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Pharmacology > 12. Fluid Volume and Electrolytes > Flashcards

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
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2
Q

fluid found inside the cells

A

intracellular fluid

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3
Q

number of particles dissolved in the serum (mainly Na, glucose, and urea)

A

osmolality

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4
Q

normal osmolality of human blood

A

275-295 mOsm/kg

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5
Q

fluid that has the same weight proportion of particles in water

A

isoosmolar

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6
Q

fluid that contains fewer particles than water

A

hypoosmolar

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7
Q

fluid that contains more particles than water

A

hyperosmolar

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8
Q

measurement of concentration of IV solutions compared w/ osmolality of body fluids

A

tonicity

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9
Q

characteristics of hemostasis

A
  • anions and cations are balanced

- fluid compartments are in osmotic equilibrium

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10
Q

4 types of fluid and particle movement

A
  • osmosis
  • diffusion
  • hydrostatic pressure
  • active transport
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11
Q

common electrolytes in serum

A
  • K (major intracellular cation)
  • Na (major extracellular cation)
  • Mg
  • Ca
  • Cl
  • phosphorus (phosphate)
  • sulfate
  • H
  • HCO3
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12
Q

movement of water across a semipermeable membrane from areas of low solute concentration to areas of high solute concentration

A

osmosis

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13
Q

movement of particles from an area of high concentration to low concentration

A

diffusion

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14
Q

force within a fluid compartment

A

hydrostatic pressure

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15
Q

requires metabolic activity and the use of energy to move a substance across a cell membrane

A

active transport

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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
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17
Q

types of IV solutions

A
  • crystalloids (includes isotonic, hypertonic, and hypotonic)
  • colloids
  • blood and blood products
  • lipid emulsion
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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
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19
Q

uses of crystalloid IV solution

A

treat dehydration and electrolyte imbalances

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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
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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
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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)
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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”
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24
Q

examples of colloid IV solutions

A
  • dextran solutions
  • albumin
  • Hetastarch
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25
Q

examples of blood and blood products

A
  • whole blood
  • packed RBCs (most common) - due to less fluid volume overload
  • plasma
  • platelets
26
Q

examples of blood and blood products

A
  • whole blood
  • packed RBCs (most common) - due to less fluid volume overload
  • plasma
  • platelets
27
Q

characteristics of blood for transfusion

A
  • 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
Q

characteristics of lipid emulsions

A
  • part of total parenteral nutrition (TPN)
  • must be given through central line or PICC line (diluted in large vessel)
  • high risk for infection
29
Q

electrolyte functions

A
  • 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
Q

normal serum range of K

A

3.5-5 mEq/L

31
Q

functions of K

A
  • 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
Q

sxs of hypokalemia

A
  • N/V
  • dysrhythmias
  • ABD distension
  • soft flabby muscles
33
Q

sxs of hyperkalemia

A
  • nausea
  • stomach cramping
  • tachycardia (initial bradycardia)
  • oliguria
  • weakness/numbness/tingling
34
Q

correction of hypokalemia

A
  • 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
Q

T/F: IV K causes irritation to peripheral vessels

A

True

36
Q

correction of hyperkalemia

A
  • restrict K intake (includes salt substitutes)

- IV Na bicarb, insulin w/ glucose (more serious)

37
Q

normal serum Na

A

135-145 mEq/L

38
Q

functions of Na

A
  • transmission and conduction of nerve impulses
  • maintain water balance
  • maintains Na/K pump
  • promotes acid-base balance
39
Q

sign of hyponatremia

A
  • muscle weakness
  • headaches
  • lethargy
  • confusion
  • seizures
  • ABD cramps
  • N/V
  • tachycardia
  • hypotension
40
Q

signs of hypernatremia

A
  • flushed dry skin
  • agitated
  • elevated body temp
  • elevated BP
  • rough dry tongue
  • N/V anorexia
  • tachycardia
  • muscle twitching/hyperreflexia
41
Q

normal Ca range

A

8.6-10.2 mg/dL

42
Q

functions of Ca

A
  • promotion of normal nerve and muscle activity
  • aids in heart contraction
  • maintains cellular permeability
  • promotes blood clotting
  • promotes bone and teeth formation
43
Q

sxs of hypocalcemia

A
  • bone fractures
  • anxiety
  • irritability
  • tetany
  • siezures
  • Trousseau sign
  • Chovstek sign
  • EKG changes: prolonged QT interval and elongated ST segments
44
Q

sxs of hypercalcemia

A
  • 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
Q

correction of hypocalcemia

A
  • oral replacement (may be IV if severe)
46
Q

correction of hypercalcemia

A
  • correct the cause
  • use IV saline to dilute
  • calcitonin and diuretics (promote rapid excretion of Ca)
47
Q

normal range of Mg

A

1.5-2.5 mEq/L

48
Q

function of Mg

A
  • promotion transmission of neuromuscular activity and cardiac contraction
  • activates enzymes for metabolism
  • promotes transportation of Na and K across cell membranes
49
Q

sxs of hypomagnesemia

A
  • neuromuscular excitability
  • loss of deep tendon reflexes
  • hypotension
  • cardiac dysrhythmias
50
Q

sxs of hypermagnesemia

A
  • lethargy
  • weakness
  • paralysis
  • loss of deep tendon reflexes
  • hypotension
  • heart block
51
Q

foods high in Mg

A
  • green vegetables
  • fruits
  • nuts/grains
  • fish
52
Q

normal serum range of chloride

A

96-106 mEq/L

53
Q

function of chloride

A
  • principle anion in ECF
  • acid-base balance
  • gastric juice for acidity
  • maintains osmolality of ECF
54
Q

sxs of hypochloremia

A
  • tremors
  • twitching
  • slow shallow breathing
  • hypotension
55
Q

sxs of hyperchloremia

A
  • weakness
  • lethargy
  • deep rapid breathing
  • unconsciousness
56
Q

normal range of phosphorus

A

2.4-4.4 mEq/L

57
Q

functions of phosphorus

A
  • 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
Q

sxs of hypophosphatemia

A
  • muscle weakness
  • tremors
  • paresthesia
  • bone pain
  • hyporeflexia
  • seizures
  • hyperventilation
  • anorexia and dysphagia
59
Q

sxs of hyperphosphatemia

A
  • hyperreflexia
  • tetany
  • flaccid paralysis
  • muscle weakness
  • tachycardia
  • nausea
  • diarrhea
  • ABD cramping
60
Q

foods high in phosphorus

A
  • whole grain cereal
  • nuts
  • milk
  • meat
61
Q

which electrolyte is a separate blood test from the rest

A

Mg

Pharmacology (22 decks)

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