCESHypovolemia: fluid volume deficit:

Clinical Manifestations include:

A

Weight loss
Decreased skin turgor
Concentrated urine output
Oliguria (low urine output)
Thirst
Dry mucous membranes
Weak, rapid peripheral pulses
Flattened neck veins
Hypotension
Pale skin

47
Q

FLUID IMBALANCESHypovolemia: fluid volume deficit

Medical Management

A

Identify and treat cause
Intake of oral fluids
IV isotonic solutions
Close monitoring

48
Q

FLUID IMBALANCESHypovolemia: fluid volume deficit

Nursing Management

A

Collection of health history

Physical assessment

49
Q

FLUID IMBALANCESHypovolemia: fluid volume deficit

Nursing Management: What does the physical assessment entail?

A

Vital signs
Mucous membranes, skin turgor
Urine specific gravity, color, volume
I&O

50
Q

FLUID IMBALANCESHypovolemia: fluid volume deficit

Complications

A

Hypovolemic shock

Oliguria leading to anuria

51
Q

FLUID IMBALANCESHypovolemia: fluid volume deficit

Complications: Hypovolemic shock?

A

Hypovolemic shock (emergency loss of blood or fluid making the heart unable to pump enough blood)

52
Q

FLUID IMBALANCESHypovolemia: fluid volume deficit (cont’d)

What kind of fluid would we give through IV?

A

Normal saline

Lactated Ringers

53
Q

FLUID IMBALANCESHypervolemia: What is it?

A

fluid volume excess

54
Q

FLUID IMBALANCESHypervolemia: fluid volume excess:

Causes?

A

Increased water and sodium retention
Cirrhosis
Heart failure
Stress conditions
Use of corticosteroids
Sodium intake

55
Q

FLUID IMBALANCESHypervolemia: fluid volume excess

Laboratory values

A

Serum electrolytes

Hematocrit

B U N

Serum osmolality

Albumin

Hyponatemia

56
Q

How are electrolyte levels in someone with hypervolemia?

A

Levels are low

57
Q

FLUID IMBALANCESHypervolemia: fluid volume excess:

Clinical manifestations

A

Weight gain
Ascites
Edema
Increased urine output
Cardiac symptoms
Respiratory symptoms (cough, orthopnea, wheezing , crackles)

58
Q

FLUID IMBALANCESHypervolemia: fluid volume excess

Medical Management includes?

A

Correcting and managing underlying cause

Treating clinical manifestations

Fluid restriction

Discontinue I V fluids

Diuretics

Dialysis

59
Q

What can be used as a diuretic?

A

Lasix

Morphine

Medsurg (21 decks)

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