IV and Electrolyte Therapy Flashcards
Biggest give away to a fluid/electrolyte imbalance?
Change in mentation
The effect of a fluid on cell volume.
Tonicity
Moves water into cell, making it swell.
Hypotonic
No impact of water movement in or out of the cell.
Isotonic
Water leaves cell, making it shrink.
Hypertonic
Primary organ for regulating fluid and electrolyte balance.
Kidney
Kidneys maintain balance by adjusting _____ volume and selectively reabsorbing water and electrolytes
Urine
Adult kidneys absorb 99% of filtrate, producing ___ L of urine/day
1.5 Liters
With impaired renal function, _______ can’t maintain fluid/electrolyte balance; resulting in edema, potassium and phosphorus retention, acidosis, and other electrolyte imbalances.
Kidneys
Adrenal cortex secretes ___ and ___.
Glucocorticoids (cortisol) and mineralocorticoids (aldosterone)
Regulate fluid/electrolyte balance
In cardiac regulation ______ are antagonists to the RAAS and ADH
They are produced by cardiomyocytes in response to increased atrial pressure and increase serum sodium.
Natriuretic peptides (ANP and BNP)
Work in the renal tubules to promote secretion of sodium and water to decrease blood volume and BP
____ intake accounts for most water intake.
Oral
GI tract secretes about _____ mL/day of digestive fluid (reabsorbed)
8,000 mL
____ and ____ prevents GI reabsorption of secreted fluid (which can lead to significant fluid/electrolyte loss).
May need isotonic solution (NS)
Diarrhea and vomiting
3 geriatric changes that affect fluid/electrolyte balance:
- Kidney changes: decrease in renal BF (blood filtration), GFR, and ability to concentrate urine.
- Hormonal changes: decrease RAAS, increase ADH and ANP
- Loss of subq: inability to respond quickly to temp changes
Fluid and electrolyte imbalances can be directly caused by ______ and/or as a result from _______ measures
Illness/disease (burns, CHF, malabsorption)
Therapeutic (diuretics, colonoscopy prep)
Prolonged NG suction/decompression can lead to ______.
Metabolic alkalosis
Deficient fluid volume
Hypocalcemia
**things would be very concentrated
Excess fluid volume
Hypervolemia
**things would be very diluted
Flash pulmonary edema (FPE)
What is the most accurate measure of volume?
Daily weights
How many mLs is equal to 1 kg (2.2 lbs)
1,000 mL
Normal urine specific gravity
1.010-1.025
Diluted-Concentrated
Skin turgid can be used to assess fluid status. What would indicate dehydration/fluid deficit?
Tenting
**Test on forearm or over clavicle
Who do we have to be careful giving fluid to?
COPD, CHF, MI
**listen to lungs and heart and monitor SpO2
Major ECF (extracellular fluid) cation?
Plays a big role in ECF volume and osmolality
Generation and nerve transmission of nerve impulses, muscle contractility, acid-base balance
Sodium (135-145)
2,000 mg/day sodium intake
