Study Guide Exam #2 (Fluid and Electrolytes) Flashcards
discuss interstitial fluid. where can it be and what does it look like on an assessment?
Interstitial fluid is found between cells. Usually found in synovial fluid in joints, cerebral spinal fluid, and ocular fluid in the eyes. Looks like edema.
discuss what the lab findings would look like in a fluid volume deficit patient
Hematocrit and Hemoglobin, potassium, urine-specific gravity, sodium - INCREASED
what is the major electrolyte in extracellular fluid ECF
Sodium
what is the major electrolyte in the intercellular fluid? ICF
Potassium
what electrolytes operate outside of the cells
sodium, calcium, ADH, chloride, bicarbonate
what electrolytes work inside the cells
potassium, magnesium, phosphorus, proteins
what is active transport
when moving fluids and electrolytes go from low to high concentration. needs energy with ATP Ex sodium-potassium pump
what is passive transport
movement of substances in and out of cells with high to low energy. no energy required. ex diffusion and osmosis
what are the normal adult blood glucose levels
70-110
discuss what and how diffusion, filtration, and osmosis work in the human body and is it active or passive transportation?
Diffusion - the process of “being widely spread,” is the random movement of molecules from an area of higher concentration to an area of lower concentration. Passive.
Filtration - the transport of water and dissolved materials through a membrane from an area of higher pressure to an area of lower pressure. Passive.
Osmosis - the diffusion of a pure solvent, such as water, across a semipermeable membrane in response to a concentration gradient, in situations where the molecules of a lower concentration to higher concentration are non-diffusible. Passive.
the sodium-potassium pumps movement of the body fluids is what type of transport
Active transport
what is the normal adult range for VS
BP: <90/<60; 120/80; <139/<89 T: 98.6F P: 60-100 R: 12-20 Pain: 1-10
name types of food that have potassium
bananas, avocados, veggies, chicken, yogourt, raisins.
HandH normal ranges for adults?
Hemoglobin:
12-16 female
14-18 male
Hematocrit:
37-47 female
42-52 male
what labs would you find elevated in a patient with hyperparathyroidism
calcium
discuss the normal range of the body’s electrolytes
Na+: 136-145 K+: 3.5-5.0 Ca+: 9.0-10.5 P-: 1.3-2.1 Cl-: 98-106 Mag+: 3.5-4.5
discuss the normal ranges for ABG’s
PaO2: 75 - 100 PaCo2: 35-45 HCo3: 22-26 Blood pH: 7.35 - 7.45 (concentration of hydrogen ions) SaO2: 95-100%
what are the normal BUN and Creatinine adult ranges
Creatinine: 0.8-1.3
Blood urea nitrogen: 8-21
what is the fastest route too hydrate someone who is dehydrated
IV fluid
name types of food that have magnesium
green leafy veggies, legumes, peanut butter, chocolate, whole grains,
ESRD patient diet should limit what food groups and why
sodium, potassium, phosphate, protein, magnesium, protein, dairy
what is the easiest way to restore proper hydration
IV fluid, drink water
chemical and protein buffers are responsible for doing what in the body
Neutralize acid. 1st chemical. 2nd lung. 3rd kidneys.
what electrolyte has the greatest influence on the bodies water balance
Sodium
a positive chvostek’s or trousseau’s sign indicates what electrolyte imbalance, and is it hypo or hyper
Hypocalcemia.
what assessment finding/s indicated your pt had chvostek’s or trousseaus’s
Numbness and tingling around the mouth.
Facial twitching
Laryngeal spasm
Abdominal muscle cramps
diminished deep tendon reflexes are indicative of hyper or hypokalemia
hypokalemia
neuromuscular and cardiac function is the responsibility of what electrolyte
potassium
what is the drug tx of choice for the patient who has hyperkalemia
loop diuretic such as Lasix (furosemide) if renal fx is adequate.
Kayexalate (sodium polystyrene sulfonate)
neuromuscular and cardiac function is the responsibility of what electrolyte
hypokalemia
would your patient who has either hypo or hyper K+ have ECG/EKG changes
Both
what is the most accurate way to dertermine your patients water balance/imbalance
Daily weight at the same time.
what are the definitions and the normal ranges for HCO3, PaCO2, pH, Pao2
PaO2: 75 - 100
PaCo2: 35-45
HCo3: 22-26
Blood pH: 7.35 - 7.45
what largest fluid compartment found in the body is
intracellular
what is the s/s of hypocalcemia
tingling. numbness and tingling around the mouth, facial twitching (chvostek’s sign), carpopedal spasm (trousseau’s sign), laryngeal spasm, laryngeal stridor, abdominal and muscle cramps, bleeding, and fractures
describe what metabolic acidosis patients ABG’s look like. Describe the possible cause/s
pH is less than 7.35.
PaCO2 is normal.
HCO3 is less than 22.
Diabetic ketoacidosis DKA Starvation Heavy Exercise Fever Seizure Kidney failure Diarrhea
describe what the metabolic alkalosis patients ABG’s would look like. Describe the possible cause/s
pH greater than 7.45.
PaCO2 is normal.
HCO3 is greater than 26.
antacids blood transfusion TPN Loss of gastric secretions potassium depletion
describe what a respiratory acidosis patients ABG’s would look like. describe possible cause/s
Ph is less than 7.35.
PaCO2 is greater than 45.
HCO3 is normal.
Hypoventilation
Respiratory depression from poisons, trauma, anesthetics. Inadequate chest expansion. Airway obstruction, asthma, and laryngospasm.
describe what a respiratory alkalosis patients ABG’s would look like. describe the possible cause/s
pH is greater than 7.45.
PaCO2 is less than 35.
HCO3 is normal.
Hyperventilation
Anxiety, fear, high altitudes, shock, early stage asthma.
what organ is responsible for excreting electrolytes out of the body
the kidneys
describe what the BUN would look like in the patient with “fluid volume deficit”
Increased
describe what the BUN would look like the patient with “fluid volume excess”
Decreased
how would the patient with FVE lungs sounds
Increased rate, shallow respirations, dyspnea, orthopnea, CRACKLES, diminished breath sounds.
what labs would you expect to see abnormal in the fluid volume excess patient
Decreased: Hct Osmolarity Urine specific gravity Sodium Arterial blood gases BUN Creatinine Potassium
hyperventilation from anxiety can cause what acid based imbalance
Respiratory alkalosis
what is a simple intervention your patient might be able to do to correct the above imbalance
Provide O2 therapy, maintain patent airway, and enhance gas exchange. GIVE PAPER BAG
what types of foods are high in sodium
cheese, milk, condiments, canned soup, canned anything
what body system is most affected by hyponatremia
the central nervous system
what electrolyte would be elevated in your patient has hyperphosphatemia
Phosphorus
what vitamin would you expect to give to the hypophosphatemia patient and why
Vitamin D. Because vitamin D enhances calcium and phosphate absorption, frequent monitoring of both is required.
what IV solution would be the most appropriate for the patient with hypernatremia
Hypotonic IV (0.3% sodium chloride)
dry mucus membranes and cracked lips indicates what
Fluid loss
respiratory depression may lead to what acid base imbalance
pH less than 7.35 and PaCO2 greater than 45
what would the patients ABG’s look like who has overdosed on ASA’s
respiratory alkalosis. CO2 low. pH is high
what symptoms would you need to report immediately to PCP in your patient who has hyponatremia and why?
muscle weakness. It puts you at risk for respiratory compromise.
metabolic acidosis causes the heart to increase or decrease why
Decreases because CO2 is less in the body.
what other symptoms would you expect your patient to have with the condition above
Diabetic ketoacidosis. Provide insulin.
GI losses. Administer antidiarrheals and provide rehydration.
If bicarb is low, administer bicarbonate.
Discuss the causes of hypovolemia
abnormal GI loses diaphoresis third spacing hemorrhage altered intake
what are the normal adult blood glucose levels
70-120
name types of foods that have magnesium
green leafy veggies, whole grain breads, nuts, beans
discuss the normal blood pH range
7.35-7.45
what types of food that have calcium
dairy, kale, sardines, yogurt
discuss the importance of sodium in the body
Your body uses 99 percent of its calcium to keep your bones and teeth strong, thereby supporting skeletal structure and function
what is the normal urine specific gravity range
1.005- 1.030
what would be the s/s of dehydration
dry mouth, lethargic, cracked lips, dry skin, sunken eyes
what is ATP
ENERGY. Transports it. Adenosine triphosphate
what is a simple intervention your patient might be able to do to correct hyperventilation from anxiety
provide O2 therapy, maintain patent airways, enhance gas exchange
what electrolyte would be elevated if your patient has hyperparathyroidism?
hypercalcemia
