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Adult Health 1 > Quiz One ch.14&15 > Flashcards

Quiz One ch.14&15 Flashcards

1
Q

Causes for Isotonic fluid loss (8)

A

Porportional loss of fluid to solute

  1. hemorrhage
  2. GI losses
  3. wound drainage
  4. fever
  5. environment
  6. burns
  7. diuretics
  8. third space fluid shifts
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2
Q

what would cause hypertonic fluid loss?

whats the ratio?

A

more water/NA than solute

  1. inability to responsd to thirst
  2. decreased H20 intake
  3. NPO status
  4. Diabetes Insipidus
  5. brain injury
  6. increased intake of solute
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3
Q

signs and symptoms of FVD (fliuid volume deficit)

A

Thirst
Concentrated urine
Low urine volume
Dry skin / ↓ turgor
Sunken eyeballs
Sunken or depressed fontanels
Hypotension
Decreased cardiac output
Tachypnea
Low grade fever
Mental status changes
Acute weight loss

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4
Q

what causes isotonic fluid excess? (5)

A
  1. Renal failure
  2. heart failure
  3. excess intake
  4. high corticosteroid levels (stress, disease, therapy-)
  5. high aldosterone levels
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5
Q

What sodium levels in the blood become too low what happens to the cell?

A

excess water enter cells and cause the cells to swell

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6
Q

Hypotonic fluid excess?

possible causes? (6)

A

More fluid than solute

  • Repeated plain water enemas
  • Repeated plain water NG tube or bladder irrigations
  • Overuse of hypotonic IV fluids too rapidly
  • Overzealous plain water intake
  • SIADH
  • Heart failure, renal failure, cirrhosis of the liver
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7
Q

Signs of Fluid Volume Excess (FVE)

A

Peripheral edema
High CVP
Pulmonary edema
Acute rapid weight gain
Altered urine output/concentration
Distended neck veins
Crackles
Tachycardia
Increased weight
Shortness of breath/wheezing

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8
Q

best bed position for a fluid overload?

A

semi fowlers

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9
Q

Normal sodium (Na) level?

A

135-145

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10
Q

Normal Potassium (k) level?

A

3.5-5.5

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11
Q

normal calcium (Ca) level?

A

8.5-10.2

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12
Q

Normal magnesium (Mg) level?

A

1.8-2.7

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13
Q

normal phosphorous level

A

2.5-4.5

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14
Q

Normal chloride (Cl) level

A

96-108

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15
Q

Normal plasma pH?

A

7.35-7.45

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16
Q

what is hyponatremia?

A

abnormally low level of sodium in the blood, less than 135 mEq/L

17
Q

What are the possible causes of hyponatremia?(7)

What are the signs/symptoms/manifestations?(8)

A
  1. Adrenal insufficiency
  2. Water intoxication
  3. SIADH
  4. Vomiting
  5. Diarrhea
  6. Sweating
  7. Diuretics

s/s:

  1. Poor skin turgor
  2. Dry mucosa
  3. Headache
  4. Decreased salivation
  5. Decreased BP
  6. Nausea
  7. Abdominal cramping
  8. Neuro changes
18
Q

how do we manage hyponatremia?

A
  • water restriction
  • monitor sodium
  • teach effects of medication
19
Q

What is Hypernatremia?

possibe causes?

s/s manifestations?

how do we manage it?

A

excess amounts of sodium in the blood, serum sodium greater than 145 meq

  • Excess water loss
  • Excess Na admin.
  • Diabetes insipidus
  • Heat stroke
  • Hypertonic IV solution
  1. Thirst
  2. Elevated temperature
  3. Dry, swollen tongue
  4. Sticky mucosa
  5. Nuero symptoms
  6. Restlessness
  7. Weakness
  • hypotonic electrolyte soln
  • D5W
  • assess OTC sources of sodium
  • encourage fluids
  • H20 via feeding tube
20
Q

what is hypokalemia?

possible causes?

s/s/m?

management?

A

low levels of potassium, less than 3.5 meq

  • GI losses
  • Medications
  • Alterations of acid-base balance
  • Hyperaldosteronism
  • Poor dietary intake
  1. Fatigue
  2. Anorexia
  3. N/V
  4. Dysrhythmias
  5. Muscle weakness
  6. Cramps
  7. Paresthesias
  8. Glucose intolerance
  9. ↓ muscle strength

increase dietary K, D5W, monitor EKG, ABG’s

21
Q

What is hyperkalemia?

causes?

manifestations, s/s?

Managment?

A

serum potassium greater than 5.0 mEq/L

  • Treatment related
  • Impaired renal fx
  • Hyperaldosteronism
  • Tissue trauma
  • Acidosis
  • *Other
  1. Cardiac changes
  2. Dysrhythmias
  3. Muscle weakness
  4. Potential respiratory impairment
  5. Paresthesias
  6. Anxiety
  7. GI manifestations
  • Monitor EKG
  • limit dietary K
  • monitor med effects
  • dietary teaching
22
Q

what is hypocalemia?

Possible Causes?

Manifestations?

Management?

A

serum calcium less than 8.5 mEq/L

  • Hypoparathyroidism
  • Malabsorption
  • Pancreatitis
  • Alkalosis
  • Massive transfusion of citrated blood
  • Renal failure
  • Medications
  1. Tetany
  2. Circumoral numbness
  3. Paresthesias
  4. Hyperactive DTR’s
  5. Trousseau’s sign
  6. Chvostek’s sign
  7. Seizures
  8. Respiratory symptoms
  9. Dyspnea
  • IV calcium gluconate
  • Calcium
  • Vitamin D
  • Diet
  • Weight bearing exercises
  • Patient teaching
  • IV calcium administration
23
Q

What is hypercalemia?

Possible causes?

Manifestations?

Managment?

A

when serum calcium is greater than 10.2 mEq/L

  • Malignancies
  • Hyperparathyroidism
  • Tumors
  • Immobilization
  • Thiazide diuretics
  • Vitamin A & D intoxication
  • Lithium and theophylline toxicity
  1. Anorexia
  2. N/V - Dehydration
  3. Constipation
  4. Abdominal/bone pain
  5. Excessive urination
  6. Severe thirst
  7. Confusion, impaired memory, slurred speech, lethargy, acute psychotic behavior or coma
  • Fluids 3/4 L a day
24
Q

What is hypomagnesim?

possible causes?

manifestations?

management?

A

serum magnesium less than 1.8 mg/dl

  • Alcoholism
  • GI losses
  • Enteral/parenteral feeding deficient in Mg
  • Medications
  • Rapid administration of citrated blood
  • Diabetic ketoacidosis
  • Sepsis
  • Burns/hypothermia
  1. Neuromuscular irritability
  2. Muscle weakness
  3. Tremors
  4. EKG changes
  5. Dysrhythmias
  6. Alterations in mood/LOC
  7. Athetoid movement

Diet
Oral Mg
MgSO4 IV
Patient teaching

25
Q

what is hypermagnesium?

possible causes?

manifestations?

management?

A

serum magnesium greater than 2.7 mg/dl

  • Renal failure
  • Diabetic ketoacidosis
  • Excessive MgSO4
  1. Flushing
  2. Lowered BP
  3. N/V
  4. Hypoactive reflexes
  5. Drowsiness
  6. Muscle weakness
  7. Depressed respirations
  8. EKG changes
  9. Dysrhythmias
  • IV calcium gluconate
  • Loop diuretics
  • Avoid MgS04 meds
  • IV NS or RL
  • Hemodialysis
  • Pt teaching r/t OTC medications with MgSO4
26
Q

what is Hypophosphatemia?

possible causes

A

serum phosphate less than 2.5 mg/dl

  • ETOH
  • Refeeding pts after starvation
  • Pain
  • Heat Stroke
  • Respiratory alkalosis
  • Hyperventilation
  • Hepatic encephalopathy
  • Major burns
  1. Neuro symptoms
  2. Confusion
  3. Muscle weakness
  4. Tissue hypoxia
  5. Muscle and bone pain
  6. ↑ susceptibility to infection
  • Oral or IV phosphorus
  • Encourage food high with phosphorus
  • Gradually introduce calories for malnourished pts on parenteral nutrition
27
Q

What is hyperphosphatemia?

possible cause?

manifestations?

management?

A

serum magnesium greater than 4.5 mg/dL

  • Renal failure
  • Excess phosphorus
  • Excess Vitamin D
  • Hypoparathyroidism
  • Chemo
  1. Soft tissue calcifications
  2. Symptoms r/t associated hypocalcemia
28
Q

Hypochloremia?

possible causes?

manifestations?

management?

A

serum chloride less than 96 mEq/L

  • Addison’s disease
  • Reduced chloride intake
  • GI loss
  • Diabetic ketoacidosis
  • Excessive sweating
  • Fever/burns
  • Medications
  • Metabolic alkalosis
  1. Agitation
  2. Irritability
  3. Weakness
  4. Hyperexcitability of muscles
  5. Dysrhythmias
  6. Seizures
  7. Coma
  • Replace Chloride
  • IV NS or 0.45% NS
  • Avoid free water
  • Encourage high-chloride foods
  • pt teaching r/t high chloride foods
  1. Restore electrolyte and fluid balance
  2. Lactated Ringers
  3. Sodium bicarbonate
  4. Diuretics
  5. Provide pt teaching r/t diet and hydration
29
Q

what is the normal plasma pH?

A

7.35-7.45

Adult Health 1 (6 decks)

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