January 28 - Fluid Electrolyte BalanceIV Therapy Flashcards
What is homeostasis
Balance of fluids
Balance of electrolytes
Balance between acid and base
How much L in
Plasma:
Interstitial Fluid:
Intracellular Fluid:
3 L
10 L
28 L
What is dehydration
- Lack of?
- Changes in
- Causes
- No water/ No Salt
- Causes changes in skin turgor, hypovolemia, tachycardia, weak pulse, postural hypotension, and confusion
- Watch for thirst, dry skin, sticky or dry mucous membranes, weight loss and concentrated urine
Fluid Volume Excess
- What is it
- Causes
- Decreased what
- how to manage
Too much fluid going in, none coming out
Causes:
- Changes in LOC, confusion, Headache, seizures
- Pulmonary congestion
- Bounding pulse, Increased BP, presence of S3, tachycardia
- anorexia, nausea
- edema
- decreased sodium concentrations
- resp assessments, check LOC, watch for edema, cardio checks
Fluid Balance: Cellular Level
Passive transport:
Osmosis
Diffusion
(What is each)
Active transport:
ATP
Osmosis = low to high concentration
Diffusion = high to low concentration
Cap Network
- what pressures
- involves what ends
Hydrostatic pressure
Osmotic pressure
Venous end vs. arterial
Sodium: -what are the Normal levels Primary Electrolyte in ECF -what are the Roles: -increased serum levels: -decreased serum levels: Not stored in body: daily intake needed -hypo or hypernatremia (depends on loss of Na compared to H2O)
Sodium (Na+): 135-145 mmol/L
Primary electrolyte in ECF
Role: fluid volume, interaction between nerves/muscles
Increased serum levels: Intake (diet, PO/IV fluids)
Decreased serum levels: large H20 intake, perspiration
Not stored in body: daily intake needed
Hypo or hypernatremia (relates to the amount of H20 loss compared to Na)
Hypernatremia “fried salt”
SS
More then 145
- Flushed skin and fever
- Restless, irritable, anxious, confused
- Increased blood pressure and fluid retention
- Edema: peripheral and pitting
- Decreased urine output and dry mouth
S: Skin Flushed
A: Agitation
L: Low-Grade fever
T: Thirst
Hyponatremia cause
SS
Less then 135
Decreased sodium caused by dilution of excess water
Lethargy, headache, confusion, apprehension, seizures, coma
Chloride Serum chloride: ? Most abundant anion in ECF Goes along with what Acid -base balance requires ? Aids in?
Serum chloride: 95-105 mmol/L
Most abundant anion in ECF
Along with sodium to maintains osmotic pressures
Acid-base balance requires sodium to be in balance with chloride and bicarbonate
Aids in digestion
Potassium
Serum levels?
Primary electrolyte where?
Hypokalemia is?
- excessive?
- SS?
Hyperkalemia is?
SS
Monitor these drugs
Monitor these pts
Potassium (K+) 3.5 – 5.0 mmol/L
Primary electrolyte in ICF
Hypokalemia: <3.5 mmol/L
excessive u/o, diarrhea, vomiting
S/S: arrhythmias, fatigue, muscle activity changes
Hyperkalemia: >5.0 mmol/L e.g. renal failure, high intake
Etiology: diarrhea, vomiting, diuretics
Digitalis, diuretics and iv fluids
Renal Failure, hydration imbalances, acid- base imbalances, cell dmg, diabetes
Acid Base Balances
Normals
pH -
PaCo2 -
HCO3 -
pH (7.35-7.45)
PaCO2 (35-45 mmHg)
HCO3 (22-26 mEq/L)
Purpose of IV therapy 4
- Maintain or restore fluid, electrolyte and/or acid-base balance.
- Restore intravascular volume (fluid losses, poor intake)
- Provide vascular access e.g. medications, diagnostic agents.
- Provide nutrition.
Isotonic solution
Hypertonic solution
Hypotonic solution
What is it
Kinds of solution
Same as blood
- REMAINS THE SAME’/ expand volume, dilute meds, keep veins open
- 0.9 % NS, D5W (isotonic until inside body, then hypo) [ metabolize glucose], Lactated ringers
More solutes then blood
- CELL BALLOONS (ADDS VOLUME)
- D5NS, D5 1/2 NS (na and volume replacement)
Less solutes then blood
- CELLS SHRINK
- 0.45% NS
What is primary Line A for B
maintenance line/ fluid
Meds
