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NUR 101A > W -16 - Fluid/Electrolyte > Flashcards

W -16 - Fluid/Electrolyte Flashcards

1
Q

Potassium

A

3.5 – 5.0

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2
Q

Sodium

A

135 – 145

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3
Q

Calcium

A

9 - 11

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4
Q

Chloride

A

96 - 106

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5
Q

Magnesium

A

1.5 - 2.5

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6
Q

pH

A

7.35 – 7.45

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7
Q

PaCO2

A

45 – 35

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8
Q

HCO3

A

22 – 26

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9
Q

PaO2

A

80 – 100

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10
Q

SaO2

A

95 – 100

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11
Q

Phosphorous

A

3.0 – 4.5

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12
Q

Movement of water down a concentration gradient?

A

Osmosis

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13
Q

Osmolality =

A

Concentration of molecules

Inside the body

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14
Q

Osmolarity

A

Per volume of fluid. (in the bag)

Outside the body

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15
Q

aka – oncotic & colloidal pressure

A

osmotic pressure

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16
Q

Pulling power

A

osmotic / oncotic / colloidal pressure

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17
Q

Albumin pulls water into space

A

osmotic

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18
Q

What body systems / elements are involved in fluid regulation?

A

Renal = excrete/retain/conserve
Renin & Angiotensin
Aldosterone
ADH

Lungs - insensible losses
GI
Heart mechanism - ANP (heart failure patients)

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19
Q

What signals kidneys to start RAAS?

A

Drop in blood pressure

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20
Q

What is the end result - outcome if RAAS?

A

Elevate Blood pressure

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21
Q

In RAAS - kidney releases ?

A

Renin

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22
Q

RAAS - Angiotensin II stimulates

hypothalamus - ??
Blood Vessels ??
Aldosterone ??

A

hypothalamus - thirst
Blood Vessels - vasoconstriction
Aldosterone - hold Na & H2O

All to elevate BP

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23
Q

What signals ADH?

A

loss of water - rise in serum tonicity (more concentrated) (Osmolality)

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24
Q

ADH release affects?

A

increased tubular reabsorption of water

retains water

increased thirst

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25
Q

Hypernatremia - skin feels?

A

Skin dry
increased temp

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26
Q

Low volume - skin feels?

A

cool and clammy

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27
Q

What causes Hypovolemia?

A

Fluid loss

GI loss
Suctioning (NG tube)
Bleeding
NPO
limited to no access to water
Third Spacing –
(ascites - fluid buildup in tummy)
(burn patients - large blisters)

28
Q

HYPOVOLEMIA

Clinical Manifestations

A

acute weight loss
decreased skin turgor
oliguria <400-500 ml UO 24h
Concentrated Urine
Orthostatic Hypotension
Weak rapid heart rate
flattened neck veins
Increased temp
Cool Clammy SKin
Thirst
Anorexia / nausea

29
Q

Hypovolemia

has what for fluid volume?

which leads to what for hydrostatic pressure?

which leads to what for BP?
Which leads to what for Heart Rate?

Which leads to what for perfusion?
S/S

A

Low fluid volume
Low hydrostatic Pressure
Low Blood Pressure
High Heart rate

Low perfusion =
to brain = confusion
skin = cool and clammy
kidneys = low UO

Weak pulse
orthostatic hypotension - dizzy

UO low and increased concentration

30
Q

Lab results for LOW VOLUME
HYPOVOLEMIA?

A

More concentration = of solutes
Serum Osmolality
Serum Na
Urin Sp Gravity
BUN
HGB & HCT

High:
HCT – hematocrit - RBCs
HGB - hemoglobin
BUN – blood urea nitrogen
NA (if dehydration)

31
Q

WBCs

A

4500 - 11,0000

from 4 - 11, WBCs in heaven

32
Q

RBCs

A

4.5 - 5.5

RBCs thrive at 4.5

33
Q

PLTs

A

150,000 - 450,000

expensive china plates cost $150-450

34
Q

Main function

Sodium

A

maintains blood volume and blood pressure

Sodium Swells (retains water)

Sodium Think - BRAIN - neuro changes

Range 135 - 145

35
Q

Main function

Potassium

A

muscles contract - including the heart muscle

Potassium Pumps

Potassium Think Heart -
cardia dysrhythmias - life-threatening can be

Range 3.5 - 5.0

36
Q

Main function

Calcium

A

Heart function
Blood clotting
Bone formation

Calcium think - Creating bone

Calcium think Bones
imbalances - leads to fractures

Range 9 - 11

37
Q

Main function

Magnesium

A

muscles and nerves stay healthy
regulates energy levels

Magnesium Manages Muscle

Magnesium Think Calm and Sedated
Magnesium acts like a sedative

Range 1.5 - 2.5

38
Q

Main function

Phosphorous

A

create and maintain teeth & bones
Repair cell and body tissue (cell walls)
energy (ATP)

Phosphorous think Perfect teeth

helps body use vitamins to maintain teeth and bone health

range 3.0 - 4.5

39
Q

Main function

Chloride

A

maintains acid-base balance
controls fluid levels in cells
Stomach Acid

Chloride - think Carrying fluids

range 96 - 108

High bicarb - low Cl, low Na. (metab alk)
Low Bicarb - High Cl, High Na (metab acid)

40
Q

S/S Hypernatremia

A

Fried Salt

F Flushed skin
R Restless - confused NEURO CHANGES
I Increased BP & fluid retention
E Edema
D Decreased UO

S Skin is dry
A Agitation
L Low grade fever
T Thirst

41
Q

S/S Hyponatremia

A

SALT LOSS

S Stupor - Coma
A Anorexia
L Lethargy
T Tachycardia

L Limp muscles
O Orthostatic hypotension
S Seizures headaches NEURO CHANGES
S Stomach cramping - hyperactive bowels

42
Q

Causes of Hypernatremia

A

Increases sodium intake

Loss of fluids from fever, burns, DI
low water = Increased salt

43
Q

Treatment of Hypernatremia

A

limit salt
IV fluids - iso or hypo

44
Q

Causes of Hyponatremia

A

5 Ds

Diaphoresis
Diarrhea & vomiting
Drains (suction)
Diuretics
Dilution - SIADH

45
Q

S/S Hyperkalemia

A

Muscles contract for too long
= tight & contracted

Tall peaked T-waves

MURDER

M muscle cramps and weakness
U Urine abnormalities
R Respiratory Distress
D Decreased cardiac contractility low HR BP
E EKG changes - tall peaked T-waves
R Reflexes low DTR

46
Q

S/S HYPOkalemia

A

Generalized weakness in muscles

Ned Has Many Strange Symptoms

N N/V
E EKG changes flattened T waves
D Decreased DTR
H Hypotension
M Muscle weakness
S Shallow breathing
S slow GI - constipation

47
Q

S/S Hypercalcemia

A

BACK ME

B Bone Pain
A Arrhythmias
C Cardia arrest (bounding pulses)
K Kidney Stones (renal calculi)

M Muscle weakness
E Excessive Urination

48
Q

S/S HYPO calcemia

A

CATS GO NUMB

C Convulsions/Seizures
A Arrhythmias
T Tetany
S Spasms and Stridor

GO NUMB - numbness in fingers.face. limbs

Positive Trousseau’s - BP cuff hand curls
Positive Chvostek’s - contraction cheek - cheeky smile when facial muscle touched

49
Q

S/S HYPERmagnesemia

A

Low Everything - Sedated

Low DTR
Low Energy - drowsiness - coma
Low HR
Low BP
Low RR
Low Bowel Sounds

50
Q

S/S HYPOmagnesemia

A

Ca & Mg direct related

High Everything - NOT SEDATED

High DTR
High HR
High BP

shallow RR
muscle twitching - paresthesias
Tetany seizures
Irritability & confusion

Positive Trousseau’s - BP cuff hand curls
Positive Chvostek’s - contraction cheek - cheeky smile when facial muscle touched

51
Q

S/S Hyper phosphate

A

Calcium and Phosphate inverse

Mice Always Dig Silently

M Muscle spasms & Tetany (
A Arrhythmias
D Dry nails/skin
S Seizures

52
Q

S/S Hypo Phosphate

A

A Lion Often Wanders

A Arrhythmias
L Loss of appetite
O Osteoporosis
W Weakness, fatigue

53
Q

S/S HYPER chloride

A

All Iguanas Have Eggs

A Arrhythmias
I Increased fluid retention
H Hypertension
E Edema

54
Q

S/S HYPO chloride

metabolic alkalosis

high bicarb

A

Same as hyponatremia
low Cl = low Na

Mom Has a Toad and A Frog

M Muscle Weakness
H Hypotension
T Tachycardia
A Altered Mental Status
F Fatigue

55
Q

Most abundant extracellular anion

56
Q

Chloride has inverse relationship with ?

57
Q

Chloride has a direct relationship with?

58
Q

Causes of HYPO chloride <96

A

Volume Overload = CHF, water intoxication

Metabolic Alkalosis. high bicarb (low CL)

Salt Losses -
burns, sweating, GI losses, Addison, cystic fibrosis

59
Q

Normal amount of insensible losses per day

A

600-900 ml/day

Skin
Lungs
GI
Sweating

60
Q

HYPERVOLEMIA

has what for fluid volume?

which leads to what for hydrostatic pressure?

which leads to what for BP?
Which leads to what HR?
Which leads to what for Edema?

Which leads to what for pulse?
UO?
S/S

A

HYYPER VOLEMIA

High fluid volume
High hydrostatic Pressure
High Blood Pressure
High HR trying to compensate

Edema - peripheral, pulmonary, cerebral

Bounding pulse - JVD

Increased UO

61
Q

What do we monitor for fluids and electrolyte imbalances?

A

I&O. (w/in 600-900 - insensible losses)
Weight daily (1 kg = 1000 mL fluid) (2.2 lb)
Lab Values

VS
SKIN - turgor, edema, mucous membranes
IV monitoring
Respiratory (overload = crackles, pulmonary edema)
Neurologic (high and low = confusion)

62
Q

KNOW!!!

Typical causes for:

Respiratory Acidosis

A

holding CO2 (high CO2 in blood)
low RR

Hypoventilation

COPD
impaired gas exchange due to:
pulmonary embolism
pulmonary edema
Hypoxia

Resp depression
opioids
Airway obstruction
choking
sleep apnea

CONFUSION - Headache - leathargy
Dysrrhythmia

63
Q

KNOW!!!

Typical causes for:

Respiratory Alkalosis

A

Breathing off CO2 (low CO2 in blood)
high RR

Hyperventilation. - (paper bag)

Afraid, anxious
Fever, Septic
Head trauma
Mechanical Vent issue

ALKALOSIS = numbness & Tingling

64
Q

KNOW!!!

Typical causes for:

Metabolic Acidosis

A

High Acid

DKA
not a lung problem (metabolic)
lactic acidosis
exercise
seizure
Alcohol
Kidney Failure

Lose too much base

Diarrhea - excessive and prolonged

65
Q

KNOW!!!

Typical causes for:

Metabolic Alkalosis

A

Base Excess
too many antacids
too much Na Bicarb given

Lost Acid
stomach acid
vomiting
low K+

ALKALOSIS = numbness & Tingling

NUR 101A (22 decks)

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