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Nursing - 115 > Fluids & Electrolytes - Part 2 - Unit 5 > Flashcards

Fluids & Electrolytes - Part 2 - Unit 5 Flashcards

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1
Q

Active Transport: Molecules move against a ___ ___ across cell membranes.

A

Concentration gradient.

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2
Q

Filtration - the movement of fluid and electrolytes through a permeable membrane from __ pressure to ___ pressure by force or pressure between intravascular and interstitial spaces.

A

High pressure —-> lower pressure.

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3
Q

Hydrostatic Pressure - the pushing force of water & solutes from a solution with ___ hydrostatic pressure to a solution with __ hydrostatic pressure.

A

High —> lower.

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4
Q

Colloid Osmotic Pressure - the pulling force that occurs by plasma proteins that puts pressure on the permeable membranes. Fluid follows the ____.

A

Proteins.

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5
Q

Osmolality - def

A

The measure of a solution’s ability to create osmotic pressure and thus affect the movement of water. Can also be described as the ratio of solutes to water.

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6
Q

Osmolarity - def

A

another term to describe the concentration of solutions. Reflects the number of particles in a liter of solution - Normal = 275-295 mOsm/kg.

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7
Q

Tonicity is a reflection of what?

A

Osmolality.

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8
Q

Isotonic - osmolality is…Fluids move?

A

Same as body fluids, like 0.9% NACL. Fluids do not move. No net transfer!

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9
Q

Hypotonic - osmolality is…Fluids move?

A

<body fluids, like 0.45% NACL. Fluid moves in the directions of greater solute concentration (INTO cells.)

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10
Q

Hypertonic - osmolality is…Fluids move?

A

> body fluids, like 3% NACL. Fluid moves in direction of greater solute concentration (OUT of cells.)

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11
Q

Colloids - particles that are too __ to pass through a semipermeable membrane.

A

LARGE, like protein.

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12
Q

What are some signs of a well-hydrated person?

A

Stable weight from day to day, moist mucous membranes, adequate food intake, straw colored urine, good tissue turgor, appropriate mental orientation, not thirsty, output equal to intake, no evidence of edema, etc.

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13
Q

Fluid Volume Excess (Isotonic/Hypervolemia) - What happens?

A

The ECF is expanded, fluid accumulates in interstitial space. It may produce edema!Could be from excessive intake of fluid or saline (Like CHF/CRF), but the gains of water and salt are equal.

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14
Q

What’s some objective data for fluid volume excess (Isotonic))?

A

Edema, urine pale and colorless (with a decrease in specific gravity), firm tissue turgor, sudden weight gain, increased pulse rate, distended neck veins, mental confusion, dyspnea, decreased hematocrit, na 135-145, Chest xray will show pulmonary edema.

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15
Q

What’s some subjective data for fluid volume excess (Isotonic)?

A

Statements of “weakness” and “anorexia.”

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16
Q

What are some nursing interventions for Fluid Volume Excess? (Isotonic)

A

Monitor vitals, restrict fluid intake, teach about NA intake, give diuretics (if ordered), monitor!

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17
Q

Fluid Volume Excess - Hypotonic ECF - what happens?

A

ICF is expanded - cells are swollen. Can be caused by SIADH, Excessive tap water enema, irrigating NG water, psychogenic polydipsia.

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18
Q

What’s some subjective data for Fluid Volume Excess (Hypotonic?)

A

Changes in LOC, widened pulse pressure, Na <295, headache. etc.

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19
Q

What are some nursing interventions for Fluid Volume Excess (hypotonic?)

A

Assess risk, vital signs, monitor weight, I&O, restrict free water, etc.

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20
Q

Hypertonic Fluid Volume Excess - is it common?

A

No, it’s rare. It occurs secondary to increased salt intake. ECF expands and ICF volume contracts.

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21
Q

Fluid Volume Deficit (Isotonic ECF) what happens?

A

Body loss of water & electrolytes from ECF, in similar portions. The ECF is contracted. Happens from ABNORMAL GI LOSSES.

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22
Q

What is some objective data for fluid volume deficit? (Isotonic)?

A

Dry, flaky skin, sunken eyes, oliguria (dark amber urine), decreased tissue turgor, weak/rapid pulse, decreased BP (with possible Orthostatic Hypotension), salivation, etc.

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23
Q

What’s some subjective data for fluid volume deficit (isotonic) ?

A

Thirst, weakness, Nausea/Vomitting, lethargy, vertigo with Orthostatic hypotension.

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24
Q

Fluid Volume Deficit (Hypertonic) - what is it?

A

Same as dehydration and hypernatremia. More water is lost than Na+.ECF is hypertonic - cells become dehydrated.

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25
Q

O/S data for Dehydration?

A

Flushed skin, thirst, dry mucous membranes, increased body temp, weight loss, decreased urinary output <30CC.

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26
Q

Nursing Interventions for Dehydration?

A

Increase oral intake or give IV fluids per MD order, I & O, Daily weights.

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27
Q

Hypotonic Fluid Volume Deficit - common or not?

A

NOT AT ALL - least common. Decreased ECF due to excessive loss and imbalance of Na+ and K+. Brain cells swell! Occurs with chronic illness and malnutrition with ingesting excessive hypotonic fluids.

28
Q

Sodium - chief cation in the ECF. T/F?

A

True!

29
Q

Sodium - maintains fluid __ and __ pressure.

A

Balance/osmotic.

30
Q

What is Hypernatremia?

A

Excess of sodium relative to body water. >145 mEq/L. LESS WATER on board.

31
Q

Hyponatremia - what is it?

A

common electrolyte imbalance refers to a deficiency of sodium in relation to body water. <135 mEq/L. MORE WATER on board.

32
Q

What can cause the sodium gain in Hypernatremia?

A

Excessive IV na+ intake, salt water drowning, cushing’s syndrome, Hyperaldosteronism, etc.

33
Q

What can cause the sodium loss (water loss) in Hyponatremia?

A

Brain injury, which decreases thirst, Diabetes inspipidus (the kidney tubules aren’t absorbing enough water, which means there’s not enough ADH, so the body can’t absorb water!)

34
Q

What will we see in someone with hypernatremia?

A

Restlessness, agitation, lethargy, confusion, weakness, twitching/seizures, serum osmolality > 295, Na > 145, increased urine specific gravity (which is an indicator of dehydration), etc.

35
Q

What are some interventions for Hypernatremia?

A

VS, closing monitoring of fluid replacement, I&O, daily weight, assess skin/mucous membranes, etc.

36
Q

What causes hyponatremia?

A

(If by sodium loss.)V/D, NG suctioning/GI loss, skin loses, renal loses, etc.
(If by water gain) - Excessive intake of electrolyte free fluids, renal, liver, or kidney failure, SIADH, psychogenic polydipsia (drinking too much - OCD?)

37
Q

What is SIADH?

A

Syndrome of Inappropriate Anti-Diuretic Hormone - kidney’s can’t excrete urine, because there is an increase in ADH.

38
Q

What do we assess for in Hyponatremia?

A

Abdominal cramps, altered LOS, muscle twitching, osmolality <285, headache, etc.
Na Loss = orthostatic hypotension, tachycardia, oliguria, etc.
Water gain = Full, bounding pulse, hypertension, low/normal specific gravity, distended neck veins.

39
Q

What are some nursing interventions for Hyponatremia?

A

VS, I&O, daily weight, assess skin turgor q 4 hours, keep safe, etc.

40
Q

What is Hypercalcemia?

A

Serum Calcium grater than 10.1 mg/dL.

41
Q

What is Hypocalcemia?

A

Serum calcium <8.9 mg/dL.

42
Q

What can cause hypercalcemia?

A

Cancer, excessive intake of vitamin D, hyperparathyroidism, immobilization (osteoclastic), reduced renal function

43
Q

What do we assess for in Hypercalcemia?

A

Muscle weakness, lack of coordination, lethargy, N/V, constipation, pruritus, kidney stones, bone pain, cardiac arrest, etc.

44
Q

What are some nursing interventions for Hypercalcemia?

A

Assist in ID of underlying cause and correcting it, fluids, safe environment, etc.

45
Q

What causes hypocalcemia?

A

Hypoparathyroidism, vitamin D deficiency, renal disease, cancer, pancreatitis, massive blood tranfusions, enema or laxative abuse.

46
Q

What are some assessment findings for Hypocalcemia?

A

Tingling in hands, fingers, feet and around the mouth, tetany, laryngospasm, positive trousseau’s sign, chvostek’s sign (Trou= use bp cuff or tourniquet, keep it on there for 3 minutes…if they spasm, they could have this!.
Chov = tap on facial nerve by ear. If they spasm..could have hypocalcemia!)

47
Q

What are some nursing interventions for Hypocalcemia?

A

ID and correct underlying cause, increase dietary calcium, etc. Seizure precaution! Keep trach tray/ambu bag near bed, in case of laryngospasm.

48
Q

What is Hyperkalemia?

A

Potassium greater than 5 mEq/L.

49
Q

What is hypokalemia?

A

Potassium lower than 3.5 mEq/L.

50
Q

What does potassium do?

A

Maintain regular heart rhythm, neuromuscular activity, related to movement of glucose, acid-base balance.

51
Q

What causes hyperkalemia?

A

Kidney failure, cellular damage, insulin deficiency (insulin is a carrier for K+. Will need insulin and glucose in IV if super high), Addison’s Disease, rapid IV infusion of potassium, high potassium intake.

52
Q

What do we assess for in Hyperkalemia?

A

Anxiety, irritability, neuromuscular weakness, GI hyperactivity, ECG changes, cardiac dysrhythmia’s, cardiac arrest/heart block.

53
Q

What are some nursing interventions for hyperkalemia?

A

Assist in identifying and correcting the underlying cause, administer meds as ordered, monitor very carefully for signs of arrest.

54
Q

What is kayexalate?

A

Extremely high potassium - explosive diarrhea!

55
Q

What causes Hypokalemia?

A

Abnormal loss of potassium (Diuretics, diarrhea, NG suction, ostomies, etc.) Inadequate placement of lost potassium, stress (severe!), Cushing’s, hyperaldosteronism, antibiotics.

56
Q

What do we assess for with Hypokalemia?

A

Muscle weakness, impaired respiratory muscle function, increased urination and thirst, ECG changes/heart changes, elevated blood glucose levels.

57
Q

What are some nursing interventions for Hypokalemia?

A

Encourage intake of potassium rich foods, monitor heart and EKG, be cautious with diuretics, identify/treat problem, teaching, etc.

58
Q

What is Hypermagnesemia?

A

Magnesium greater than 2.5 mEq/L.

59
Q

What is Hypomagnesemia?

A

Magnesium less than 1.5 mEq/L?

60
Q

What causes Hypermagnesemia?

A

renal failure, diabetic ketoacidosis, magnesium sulfate therapy, magnesium based laxative use.

61
Q

What do we assess for with Hypermagnesemia?

A

Hypotension, weakness, depressed reflexes, paralysis, bradycardia, respiratory failure, cardiac arrest/EKG changes.

62
Q

What are some nursing interventions for Hypermagnesemia?

A

ID and correct underlying cause, prepare for dialysis, protect IV access, be prepared to resuscitate, etc.

63
Q

Hypomagnesemia Causes?

A

Impaired intake, impaired intestinal absorption, excessive urinary excretion (secondary to diuretics and chronic alcoholism)

64
Q

What are some assessment findings for Hypomagnesemia?

A

Tremors, cramps, difficulty swallowing, CV changes/tachycardia.

65
Q

What are some nursing interventions for hypomagnesemia?

A

ID and treat underlying cause, encourage intake of foods high in magnesium, assess mental status, safety, swallow reflex study, etc.

Nursing - 115 (35 decks)

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