Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 112 > NUR 112 Exam 1 Electrolytes: FVD, FVE & Na+ > Flashcards

NUR 112 Exam 1 Electrolytes: FVD, FVE & Na+ Flashcards

1
Q

What is hypovolemia?

A

ECF volume deficit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is hypervolemia?

A

ECF volume excess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Is FVD the same as dehydration?

A

No!

Dehydration = loss of pure water w/out Na+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

List the 3 MAIN causes of FVD

A
  1. abnormal loss of body fluid
  2. inadequate fluid intake
  3. Shift of fluid from plasma to IF (edema)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List 5/10 causes/examples of abnormal loss of body fluids leading to FVD

A 
vomiting
diarrhea
fistula
hemorrhage
polyuria
NG suction
x.s. diuretics
insensible loss/perspiration
diabetes insipidus (x.s. ADH)
third spacing - burns, intestinal obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

list 3 possible Tx for FVD

A

LR
0.9% NS
Blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

s/s FVD 1. CNS related (5)

A
  1. restlessness, drowsiness, lethargy, confusion, coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q 
Do the following indicate FVD or FVE?
inc resp rate
inc pulse rate
dec CVP
dec urine output
urine specific gravity 1.035
A

FVD
less vol blood to carry O2 so resp rate inc.
less vol blood to carry O2 so HR rate inc
less blood vol so CVP dec
kidneys compensate by reabsorbing H2O
urine becomes more concentrated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q 
What do the following s/s indicate?
thirst
dec skin turgor
postural hypotension
weakness
dizziness
weight loss
A

FVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

List the 3 MAIN causes of FVE

A
  1. Excess in take of fluids
  2. Abnormal retention of fluids
  3. Shift of fluid from IF to plasma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

List 3/5 causes/examples of abnormal retention of body fluids leading to FVE

A 
heart failure (correct exchange does not occur with IF/cells)
renal failure (kidneys do not excrete appropriate fluid)
SIADH too much ADH = too much H2O kept
Cushing's (x.s. cortisol acts like aldosterone and retains Na+ which in turn retains H2O)
Long term corticosteroid use (see above)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

list 3 possible Tx for FVE

A
  1. restrict fluids
  2. diuretics
  3. restrict Na+
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

s/s FVE related to lungs (3)

A
  1. dyspnea
  2. crackles
  3. pulmonary edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q 
What do the following s/s indicate?
headache
confusion
lethargy 
peripheral edema
weight gain
A

FVE
cells swell and x.s.fluid in blood puts pressure on nerves causing pain
CNS - cells swell
CNS - cell swell
pressure caused by x.s.fluid in intravascular forces fluid to interstitium = edema
1L weighs 2.2 lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pt. presents with bounding pulse, JVD, normal renal function and polyuria what do you suspect is the primary cause?

A

FVE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

FVE or FVD?

seizures, muscle spasms progressing to coma

A

FVE
pressure on nerves causes seizures
electrolytes overdiluted causes muscle spasms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What do nurses assess for FVE/FVD?

6 main categories/systems

A 
1. I & O
urine specific gravity
2. daily weights
3. Cardiac system
HR, Pulse pressure, JVD, BP
4. Respiratory system
resp rate inc = FVD 
SOB, crackles, cough = FVE
5. Neurological
LOC A&O x3, pupillary response, voluntary movement of extremities & strength
6. Integumentary
skin turgor
dry mucous membranes,
18
Q

Edematous skin may be cool to touch - why?

A

dec in blood flow, secondary to increased pressure of interstitial fluid build up.

19
Q

Pt. on NG suction are not typically given water to drink - why?

A

H2O pulls electrolytes from GI cells - which are then suctioned and removed from body.

20
Q

What fluid is used to irrigate a NG suction tube?

A

0.9% NS

21
Q

3 ways Na+ excreted from body?

A

urine
sweat
feces

22
Q
  1. ADH regulates water or sodium?

2. Aldosterone directly regulates water or sodium?

A
  1. H2O - retention

2. Na+ - reabsorption

23
Q

changes in serum Na+ may reflect a primary _________________ imbalance.
A primary _______________ imbalance or __________

A
  1. water (too much or too little)
  2. sodium (too much or too little)
  3. both!
24
Q

hypernatremia caused by 1. _______ of H2O, or ___________ of Na+

A
  1. loss H2O

2. gain Na+

25
Q

list 4 disease states that cause hypernatremia

A
  1. diabetes insipidus (too much ADH - too much H2O lost in urine)
  2. hyperglycemia - due to uncontrolled diabetes mellitus - causes osmotic diuresis so dilute urine is lost & Na+ is left behind.
  3. cushing’s X.S. cortisol acts like aldosterone and keeps Na+
  4. primary aldosteronism - x.s. aldosterone made by body.
26
Q

s/s hypernatremia with normal ECF volume

do not list all that occur with FVD and normal FV - just those specific to normal FV

A

Intense thirst with normal mucous membranes

weight gain

27
Q

s/s hypernatremia with FVD

A 
restlessness
agitation
twitching (neurons more easily activated)
seizures
coma
weakness
lethargy
intense thirst - dry swollen tongue - sticky mucous membranes
postural hypotension
weight loss
28
Q

Tx for H2O deficit hypernatremia

  1. aim of Tx
  2. fluids used
  3. Tx fast or slow & why?
A
  1. Replace H2O, prevent further loss
  2. IV D5W
    Hypotonic NS (0.45% NS)
  3. slow - prevent cerebral edema
29
Q

Tx for X.S Na+ hypernatremia (2)

A
  1. diuretics

2. restrict Na+ intake

30
Q

loss of Na+ from body

inc. in H2O in body can both lead to …….

A

hyponatremia

31
Q

2 types of Iv fluids can cause hyponatremia

A
  1. hypotonic

2. sodium free

32
Q

does SIADH cause hypernatremia or hyponatremia?

Explain:

A

Hypo.

x.s. ADH causes body to retain x.s. H2O - dilutes Na+ alters ratio. effectively dec. Na+ in body

33
Q

List 6 ways Na+ rich fluids are abnormally lost from body

A 
diarrhea
vomiting
NG suction
fistulas
burns
wound drainage
34
Q

What effect do hypoaldosteronism and adrenal insufficiency have on the body?

A

too little Na+ reabsorbed

35
Q 
What do the following indicate?
irritability
apprehension
confusion
dizziness
personality changes
tremors
seizures
coma
tachycardia
thready pulse
orthostatic hypotension
cold clammy skin
dry mucous membranes
A

Dec ECF Vol hyponatremia

cells swell - CNS effects

36
Q

Normal ECF Vol with hyponatremia s/s include:

A 
NVD
abdominal cramps
headache
apathy
confusion
muscle spasms
seizures
coma
37
Q

Tx hyponatremia caused by x.s. H2O (2)

A
  1. fluid restrictions

2. if seizures develop 3% NS

38
Q

Tx hyponatremia caused by fluid loss

A

replace fluid with IV solutions containing Na+

39
Q

Drugs that block ADH can be used to Tx hyponatremia (2)

A

Conivaptan - inc urine output while conserving Na+ & K+

Tolvaptan - used for HF, Liver cirrhosis, SIADH

40
Q

Implementation of nursing care for a patient with hypernatremia includes:

a. fluid restriction
b. administration of 3% NS IV fluids
c. administration of D5W IV fluids
d. administration of drugs that block ADH such as Conivaptan

A

c. administration of D5W IV fluids

hypotonic - adding free water to dilute NA+

NUR 112 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions