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3910 Health Promotion & Caring: Client's with Health Challenges I > Week 1 Fluid Electrolyte Balance > Flashcards

Week 1 Fluid Electrolyte Balance Flashcards

1
Q

Hypervolemia

A
  • Too much fluid
  • Fluid volume overload
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2
Q

Hypovolemia

A
  • Too little fluid
  • Fluid volume deficit
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3
Q

Edema

A
  • Excess fluid in interstitial space
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4
Q

Osmosis

A
  • Movement of water
  • High concentration to low concentration
  • Across semi-permeable membrane
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5
Q

Diffusion

A
  • Movement of particles
  • High concentration to low concentration
  • Electrolytes require active (facilitated) diffusion - ion pumps
  • Across semi-permeable membrane
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6
Q

Filtration

A
  • Movement of fluid through cell/vessel membrane
  • Hydrostatic pressure differences
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7
Q

Hydrostatic Pressure

A
  • Pressing of water molecules outwards from confined space
  • High pressure to low pressure
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8
Q

Angiotensin II Function

A
  • Vasoconstriction
  • Stimulate thirst
    Stimulate aldosterone to retain water & sodium
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9
Q

Atrial Natriuretic Peptide (ANP)

A
  • Inhibits RAAS when in a state of overdrive
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10
Q

Hypovolemia Causes

A
  • Insufficient intake
  • Excessive loss
  • Fluid shifts in body
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11
Q

Intravascular Space Deficit

A
  • Difficulty perfusing body
  • Systems activate to raise BP
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12
Q

Hypervolemia Causes

A
  • Excessive intake
  • Abnormal retention - kidney/heart failure
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13
Q

Intravascular Space Overload

A
  • Raise BP
  • Stress on systems
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14
Q

Cardiovascular Hypovolemia Findings

A
  • Increased HR
  • Thready pulse
  • Decreased BP - orthostatic hypotension
  • Flat veins
  • Dysrhythmias
  • Decreased peripheral pulses
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15
Q

Respiratory Hypovolemia Findings

A
  • Increased RR
  • Dyspnea
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16
Q

Neuromuscular Hypovolemia Findings

A
  • Confusion
  • Dizziness, weakness, lethargy
  • Decreased LOC - coma
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17
Q

Integumentary Hypovolemia Findings

A
  • Dry mouth
  • Poor skin turgor - tearing
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18
Q

GI Hypovolemia Findings

A
  • Decreased bowel sounds & motility
  • Constipation
  • Weight loss
  • Thirst
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19
Q

Cardiovascular Hypervolemia Findings

A
  • Increased HR
  • Bounding pulse
  • Increased BP
  • Distended veins
  • Dysrhythmias
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20
Q

Respiratory Hypervolemia Findings

A
  • Increased RR
  • Dyspnea
  • Crackles on auscultation
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21
Q

Neuromuscular Hypervolemia Findings

A
  • Confusion
  • Headache
  • Decreased LOC - coma
  • Muscle spasms (electrolytes)
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22
Q

Integumentary Hypervolemia Findings

A
  • Cool, pale skin
  • Edema
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23
Q

GI Hypervolemia Findings

A
  • Increased bowel sounds & motility
  • Diarrhea
  • Weight gain
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24
Q

Nursing Management: Fluid Deficit

A
  1. Correct underlying cause of deficit
  2. Replace fluids & electrolytes
  3. Prevent & assess inadequate perfusion
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25
Nursing Management: Fluid Overload
1. Prevention in at-risk clients 2. Correct underlying cause 3. Limit sodium/fluid intake 4. Administer diuretics
26
Furosemide (Lasix) Action
- Increases renal excretion - Mobilize excess fluid - Decreases BP
27
Furosemide (Lasix) Side Effects
- Dizziness - Headache - Hypotension - Electrolyte imbalance
28
Furosemide (Lasix) Nursing Considerations
- Fall risk of older clients - Electrolyte imbalance - Pre-existing kidney function & impact - Monitor weight - Avoid taking at night *nocturnal urination disrupts sleep*
29
Shock Causes
- Hypovolemic - hemorrhage - Cardiogenic - myocardial infarction - Distributive - Neurogenic - spinal cord injury - Anaphylactic - severe allergic reaction - Septic - systemic infection
30
Compensatory Shock Symptoms
- Normal BP - Increased HR & RR - Blood shunting to vital organs - Pale skin - Hypoactive bowel sounds - Decrease urine output - Confusion
31
Progressive Shock Symptoms
- Decrease BP - Decrease LOC
32
Healthy Tissue Perfusion
MAP - 70 to 100 mmHg
33
Hypovolemic Shock
- Decreased intravascular fluid volume - External fluid losses - Fluid shifts between intravascular & interstitial compartments (internal fluid losses)
34
Nursing Management: Hypovolemic Shock
- Call for help - Notify MPR - Position client in modified Trendelenburg - Administer IV fluids, meds, blood products - according to provider orders - Apply oxygen
35
Trendelenburg Position
- Head of bed down - Blood moves to brain with less gravity - Head of bed up - less gravity restricting breath, increases breath quality
36
Potassium K+
- 3.5-5mmol/L - Intercellular electrolyte - Maintains heart & muscle contraction
37
Hypokalemia
- <3.5mmol/L - Not consuming enough K - Loss (vomit, GI suction, sweat) - Medications that move K (diuretics, insulin (K+ move into cell)
38
Hyperkalemia
- >5.0 - Excessive intake - Renal failure - Medications that retain (ACE inhibitors, sparing diuretics, NSAIDs)
39
Hypokalemia Symptoms (7 L's)
- Low BP & HR - Lethargy - Low shallow respirations (decreased ability to use accessory muscles) - Lethal cardiac dysrhythmias (ST depression, shallow T wave, projecting U wave) - Lots of urine - Leg cramps - Limp muscles (decrease deep tendon reflexes)
40
Hyperkalemia Symptoms
- Weak pulse, low HR - Muscle twitches, cramping - Resp failure - Peaked T waves - Prolonged PR interval
41
Hypokalemia Interventions
- Supplement K - IV admin, high alert, administer slow (NO PUSH) - Falls prevention - Cardiac monitoring
42
Hyperkalemia Interventions
- Meds to lower potassium & support cardiac health (insulin, diuretics) - Falls prevention - Cardiac monitoring
43
Sodium Na+
- 135-145mmol/L - Extracellular electrolyte - Regulates water inside & outside cells
44
Hyponatremia Causes
- <135mmol/L - Not consuming enough Na - Hypovolemic - excessive losses, diuretics, vomiting, sweating - Hypervolemic - excess fluid dilutes sodium - Decrease serum osmolality - Cells swell as water moves in
45
Hypernatremia Causes
- Overconsumption - Syndromes that causes high cortisol/aldosterone = retain Na - Water loss - Increase serum osmolality - Cellular dehydration
46
Hyponatremia Impact on CNS - SALT LOSS
- Seizures & stupor (decreased LOC, confusion) - Abdominal cramping - Lethargic - Tendon reflexes diminished - trouble concentrating - Loss of urine & appetite - Orthostatic hypotension, overactive bowel sounds - Shallow respirations - Spasms of muscles - Hypertension
47
Hypernatremia Impact on CNS - no FRIED foods for you
- Fatigue - Restless, agitated, confused - Increased reflexes - Extreme thirst - Decreased urine output, dry mouth/skin - Tachycardia/hypotension
48
Hyponatremia Interventions
- Isotonic (non-severe) - Na+ fluids <120 - Normal/excess fluids: meds (diuretics promote water loss)
49
Hypernatremia Interventions
- Health teaching - Na restricted diet - Administer IV infusion - volume loss (hypotonic/isotonic) - Meds (diuretics promote Na loss - loop)
50
Chloride Cl-
- 95-105mEq/L - Blood pressure & volume maintenance - pH balance - Goes with Na, Na low = Cl low
51
Magnesium Mg2+
- 1.6-2.6mg/dL - Neuromuscular contractility
52
Calcium Ca2+
- 4.5-5.5 mEq/L - Neuromuscular contractility - Coagulation - Bone health
53
Phosphate P
- 1.9-2.6mEq/L - Bone & teeth health - Muscle & RBC function - Inverse relation to Ca, Ca high = P low
54
Vascular Access Device Selection
- Duration: PIV (short) CVAD (long) - Patency: PIV more risk for loss of patency - History of vascular access & comorbidities: difficult prior access, skin, vessels - Types of therapy: vesicant/irritants, pH - Patients preference - Always select smallest gauge (22 for PIV) & minimum # of lumens
55
PIV Selection
- Access to upper extremity - Short term therapy <7 days - Monitor for repeated failed/loss access
56
CVAD Selection
- PIV access unavailable - Long term therapy - Suitable for vesicant/irritant medications/nutrition
57
CVAD Access
- Large vein central circulation system - Tip of catheter sits in superior vena cava - Inserted by HCP with specialized knowledge - Ultrasound guided technique
58
Common CVADs
- PICC - Non tunneled - Tunneled - Implanted
59
PICC
- Enters body on upper arm - Catheter runs to superior vena cava - Very common in clinical settings - RNs can insert & remove - Medium term use
60
Non-Tunneled CVAD
- Enters body at vessel site (internal/external jugular, subclavian, femoral) - Catheter outside body at injection site - Common in critical care (shorter term)
61
Tunneled CVAD
- Hickman or broviac - Proximal end tunneled subcutaneously from insertion site & brought out through skin at exit site - Antimicrobial cuff - Long term use
62
CVAD Infections
- High risk for sepsis - PPE - Anti-microbials
63
VAD Insertion
- All can cause phlebitis at insertion site - Skin assessment

3910 Health Promotion & Caring: Client's with Health Challenges I (15 decks)

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