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NU250 > Test 1 > Flashcards

Test 1 Flashcards

1
Q

What is the primary fluid in humans

A

Water

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2
Q

What is the percent of fluids in the average adult

A

60%

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3
Q

What is the amount of fluid in an infant

A

70%

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4
Q

What percentage makes up elderly bodies of fluid

A

50-55%

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5
Q

What are the functions of body fluid

A

Maintain blood pressure
Medium for excreting waste
Transport materials in and out of cells(as well as through the body)
Medium for cellular metabolism
Maintain body temperature
Assist with food digestion

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6
Q

Two compartments for fluids to go

A

Intracelular
Extracellular

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7
Q

What are the spaces in extracellular

A

Interstitial
Intravascular
Transcellular

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8
Q

ICF

A

Intercellular fluid
Majority of all fluid in the body

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9
Q

ECF

A

Fluid found out side of the cell can be found in three spaces
In the vascular system
Interstitial between the cells
Or specialized fluids contained in body spaces.

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10
Q

What is it called if there is fluid found in none of the ECF spaces or ICF

A

Third spacing
Broad term for any fluid that is abnormal in spacing

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11
Q

Intravascular fluid

A

Fluid found in the vascular system this is the plasma in the blood.
Second smallest amount of fluid out of the 4

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12
Q

Transcellular fluid

A

Smallest portion of fluid found in the body
Specialized fluids contained in the body
CSF

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13
Q

What is the recommended amount of water a female should take in during the day

A

2700 ml/day

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14
Q

How much fluids should males intake in a day

A

3500ml/day

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15
Q

What percentage of fluids should come from food

A

20%

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16
Q

What are in control of thirst

A

Aldosterone
Hypothalamus

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17
Q

What is sensible fluid loss from urine in a day

A

1,500ml/day

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18
Q

What is a sensible loss of fluids from bowl movements in a day

A

100-200ml/day

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19
Q

If the loss of fluid isn’t sensible what is it

A

Insensible you cannot see the loss

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20
Q

What are the routes of insensible loss

A

Through skin and perspiration
While breathing exiting through the lungs to the air

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21
Q

If you have more fat what happens to fluid volume

A

The amount goes down for the total percentage

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22
Q

What plays a factor on total body fluid

A

Age older you get the less you have
Sex males have for fluid
Fat deposits the more fat you have the less fluids you’ll have

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23
Q

How much does your ICF contribute to your total weight

A

40%

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24
Q

What receptors activate thirst in the brain

A

Osmoreceptors

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25
Q

In what direction does water flow

A

Water follows the way of the higher concentration

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26
Q

Hydrostatic pressure

A

Pressure on capillary walls by fluids to leave

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27
Q

Oncotic pressure

A

Pulls fluid into the capillaries

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28
Q

What does oncotic pressure prevent

A

Particles called Colloids passing through the cell membrane

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29
Q

Hydrostatic pressure > oncotic pressure

A

Fluid enters capillaries

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30
Q

Sodium

A

135-145mg/dl
Encourages osmosis
Attracts water

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31
Q

Albumin role in osmosis

A

Maintains Intravascular oncotic pressure
Attracts water

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32
Q

Tonicity

A

Refers to the osmotic pressure gradient between two solutions

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33
Q

Isotonic

A

Same concentration as blood
Will not have fluid leave or enter a cell

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34
Q

Hypotonic

A

Less concentration in the solution than the blood. Water will follow the concentration and go to the cells

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35
Q

Hypertonic

A

Greater concentration in solution than in the blood. Fluid will leave the cells for the high concentration in the fluid

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36
Q

Where are osmoreceptors

A

Hypothalamus

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37
Q

ADH hormone

A

Released by posterior pituitary gland
Decreases urine output
Body will hold onto water
Increases blood pressures

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38
Q

What is renin

A

A hormone to retain water and sodium from the kidney

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39
Q

What two solutes are very water attractive

A

Sodium
Glucose

Too much can cause dehydration

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40
Q

Dehydration

A

Low fluid volume

Step one fluid leaves ICF of cells, cells shrink

Step two low ECF causes tachycardia, low blood pressure

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41
Q

Fluid excess

A

Holding on to fluid in the body

Hypertension
Edema
Increase urine output

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42
Q

Dependent edema

A

Edema related to the influence of gravity on the area effected

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43
Q

What can low oncotic pressure cause

A

Edema

Can be from hypoalbuminemia (protein in blood that attracts water back to the vascular system)

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44
Q

Mannitol

A

Osmotic diuretic
Decreases cerebral edema

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45
Q

What are the 5 most important ions

A

Sodium Na+
Potassium K+
Calcium Ca++
Phosphorus PO4 3-
Magnesium ++

46
Q

What can cause third spacing

A

Burn wounds

47
Q

Insensible fluid loss

A

Not perceived
Skin and lungs

48
Q

Olguria

A

Less than 30ml of urine a hour

49
Q

Insensible fluid loss by skin and lungs

A

900 ml a day

600 by skin
300ml a day by lungs

50
Q

Insensible loss increases with

A

Wounds, burns, skin breakdown

51
Q

Nursing management of fluid volume deficit

A

Measure I&O
Check electrolytes, CBC, urine gravity
Asses for hypotension/ weak pulse
Asses respiratory and perfusion
Asses orientation, vision, reflexes, hearing, muscle strength
Daily weight
Check for skin breakdown

52
Q

Causes of dehydration

A

Inadequate fluid intake
No water no salt or both

Diabetes
Vomiting and diarrhea
Surgery
Trama
Burns

53
Q

First symptom of dehydration

A

Thirst

54
Q

Positive orthostatic hypotension blood pressure

A

Systolic change by 20

55
Q

Significant weight loss

A

5%
10% is severe
15% is fatal

56
Q

What can sodium imbalances lead to

A

Cerebral edema
Seizures

57
Q

Who are likely to be hypomagnesiemia

A

Alcoholics

58
Q

What are ways someone can become hypernatremic

A

Excess sweat with little intake
Supplements that are concentrated
Taking lithium
Burns
Diabetes
Flu like symptoms such as fever and diarrhea

59
Q

What can be causes of hyperkalemia

A

Renal failure
GFR that’s low (below 50, 20 for example)
High creatine serum levels

Adrenal cortex insufficiency (addisons disease lack of aldosterone causes secondary hyperkalemia)

Potassium sparing diuretic

Drugs that interact with kidney such as NSAID

60
Q

What can cause hypomagnesemia

A

Alcoholic
Positive Chvostek sign
Abusing laxatives
Malnourished

61
Q

What can cause hypermagnesemia

A

Lithium toxicity
Taking milk of mag

62
Q

Hypercalcemia

A

8.2-10.2mg/dl

Malignant tumors such as lymphoma
Cancer that has metastasize to bone

Theophylline toxicity

63
Q

Hypocalcemia

A

8.2-10.2mg/dl

Pregnancy
Chronic alcoholism
Limited dairy intake
Vitamin D deficiency

64
Q

Low phosphorus

A

Normal 2.5-4.5mg/dl

Inverse with calcium

Respiratory Alkalosis phosphate shifts to the cell

Excessive burns through water salt diuresis

Refeeding syndrome

AKI from hypovolemic event

65
Q

What electrolyte imbalances can lithium cause

A

Hypernateremia
Hypermagnesemia

66
Q

How many grades of phlebitis are there

A

4

67
Q

What are the three routes to cause phlebitis

A

Mechanical
Chemical (potassium)
Bacterial

68
Q

Nurse management for fluid overload

A

Daily weight
Fluid restriction
Measure I&O
Asses lung sounds for wet crackles (pulmonary edema)
Check LOC
Edema check

69
Q

Overhydration

A

Too much salt intake
Too much fluid intake
Kidney failure
Heart failure

Pulmonary congestion
High BP
Bounding pulse
Tachycardia
Extended JVD
Dependent pitting edema

70
Q

A nurse caring for a patient with third spacing what condition should the nurse watch for

A

Excessive edema

71
Q

Where gravity iv’s used

A

Surgery pre op post op
Emergency room
Field start

72
Q

When do you clear a IV pump

A

At start and end of shift
So you can document what was delivered during your shift

73
Q

Phlebitis

A

Swelling, pain at the site

Caused by too large of cath
Improperly secured cath or tubing
Meds not diluted or too quick of a rate (K+)

74
Q

What Can phlebitis lead to

A

Thrombosis
Sepsis

75
Q

Phlebitis grade 0

A

No sighs or symptoms monitor site

76
Q

Phlebitis grade 1

A

Redness at site with or without pain observation of site

77
Q

Phlebitis grade 2

A

Pain at site with redness and/or edema
Stop iv consult Iv therapy

78
Q

Phlebitis grade 3

A

Pain at access site with erythema and/or edema, streak formation along vein and palpable venous cord

Stop IV asses damage switch sides.

79
Q

Phlebitis grade 4

A

Pain at access site. Erythema and/or edema, streak formation along vein, palpable venous cord >1 inch
Purulent drainage

Stop immediately asses site inform provider

80
Q

Which site has lowest rate of phlebitis

A

AC elbow

81
Q

Highest rate of phlebitis

A

Hand sites

82
Q

Treatment of phlebitis

A

Warm compress 3 times a day

83
Q

What setting has highest rates of bacterial phlebitis

A

Ems field starts
Emergency situations

84
Q

True or false
Phlebitis can start after removing iv catheter

A

True

85
Q

Infiltration

A

Can happen to any iv device
Fluids infuse to tissue

86
Q

How Can infiltration happen

A

A fibrin sheath blocks flow causing backflow

87
Q

What are signs and symptoms of infiltration

A

Non blanchable skin
Coolness to touch
Sharp pain

88
Q

Treatment for infiltration

A

Time the body will reabsorb fluid
Warm compress can speed it up

89
Q

Thrombosis

A

Clot formation in the vein

90
Q

Causes of thrombosis

A

Venous trauma, low flow rate

91
Q

Thrombosis signs

A

Hard to flush iv, constant iv occlusion, low flow rate.

92
Q

How to prevent thrombosis

A

Flush before and after medication and at regular times to keep line open and clear.

93
Q

Hematoma

A

Blood leaking out of vein pooling in tissue space.

94
Q

Causing of hematoma

A

Wrong technique for placement. Pulling back not proceeding forward
Going all the way through vein
Steroids (makes skin tissue thin and weak)
Anticoagulants

Not enough pressure when removing iv

95
Q

Venous spasm

A

Sudden involuntary contraction of vein

From cold infusion or irritating infusion

Cramping and pain above the site going up the arm

Can clamp down on central line when removing

96
Q

Venous spasm prevention

A

Dilution of medicine
Proper rate
Warm up solution before infusion

Warm compress

97
Q

Extravasation

A

Infusion of medication into tissue
Causes blisters
Necrosis
Sloughing

Phenergan
Dilantin
Dopamine
Kcl

98
Q

How to prevent extravasation

A

Verify iv is good, flush before/after
Treat with antidote if possible

99
Q

Iv complications prevention

A

Ask patient if it hurts
Check compatibility
Flush iv looking for swelling ease of push tissue density

100
Q

What do you check after removing a iv

A

Check the catheter to make sure it didn’t break off

Feel for it tie off above location
Call provider
Put patient on left side to prevent going to pulmonary artery

Life threatening

101
Q

How many layers do veins have?

A

3 layers

Inside -tunica intima. Endothelium
Middle- tunica media. Smooth muscle
Outside - tunica adventia Fineries connective tissue

102
Q

Tunica intima

A

Single layer of endothelial cells
Inside layer of veins

103
Q

What do you avoid when doing a iv on a vein

A

Bumps on the veins
Those are the valves

Avoid scarring

Avoid going distally from previously blown Ivs

Locations that are highly susceptible to phlebitis

104
Q

Why do you avoid the side of a mastectomy

A

Poor lymph drainage

105
Q

Best spot for iv for obese patients

A

Hands and forearms

106
Q

Where would you start the iv

A

Start distally then move in

107
Q

Catheter sizes

A

Grey 16g
Green 18g
Blood/ large volume

Pink 20g could do blood
Blue 22g
Yellow 24g peds

108
Q

ABG

A

Arterial blood gas

109
Q

Test before ABG

A

Allen test to check radial and ulnar artery blood flow

110
Q

ABG values

A

PH 6.8-7.8
PaCo2 35-45 mmhg
Hco 22-28 mmhg

111
Q

Tube types

A

Dobhoff tube for nasalduodenal feeding

Sengstaken-blakemore has a ballon for esophageal bleeding

Salem pump for continuous suction

Ewald for stomach irrigation

NU250 (8 decks)

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