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TERM 3 N2109 HLTH 3 > WEEK 2 FLUIDS AND ELECTROLYTES > Flashcards

WEEK 2 FLUIDS AND ELECTROLYTES Flashcards

1
Q

What is the difference between facilitated diffusion and active transport?

A

Facilitated diffusion: movement of solutes from higher concentration to lower concentration through a carrier protein

Active transport: movement of solutes against concentration gradient through a carrier protein using ATP

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2
Q

What is the difference between hydrostatic pressure and oncotic pressure?

A

Hydrostatic pressure: Push of fluids

Oncotic pressure: Pull of fluids from proteins such as albumin

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3
Q

Of the total body water volume of about 40 L (60% of body weight), where is the majority of this water found?

A

Intracellular fluid (25 L, 40% of body weight)

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4
Q

Of the extracellular fluid volume of about 15 L (20% of body weight), where is the majority of this fluid found?

A

Interstitial fluid (12 L, 80% of ECF)

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5
Q

Of the ECF volume, where is the smallest portion of this fluid found?

A

Plasma volume (3 L, 20% of ECF)

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6
Q

Of the age groups, which population has the highest percent of body water?

A

Baby

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7
Q

Of the age groups, which population has the lowest percent of body water?

A

Older adult

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8
Q

What is the term for the balance of fluid and electrolytes within normal limits?

A

Homeostasis

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9
Q

What mechanism is for regulation of fluid input?

A

Thirst

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10
Q

What is the main mechanism for regulation of fluid output?

A

Urine

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11
Q

About how much urine is produced per day?

A

1500 ml

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12
Q

What are 4 other ways fluid output is regulated?

A

Sweat, feces, respiration, menstruation

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13
Q

In fluid spacing, what is the term for normal distribution of fluids?

A

1st spacing

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14
Q

What is the term for an abnormal accumulation of interstitial fluid?

A

2nd spacing

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15
Q

What is the term for accumulation of fluid which is not easily exchanged and not where it is supposed to be?

A

3rd spacing

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16
Q

What is the most common example of 3rd spacing?

A

Ascites

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17
Q

What are 3 causes of edema and 3rd spacing? Give examples.

A
  1. Hydrostatic pressure increases (HF)
  2. Oncotic pressure decreases (renal failure, liver dysfunction)
  3. Interstitial oncotic pressure increases (burns)
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18
Q

What are 2 neurological clinical manifestations of fluid volume excess?

A

Confusion, weakness

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19
Q

What are 2 respiratory manifestations of fluid volume excess?

A

Crackles, SOB

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20
Q

What are 2 gastrointestinal manifestations of fluid volume excess?

A

Abdo distension, nausea/vomiting

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21
Q

What is a genitourinary manifestation of fluid volume excess?

A

Increased urine output

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22
Q

What are 3 neurological manifestations of fluid volume deficit?

A
  1. Confusion
  2. Weakness
  3. Increased thirst
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23
Q

What is a safety concern for fluid volume deficit?

A

Postural hypotension

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24
Q

Other than hypotension and tachycardia, what are 3 clinical manifestations of fluid volume deficit?

A
  1. Weight loss
  2. Dry skin and mucous membranes
  3. Elevated hematocrit
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25
Q

What is a respiratory manifestation of fluid volume deficit?

A

Increased RR

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26
Q

What are 2 gastrointestinal manifestations of fluid volume deficit?

A

Hard stool, decreased motility

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27
Q

What are 2 GU manifestations of fluid volume deficit?

A

Decreased urine output, concentrated urine

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28
Q

Name 4 treatments for FVE

A
  1. Diuretics
  2. Fluid and sodium restrictions
  3. Elevate swollen areas to promote venous return
  4. Daily weights, 24-hr intake/output
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29
Q

Name 5 kinds of diuretics

A
  1. Carbonic anhydrase inhibitors (CAIs)
  2. Loop diuretics
  3. Osmotic diuretics
  4. Potassium-sparing diuretics
  5. Thiazide and thiazide-like diuretics
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30
Q

What is the purpose of carbonic anhydrase?

A

Makes hydrogen ions that body exchanges for sodium and water that are resorbed back into blood.

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31
Q

What is another therapeutic effect of CAIs?

A

Increase oxygenation during hypoxia.

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32
Q

What is a negative effect of CAIs?

A

Elevation of blood glucose.

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33
Q

What is an example of a CAI?

A

Acetazolamide

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34
Q

What is the action of loop diuretics?

A

Block chloride resorption and secondarily sodium resorption

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35
Q

What is an example of a loop diuretic?

A

Furosemide (Lasix)

36
Q

What is the action of osmotic diuretics?

A

Increases osmotic pressure in filtrate to pull fluid into renal tubules from tissues and inhibit tubular resorption.

37
Q

What is an example of an osmotic diuretic?

A

Mannitol

38
Q

What is the action of potassium sparing diuretics?

A

Block aldosterone receptors to block resorption of sodium and water.

39
Q

What are 2 examples of a potassium sparing diuretics?

A
  1. Spironolactone
  2. Triamterene
40
Q

What are 2 actions of thiazide and thiazide-like diuretics?

A
  1. Inhibits resorption of sodium, potassium, and chloride to result in osmotic water loss.
  2. Direct relaxation of arterioles to reduce peripheral vascular resistance (afterload)
41
Q

What are 2 examples of thiazide and thiazide-like diuretics?

A

Hydrochlorothiazide, metolazone

42
Q

Which group of drugs may interact with loop diuretics?

A

NSAIDs

43
Q

What is an adverse event associated with loop and thiazide diuretics?

A

Decreased serum potassium

44
Q

What lab result would be concerning in a patient taking spironolactone?

A

Hyperkalemia (higher than ~5.2)

45
Q

What is a negative effect of thiazide diuretics?

A

Elevated blood glucose

46
Q

When should loop diuretics be taken?

A

At the same time every morning

47
Q

What adverse events associated with loop diuretics are directly linked to patient safety?

A

Orthostatic hypotension, muscle weakness, dizziness

48
Q

What drug group may cause ototoxicity if taken with furosemide?

A

Aminoglycosides

49
Q

Why would a physician prescribe spironolactone and furosemide together?

A

Promotes diuresis but prevents hypokalemia

50
Q

Name 3 foods that are a source of potassium

A

Potatoes, meats, bananas

51
Q

What are 3 common adverse events related to potassium sparing diuretics?

A

Hyperkalemia, dizziness, headache

52
Q

Which laboratory test result is a common adverse effect of furosemide?

A

Hypokalemia

53
Q

Why would a health care provider prescribe furosemide for a patient with a history of renal insufficiency?

A

Furosemide continues to be effective even in impaired renal function

54
Q

Why is mannitol contraindicated in patients with anuria?

A

Mannitol does not influence urine production, it only increases existing urine output.

55
Q

If the patient asks about taking potassium supplements with spironolactone, what should the nurse say?

A

Spironolactone is potassium sparing, so no need to take supplements.

56
Q

What is the diuretic used for pulmonary edema?

A

Furosemide

57
Q

What is a possible adverse effect from taking triamterene?

A

Hyperkalemia

58
Q

What is a common symptom of hypokalemia?

A

Muscle weakness

59
Q

What are three indications for acetazolamide?

A
  1. Open angle glaucoma
  2. High altitude sickness
  3. Edema associated with heart failure
60
Q

Name 3 treatments for fluid volume deficit

A
  1. IV fluids
  2. Encourage oral intake
  3. Review medications with pharmacist and/or doctor
61
Q

Explain the difference between dehydration, FVD, and hypovolemia

A

Dehydration: Loss of total body water (ICF and ECF) that results from increase in solutes

FVD: Loss of ECF only

Hypovolemia: Loss of blood volume only

62
Q

What are 3 functions of sodium?

A
  1. Maintains blood pressure and volume
  2. Maintains pH balance
  3. Maintains nerve function
63
Q

What is the normal lab value for sodium?

A

135-145 mEq/L

64
Q

What are 4 causes of hyponatremia?

A

Sodium loss or water gain due to:
1. SIADH
2. Diuretics
3. Excess water intake
4. Diarrhea

65
Q

What are 3 areas of clinical manifestations of hyponatremia?

A

Depressed & deflated:
1. Neuro: lethargy/weakness, coma, seizures
2. Heart: tachy, weak/thready pulse
3. Resp arrest

66
Q

How is hyponatremia treated?

A
  1. IV fluids
  2. Fluid restriction
  3. Medication review
67
Q

What are 4 causes of hypernatremia?

A

Water loss or sodium gain:
1. Diabetes insipidus
2. Excess salt intake
3. Renal failure
4. Dehydration

68
Q

What are 3 areas of clinical manifestations of hypernatremia?

A

Big & bloated:

  1. Skin: flush, edema, low grade fever
  2. Polydipsia
  3. Late serious signs: swollen dry tongue, nausea/vomiting, increased muscle tone
69
Q

What are 3 functions of potassium?

A
  1. Heart and muscle contraction
  2. Nerve function
  3. Fluid balance
70
Q

What is the normal lab value for potassium?

A

3.5 to 5.0 mEq/L

71
Q

What are 3 causes for hypokalemia?

A
  1. GI losses
  2. Renal losses
  3. Skin losses
72
Q

What are clinical manifestations of hypokalemia?

A

Low and slow:

  1. Heart: dysrhythmias
  2. Muscular: decreased reflexes, muscle cramps, flaccid paralysis
  3. GI: Constipation, abdo distention, paralytic ileus
73
Q

What are 3 treatments for hypokalemia?

A
  1. K-dur
  2. IV fluids with K+
  3. Switch to potassium sparing diuretics
74
Q

What are 2 causes for hyperkalemia?

A
  1. Excess potassium intake
  2. Renal insufficiency
75
Q

What are 3 areas of clinical manifestations for hyperkalemia?

A

Tight and contracted:

  1. Heart: Dysrhythmias, hypotension, bradycardia (heart can’t pump)
  2. GI: Diarrhea, hyperactive bowel sounds
  3. Neuromuscular: paresthesia/paralysis of extremities, increased reflexes, muscle weakness/heaviness
76
Q

What are 4 reasons older adults are more at risk for fluid imbalance?

A
  1. Decreased lean muscle (stores water)
  2. Thinning skin
  3. Decreased hormone production
  4. Decreased thirst
77
Q

What are the 3 B’s that calcium is responsible for?

A
  1. Bones
  2. Blood (clotting)
  3. Beats (heart contraction)
78
Q

What are 4 signs and symptoms of hypercalcemia?

A

Swollen & Slow:

  1. Constipation
  2. Bone pain (bone demineralization)
  3. Stones (renal calculi)
  4. Deep tendon reflexes
79
Q

What are 4 signs of hypocalcemia?

A
  1. Bone pain
  2. Decreased clotting time (bleeding)
  3. Dysrhythmias
  4. Excitability of all systems
80
Q

What are the 2 functions of phosphate?

A
  1. Bone and teeth formation
  2. Regulates calcium
81
Q

How are calcium and phosphate levels related?

A

Inversely: when one is high, the other is low

82
Q

What is the main function of magnesium?

A

Muscle regulation, especially in heart and uterus

83
Q

What are 4 main causes of hypermagnesemia?

A
  1. Diabetic ketoacidosis
  2. Antacids
  3. Renal failure
  4. Hyperkalemia
84
Q

What are 5 clinical manifestations of hypermagnesemia?

A

Calm and quiet:
1. Bradycardia, hypotension, dysrhythmias
2. Respiratory depression
3. Hypoactive bowel sounds
4. Drowsiness, lethargy, coma
5. Muscle weakness, reduced DTR

85
Q

How is hypermagnesemia treated?

A
  1. Hemodialysis
  2. IV Calcium gluconate
86
Q

What are 5 signs and symptoms of hypomagnesemia?

A
  1. Tachycardia, dysrhythmia
  2. Dyspnea, tachypnea
  3. Diarrhea
  4. Confusion, irritability, insomnia, seizures
  5. Hyperflexion, twitching, paresthesias
87
Q

How is hypomagnesemia treated?

A

IV Magnesium Sulfate

TERM 3 N2109 HLTH 3 (3 decks)

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