12. Fluid Volume and Electrolytes Flashcards
1
Q
3 categories of extracellular fluids
A
- interstitial: surrounds the cells
- intravascular: within blood vessels
- transcellular (third space): mucus, GI secretion, CSF, synovial, pericardial, and ocular fluids
2
Q
fluid found inside the cells
A
intracellular fluid
3
Q
number of particles dissolved in the serum (mainly Na, glucose, and urea)
A
osmolality
4
Q
normal osmolality of human blood
A
275-295 mOsm/kg
5
Q
fluid that has the same weight proportion of particles in water
A
isoosmolar
6
Q
fluid that contains fewer particles than water
A
hypoosmolar
7
Q
fluid that contains more particles than water
A
hyperosmolar
8
Q
measurement of concentration of IV solutions compared w/ osmolality of body fluids
A
tonicity
9
Q
characteristics of hemostasis
A
- anions and cations are balanced
- fluid compartments are in osmotic equilibrium
10
Q
4 types of fluid and particle movement
A
- osmosis
- diffusion
- hydrostatic pressure
- active transport
11
Q
common electrolytes in serum
A
- K (major intracellular cation)
- Na (major extracellular cation)
- Mg
- Ca
- Cl
- phosphorus (phosphate)
- sulfate
- H
- HCO3
12
Q
movement of water across a semipermeable membrane from areas of low solute concentration to areas of high solute concentration
A
osmosis
13
Q
movement of particles from an area of high concentration to low concentration
A
diffusion
14
Q
force within a fluid compartment
A
hydrostatic pressure
15
Q
requires metabolic activity and the use of energy to move a substance across a cell membrane
A
active transport
16
Q
fluid replacement considerations
A
- all routes of fluid intake and loss
- daily water requirements
- water, electrolytes, and protein requirements
- patient weight and caloric need
- body surface area
- illness
- surgery
17
Q
types of IV solutions
A
- crystalloids (includes isotonic, hypertonic, and hypotonic)
- colloids
- blood and blood products
- lipid emulsion
18
Q
characteristics of crystalloid IV solution
A
- fluid and electrolytes only
- move freely across capillary walls
- don’t contain proteins
- short-term maintenance therapy
- may be isotonic, hypotonic, or hypertonic
19
Q
uses of crystalloid IV solution
A
treat dehydration and electrolyte imbalances
20
Q
examples of crystalloid IV solution
A
- dextrose in water (D5W): isotonic unless continuous or rapid
- norma saline (0.9% NSS): isotonic
- lactated ringers
21
Q
explain hypotonic IV solution
A
- less osmolality
- allows fluid to move into cells
- can rupture RBCs in excess (fluid shifting into cells)
- may see decreased BP and decrease vascular fluid volume
22
Q
explain hypertonic IV solution
A
- exerts greater osmotic pressure than extracellular fluid
- pulls fluid to vascular fluid and away from intracellular fluid
- causes cellular shrinkage
- monitor for circulatory overload (ex CHF)
23
Q
characteristics of colloid IV solution
A
- contain protein or other large molecular substances that increase osmolality without decrease in solution
- don’t pass through semipermeable membranes in capillaries
- remain in intravascular space and pull fluid from interstitial space into plasma
- can be called “volume expanders”
24
Q
examples of colloid IV solutions
A
- dextran solutions
- albumin
- Hetastarch
25
examples of blood and blood products
- whole blood
- packed RBCs (most common) - due to less fluid volume overload
- plasma
- platelets
26
examples of blood and blood products
- whole blood
- packed RBCs (most common) - due to less fluid volume overload
- plasma
- platelets
27
characteristics of blood for transfusion
- use 19G needle (usually 18G)
- once out of refrigerator must be administered within 4 hours
- use Y tubing w/ micro-aggregate filter tubing
- isotonic NS used w/ infusion
28
characteristics of lipid emulsions
- part of total parenteral nutrition (TPN)
- must be given through central line or PICC line (diluted in large vessel)
- high risk for infection
29
electrolyte functions
- transmission and condition of nerve impulses
- contraction of cardiac, skeletal, and smooth muscles
- normal kidney function
- change carbs to energy
- change AA to proteins
- role in acid-base balance
- regulates osmolality of cellular fluids
30
normal serum range of K
3.5-5 mEq/L
31
functions of K
- transmission and conduction of nerve impulses
- condition of cardiac, skeletal and smooth muscles
- enzyme action to change carbon, hydrogen, and O2 to energy and AA to proteins
- promotes glycogen storage in liver
- promotes osmolality of cellular fluids
32
sxs of hypokalemia
- N/V
- dysrhythmias
- ABD distension
- soft flabby muscles
33
sxs of hyperkalemia
- nausea
- stomach cramping
- tachycardia (initial bradycardia)
- oliguria
- weakness/numbness/tingling
34
correction of hypokalemia
- replace K oral (w/ food or at least 8oz of water or juice) or IV (more severe)
- encourage foods w/ K (fruits, vegetables, and fruit juice)
35
T/F: IV K causes irritation to peripheral vessels
True
36
correction of hyperkalemia
- restrict K intake (includes salt substitutes)
| - IV Na bicarb, insulin w/ glucose (more serious)
37
normal serum Na
135-145 mEq/L
38
functions of Na
- transmission and conduction of nerve impulses
- maintain water balance
- maintains Na/K pump
- promotes acid-base balance
39
sign of hyponatremia
- muscle weakness
- headaches
- lethargy
- confusion
- seizures
- ABD cramps
- N/V
- tachycardia
- hypotension
40
signs of hypernatremia
- flushed dry skin
- agitated
- elevated body temp
- elevated BP
- rough dry tongue
- N/V anorexia
- tachycardia
- muscle twitching/hyperreflexia
41
normal Ca range
8.6-10.2 mg/dL
42
functions of Ca
- promotion of normal nerve and muscle activity
- aids in heart contraction
- maintains cellular permeability
- promotes blood clotting
- promotes bone and teeth formation
43
sxs of hypocalcemia
- bone fractures
- anxiety
- irritability
- tetany
- siezures
- Trousseau sign
- Chovstek sign
- EKG changes: prolonged QT interval and elongated ST segments
44
sxs of hypercalcemia
- fatigue
- muscle weakness
- depressed deep tendon reflexes
- confusion/impaired memory
- anorexia
- N/V
- constipation
- kidney stones
- EKG changes: shortened QT and ST segments and bradycardia
45
correction of hypocalcemia
- oral replacement (may be IV if severe)
46
correction of hypercalcemia
- correct the cause
- use IV saline to dilute
- calcitonin and diuretics (promote rapid excretion of Ca)
47
normal range of Mg
1.5-2.5 mEq/L
48
function of Mg
- promotion transmission of neuromuscular activity and cardiac contraction
- activates enzymes for metabolism
- promotes transportation of Na and K across cell membranes
49
sxs of hypomagnesemia
- neuromuscular excitability
- loss of deep tendon reflexes
- hypotension
- cardiac dysrhythmias
50
sxs of hypermagnesemia
- lethargy
- weakness
- paralysis
- loss of deep tendon reflexes
- hypotension
- heart block
51
foods high in Mg
- green vegetables
- fruits
- nuts/grains
- fish
52
normal serum range of chloride
96-106 mEq/L
53
function of chloride
- principle anion in ECF
- acid-base balance
- gastric juice for acidity
- maintains osmolality of ECF
54
sxs of hypochloremia
- tremors
- twitching
- slow shallow breathing
- hypotension
55
sxs of hyperchloremia
- weakness
- lethargy
- deep rapid breathing
- unconsciousness
56
normal range of phosphorus
2.4-4.4 mEq/L
57
functions of phosphorus
- major anion in ICF
- bone and teeth formation
- neuromuscular activity
- important component of DNA and RNA
- maintains cellular osmotic pressure
- supports acid-base balance
58
sxs of hypophosphatemia
- muscle weakness
- tremors
- paresthesia
- bone pain
- hyporeflexia
- seizures
- hyperventilation
- anorexia and dysphagia
59
sxs of hyperphosphatemia
- hyperreflexia
- tetany
- flaccid paralysis
- muscle weakness
- tachycardia
- nausea
- diarrhea
- ABD cramping
60
foods high in phosphorus
- whole grain cereal
- nuts
- milk
- meat
61
which electrolyte is a separate blood test from the rest
Mg
