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Funds II Theory > Module 2: Fluid & Electrolytes and Acid-Base Balance > Flashcards

Module 2: Fluid & Electrolytes and Acid-Base Balance Flashcards

1
Q

Potassium Normal Range

A

3.5-5.0 mEq/L

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2
Q

Sodium Normal Range

A

135-145 mEq/L

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3
Q

Calcium Normal Range

A

8.5-10.2 mg/dL

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4
Q

Function of Sodium in the body

A

regulates fluid balance (water retention)
nerve impulses
muscle contractions

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5
Q

Main factors that increase sodium

A

DEHYDRATION
kidney dysfunction
TUBE FEEDINGS (bc it’s hypertonic)
vomiting/diarrhea
diaphoresis

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6
Q

Main factors that decrease sodium

A

fluid overload
excess fluid loss
GI suctioning
vomiting/diarrhea
potassium-sparing diuretics
inadequate sodium intake
hypertonic solutions

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7
Q

Main S/S of decreased sodium

A

CONFUSION
seizures
MUSCLE WEAKNESS
restlessness
(seizure -> coma -> death)

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8
Q

Main S/s of increased sodium

A

edema
HYPERTENSION
CNS effects
excessive thirst
DRY
nausea/vomiting
LOW GRADE FEVER
DECREASED URINE OUTPUT

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9
Q

Nursing considerations for sodium

A

hyponatremia is helped by hypertonic IV fluids
I&O
daily weights
monitor fluid balance
NEURO ASSESSMENT

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10
Q

Function of Potassium in the body

A

cardiac (rhythm)
CNS

if Na goes up, K goes down (vice versa)

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11
Q

Main factors that cause increased potassium

A

RENAL FAILURE
diabetes
DEHYDRATION
ACIDOSIS (metabolic or respiratory)
burns/traumatic injury
excessive potassium intake

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12
Q

Main factors that cause decreased potassium

A

diuretics (non-potassium sparing)
DIARRHEA
VOMITING

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13
Q

Main S/S of decreased potassium

A

muscle twitches/cramps
NUMBNESS/TINGLING
NAUSEA
VOMITING
ILEUS (no peristalsis)

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14
Q

Main S/S of increased potassium

A

heart palpitations
SOB
angina
cramping
arrhythmias
diarrhea
tachypnea
bradycardia
abdominal cramping
decreased BP

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15
Q

Nursing considerations for potassium

A

non-K sparing diuretics (furosemide) = hypokalemia, closely monitor, may require K+ supplements

NEVER give K+ as IV push or injection - only oral route or via infusion pump (on slow)

I&O

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16
Q

Function of Calcium in the body

A

blood coagulation
bone/teeth formation

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17
Q

Main Factors causing decreased calcium

A

renal disease
decreased Ca and vitamin D intake
increased Mg levels

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18
Q

Main S/S of decreased calcium

A

positive trousseau’s sign:
-wrist flexion when inflating BP cuff

positive chvostek’s sign:
tap on cheek and will cause muscles to contract
-facial twitching
-arrhythmias
-numbness and tingling
-diarrhea

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19
Q

Main S/s of increased calcium

A

muscle weakness
fatigue and weakness
constipation
hypo-active reflexes
bone pain
renal calculi
bradycardia/bradypnea

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20
Q

Nursing considerations for calcium

A

hypocalcemia = increased risk for fractures and bleeding

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21
Q

Function of hypotonic fluids

A

ECF moves inside cell

CELL SWELLS

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22
Q

Uses for hypotonic fluids

A

dehydrated cells
diabetic ketoacidosis
hyperglycemia (increased bl sugar)

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23
Q

Side effects of hypotonic fluids

A

can cause cell lysis
decreased bp

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24
Q

Examples of hypotonic fluids

A

5% dextrose in water (D5W)
0.25% NaCl (1/4 NS)
0.45% NaCl (1/2 NS)

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25
Q

Function of isotonic fluids

A

increase ECF volume (blood volume)

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26
Q

Uses for isotonic fluids

A

blood loss
surgery
vomit
diarrhea
dehydration

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27
Q

Examples of isotonic fluids

A

lactated ringers (LR)
0.9% NaCl (NS)
5% dextrose in water (D5W) (in bag)

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28
Q

Function of hypertonic fluids

A

ICF moves outside of cell
CELL SHRINKS

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29
Q

Uses of hypertonic fluids

A

swollen cells
CEREBRAL EDEMA
HYPONATREMIA

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30
Q

Side effects of hypertonic fluids

A

can cause fluid overload (PE)
can cause phlebitis

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31
Q

Examples of hypertonic fluids

A

5% dextrose in 0.45% NaCl
5% dextrose in 0.9% NaCl (NS)
3% NaCl

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32
Q

Phlebitis: definition, S/S, intervention

A

inflammation of a vein

pain, increased skin temp, redness

D/C IV line, apply moist warm compress, monitor IV site for redness/tenderness to prevent infection

33
Q

Infiltration: definition, S/S, intervention

A

leakage of IV solution or med into extravascular tissue (non-vesicant - doesn’t irritate tissue)

edema, pallor, decreased skin temp around site, pain

D/C IV line, elevate extremity, warm compress to absorb fluid

34
Q

Extravasation: definition, S/S, intervention

A

IV catheter becomes dislodged and med infuses into tissues (vesicant - irritates tissue)

pain, stinging, burning, swelling, redness at site

D/C IV line, apply cool compress, admin antidote if exists for med

35
Q

Hypervolemia cause

A

overhydration

36
Q

Hypervolemia VS

A

hypertension
increased temp
bounding pulses
increased RR, HR

37
Q

Hypervolemia S/S skin

A

moist/wet/oozy skin/wounds
warm to touch skin
redness
edema (may be pitting)
moist mucous membranes

38
Q

Hypervolemia S/S neuro/musculoskeletal

A

decreased mobility
decreased ROM
confusion
weakness

39
Q

Hypervolemia S/S CV/pulmonary

A

tachycardia
tachypnea
crackles
regurgitation in heart
productive cough
dyspnea
JVD
S3 sounds

40
Q

Hypervolemia S/S GU

A

increased urination/output
clear urine

41
Q

Hypervolemia labs

A

decreased Hct, K, Na, osmolality (bl thickness)

42
Q

Nursing assessments for hypervolemia

A

cardiac assess (for heart failure)
pulmonary assess

43
Q

Nursing interventions for hypervolemia

A

diuretics
daily weights
fluid restriction
hypertonic fluids

44
Q

Hypovolemia cause

A

dehydration
rapid loss of 3% body wt associated with fluid and electrolyte imbalances

45
Q

Hypovolemia VS

A

hypotension
weak pulses
increased RR, HR
decreased SpO2

46
Q

Hypovolemia S/S skin

A

dry
cool to touch
pallor
decreased skin turgor
dry mucous membranes

47
Q

Hypovolemia S/S neuro/musculoskeletal

A

confusion
weakness
lethargy
cramping
no perspiration

48
Q

Hypovolemia S/S CV/pulmonary

A

tachycardia
tachypnea
orthostatic hypotension
weak pulses
slow cap refill

49
Q

Hypovolemia S/S GU

A

decreased urination/output
dark urine/concentrated
no output

50
Q

Hypovolemia labs

A

hyperkalemia
hypernatremia
INCREASED HCT
increased Hgb
increased osmolality (dense/thick)

51
Q

Nursing assessments for hypovolemia

A

cardiac/pulmonary

52
Q

Nursing interventions for hypovolemia

A

CIRCULATION
IV fluids
increased oral intake
assist w/ ambulation
bed alarm

53
Q

pH normal range

A

7.35 - 7.45

54
Q

PaCO2 normal range

A

35 - 45 mmHg

55
Q

HCO3 normal range

A

22 - 26

56
Q

PaO2 normal range

A

80-100

57
Q

SpO2 normal range

A

97-100%

58
Q

Osmolality (serum) normal range

A

275-295

if HIGH pt is dehydrated, if LOW pt is overhydrated

59
Q

What causes metabolic acidosis?

A

kidney failure
liver failure
severe diarrhea (ASSidosis)

60
Q

Anticipating ABG Values for metabolic acidosis

A

pH < 7.35
HCO3 < 22
PaCO2 = normal (uncompensated)

61
Q

How does the body compensate for metabolic acidosis?

A

respiratory system increases pH and decreases acidity by increasing RR to remove CO2 (kussmaul breathing)

62
Q

What else is retained with metabolic acidosis?

A

potassium ions (hyperkalemia)

63
Q

What causes metabolic alkalosis?

A

loss of gastric contents; vomiting (AHHHlkalosis)

64
Q

Anticipated ABG values for metabolic alkalosis

A

pH > 7.45
HCO3 > 26
CO2 = normal (uncompensated)

65
Q

How does the body compensate for metabolic alkalosis?

A

respiratory system by increasing CO2 via HYPOventilation

66
Q

What causes respiratory acidosis?

A

HYPOventilation: drug overdose, opioids, sleep apnea, COPD, asthma

67
Q

Anticipated ABG values for respiratory acidosis

A

pH < 7.35
CO2 > 45
HCO3 = normal (uncompensated)

68
Q

How does the body compensate for respiratory acidosis?

A

kidneys increase HCO3 and absorb HCO3 (use more of it)

69
Q

What causes respiratory alkalosis?

A

HYPERventilation: pain, anxiety, fear

70
Q

Anticipated ABG values for respiratory alkalosis

A

pH > 7.45
CO2 < 35
HCO3 = normal (uncompensated)

71
Q

How does the body compensate for respiratory alkalosis?

A

kidneys excrete (get rid of) HCO3

72
Q

How many abnormalities do uncompensated imbalances have?

A

2 will be abnormal (including pH)
1 will be normal

73
Q

How many abnormalities do partially compensated imbalances have?

A

All 3 will be abnormal

74
Q

How many abnormalities do fully compensated imbalances have?

A

pH will be normal
other 2 will be abnormal

75
Q

Diuretics do what to potassium levels?

A

DROP THEM

76
Q

Do you give diuretics if the potassium level is low?

A

NO bc it will drop it even more

77
Q

What is the first type of fluids that will most likely be given?

A

isotonic

78
Q

What is the priority electrolyte?

A

potassium

Funds II Theory (7 decks)

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