Test 1 SG Flashcards
Water does not move into or out of body’s cells
• Risk for fluid overload, especially older adults
Isotonic fluid
Types is isotonic fluid
NS, LR, D5W -
Corrects fluid, electrolyte, and acid–base imbalances by moving water out of body’s cells, into bloodstream
Hypertonic fluid
Types of hypertonic fluid
3% saline & parenteral nutrition, d5NS
Moves water into cells & expands them
Hypotonic
Hypotonic fluid
Ex: ½ NS & less
solutions are used to correct altered FLUID AND ELECTROLYTE BALANCE and acid-base imbalances. These fluids are infused, water moves out of the cells in an attempt to dilute the infusate, shrinking the cells.
Hypertonic
solutions are commonly used to give fluids intravenously to hospitalized patients in order to treat or avoid cellular dehydration.
Hypotonic
solutions- hemorrhage, vomiting, diarrhea, hypovolemia, hemorrhage, drainage from GI suction, metabolic acidosis, or shock.
Isotonic
135-145, Wherever this goes, water follows, Responsible for excitable cell membrane depolarization, S/S of Na+ alterations are d/t effects on excitable cellular activity
Sodium
- 1.3-2.1- Critical for skeletal muscle contraction
- Carbohydrate metabolism
- ATP formation-fuel for cells
- Vitamin activation
- Cell growth
Magnesium
9-10.5
Absorption requires active form of vitamin D, stored in bones, Parathyroid hormone-increases serum Ca+, Thyrocalcitonin-decreases serum Ca+, Ca+ stabilizes action potentials in cells
Calcium
- Normal level: 3.5 to 5.0 mEq/L
- Almost all foods contain potassium
- Sodium-potassium pump
- Moves extra Na+ from the ICF & moves extra K+ from the ECF back into the cell.
- Serum K+ remains low & cellular K+ remains high
Potassium
Normal & abnormals & signs & symptoms of
Elevated: Hypernatremia;
dehydration; kidney disease; hypercortisolism
Low: Hyponatremia; s/s
fluid overload; liver disease; adrenal insufficiency
Elevated: Hyperkalemia;
dehydration; kidney disease; acidosis; adrenal insufficiency; crush injuries
Low: Hypokalemia;
fluid overload; diuretic therapy; alkalosis; insulin administration; hyperaldosteronism
Elevated: Hypercalcemia;
hyperthyroidism; hyperparathyroidism
Low: Hypocalcemia;
vitamin D deficiency; hypothyroidism; hypoparathyroidism; kidney disease; excessive intake of phosphorus-containing foods and drinks
Elevated: Hypermagnesemia;
kidney disease; hypothyroidism; adrenal insufficiency
Low: Hypomagnesemia;
malnutrition; alcoholism; ketoacidosis
Assessment findings & techniques
Hyponatremia-
Caused by:
S/s
• Na+ less than 135 • Often occurs with a fluid imbalance • Prolonged use of diuretics • Excessive sweating • SIADH • Psychogenic water intoxication • Excess water in plasma leads to dilution of Na+ • Hypovolemia s/s • Altered mental status/confusion • Muscle weakness • Seizures • Decreased deep tendon reflexes • Increased GI motility • Changes in cardiac output • Coma
Hypernatremia-
Caused by:
S/s
Dehydration
-Diabetes Insipidus
Usually due to a LOSS OF WATER (vomiting, excessive diarrhea-leads to dehydration)
s/s:
-Decreased urine output
NEURO: short attention span, agitation, confusion, coma
-Thirst, dry mucous membranes, flushed
Hyperkalemia
Caused by
RARE unless chronic or acute kidney failure
-Potassium sparing diuretics
ACEI’s (usually in the setting of renal failure)
-salt substitutes
Hypokalemia
Caused by?
Diarrhea/laxatives Diuretics Vomiting S/s: -muscle weakness EKG changes Decreased peristalsis
Hypermagnesemia
Caused by?
RARE
Renal failure
-excessive intake of Mg+ containing antacids
S/s :
- decreased respiratory rate
- muscle weakness/decreased deep tendon reflexes
- peripheral vasodilation/hypotension
- bradycardia
Hypomagnesemia
Caused by?
loop & thiazide diuretics chronic alcoholism -malabsorption S/S muscular excitability/tetany Stridor/laryngospasm -hyperactive deep tendon reflexes
-tremors
Hypercalcemia
Caused by?
prolonged immobility overactive parathyroid gland -cancer -severe dehydration s/s? -dysrhythmias -muscle weakness/decreased reflexes
Hypocalcemia
Caused by?
hypoparathyroidism -low vitamin D s/s? muscle spasms/tetany -stridor/laryngospasm -paresthesia’s -dysrythmias