Fluids pt. 2 Flashcards
When does third space fluid shift occur?
Why?
When there’s low blood protein (albumin) in BV.
Albumin maintains osmotic pressure; fluid leaks from intravascular to interstitial
Third space fluid shift causes what condition:
What is the main treatment?
Edema
Hypertonic fluid (albumin) pulls fluid back to intravascular space
What are the symptoms of Third-spacing?
Same as hypovolemia
- Thirst
- low BP and urine
- High HR
What is the normal lab value for:
- Sodium
- Potassium
- Calcium
- Sodium= 135-145
- Potassium= 3.5-5
- Calcium= 8.5-10.5
Low and high serum levels of sodium are called:
low: Hyponatremia
high: Hypernatremia
High/low serum levels of potassium are called:
High: Hyperkalemia
low: Hypokalemia
High/low levels of serum calcium are called:
High: Hypercalcemia
Low: Hypocalcemia
Hyponatremia caused by:
Manifests as:
causes: Water intoxication, adrenal insufficiency
Manifests: Skin turgor tenting, decreased BP, neurological problems
Hypernatremia caused by:
manifests as:
causes: water loss, diabetes insipidus, heat stroke
Manifests: thirst, high temp, swollen tongue
Hypokalemia caused by:
Manifests as:
causes: blood alkalosis, GI losses
Manifests: Fatigue, muscle weakness, cardiac problems
Flat ECG T wave
Hyperkalemia causes:
Manifestation:
Causes: usually treatment related, acidosis
Manifests: Cardiac changes, Peaked ECG T wave
What should nurses be aware of with patients with renal failure?
Potassium-sparing diuretics can cause elevation of K
Do NOT use
Hypocalcemia causes:
Manifests as:
Causes: hypoparathyroidism
Manifestions: Circumoral numbness
What is Chvostek’s signs for calcemia?
Tap in front of ear:
If facial muscle contract= low calcium
What are Trousseau’s sign for calcemia?
Patient’s thumb and index finger draw together when BP cuff is inflated above systolic pressure = low calcium
Causes of hypercalcemia:
Manifests as:
Causes: hyperparathyroidism
Manifests: muscle weakness, bone pain
What is the relationship between serum calcium and serum magnesium?
Low magnesium usually equals low calcium
What are the risks associated with hypomagnesemia?
- What should healthcare providors ensure?
Patients have difficulty swallowing.
Assess ability to swallow with water before giving food/meds
What are the risks associated with hypermagnesium?
What needs to be considered?
Most medications contain magnesium.
Check all meds before administering.
What is the relationship between calcium and phosphorus?
Low calcium usually results in high phosphorus
And vice versa
Who is at most risk of hypophosphatemia?
Starved patients.
Refeeding should be gradual for malnourishment
What is the normal pH for blood plasma?
What regulates this?
- 35-7.45
* bicarbonate-carbonic acid buffer system
What organs control the bicarbonate-carbonic acid buffer system?
- Kidneys regulate bicarbonate
- Lungs (controlled by medulla) regulate CO2, carbonic acid
What are the normal values for:
CO2
pO2
HCO3 (bicarbonate)
- CO2= 35-45
- pO2= 80-100
- HCO3= 22-25
What are the pH values for high and low:
CO2
HCO3
High CO2= acidic
High HCO3= basic
What are the normal values for:
Specific gravity
What does it indicate?
1.010-1.025
High specific gravity= dehydration
What are the normal values for:
- BUN
- Creatinine
What do high values indicate?
- BUN= 10-20
High BUN= concentrated solutes in Urine
- Creatinine= 0.6-1.2
High creatinine= Kidney function failure
