Fluids and Electrolytes Flashcards

1
Q

How much of an adult’s total body weight is water?

A

50-60%

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2
Q

How much of an infant’s total body weight is water?

A

75-80%

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3
Q

How much body fluid is intracellular?

A

2/3

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4
Q

How much body fluid is extracellular

A

1/3

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5
Q

Isotonic fluids indication

A
  • Treat vascular system fluid deficit
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6
Q

Isotonic fluid characteristics

A
  • Concentration equal to plasma
  • Prevent fluid shift between compartments
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7
Q

Isotonic solutions (3)

A
  • Normal saline (0.9% NS)
  • Lactated ringers
  • 5% dextrose in water (D5W)
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8
Q

Hypotonic fluid indication

A

Treat intracellular dehydration

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9
Q

Hypotonic characteristics

A
  • Osmolality higher than ECF
  • Shift fluid from ECF to ICF
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10
Q

Hypotonic solutions (2)

A
  • 0.45% normal saline (0.45% NS)
  • 2.5% dextrose in 0.45% saline (D2.545% NS)
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11
Q

Hypertonic fluid indication

A
  • Used only when serum osmolality is critically low
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12
Q

Hypertonic fluid characteristics

A
  • Osmolality higher than ECF
  • Shift fluid from ICF to ECF
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13
Q

Hypertonic solutions (5)

A
  • 10% dextrose in water (D10W)
  • 50% dextrose in water (D50W)
  • 5% dextrose in 0.9% saline (D5NS)
  • 5% dextrose in 0.45% saline (D5W in 0.45% NaCl)
  • 5% dextrose in lactated ringers (D5LR)
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14
Q

Hypokalemia risk factors adverse effects of medications (4)

A
  • Corticosteroids
  • Diuretics
  • Digitalis
  • Laxatives abuse
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15
Q

Hypokalemia risk factors body fluid loss (4)

A
  • Vomiting
  • Diarrhea
  • Wound drainage
  • NG suction
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16
Q

Hypokalemia other risk factors (4)

A
  • Excessive diaphoresis
  • Kidney disease
  • Dietary deficiency
  • Alkalosis
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17
Q

Hypokalemia manifestations (8)

A
  • Muscle weakness, cramping
  • Fatigue
  • N/V
  • Irritability, confusion
  • Decreased bowel motility
  • Paresthesia
  • Dysrhythmias
  • Flat and/or inverted T waves
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18
Q

Hyperkalemia risk factors (4)

A
  • Renal failure
  • Adrenal insufficiency
  • Acidosis
  • Excessive potassium intake
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19
Q

Hyperkalemia medication risk factors (2)

A
  • Potassium sparing diuretics
  • ACE inhibitors
20
Q

Hyperkalemia manifestations (5)

A
  • Peaked T waves
  • Ventricular dysrhythmias
  • Muscle twitching, paresthesia (early)
  • Ascending muscle weakness (late)
  • Increased bowel motility
21
Q

Hyperkalemia medication interventions (5)

A
  • Kayexalate
  • 50% glucose with insulin
  • Calcium gluconate
  • Bicarbonate
  • Loop diuretics
22
Q

Hyponatremia risk factors (7)

A
  • GI loss
  • SIADH
  • Adrenal insufficiency
  • NPO
  • Restricted sodium diet
  • Water intoxication
  • Excessive diaphoresis
23
Q

Hyponatremia medication risk factors (5)

A
  • Diuretics
  • Anticonvulsants
  • SSRIs
  • Lithium
  • Demeclocycline
24
Q

Hyponatremia manifestations (10)

A
  • Weakness
  • Lethargy
  • Confusion
  • Seizures
  • Headache
  • Anorexia, N/V
  • Muscle cramps, twitching
  • Hypotension
  • Tachycardia
  • Weight gain, edema
25
Q

Hyponatremia medication intervention

A

Conivaaptan hydrochloride

26
Q

Hypernatremia risk factors (9)

A
  • Dehydration
  • GI loss
  • Hyperaldosteronism
  • Hypertonic tube feedings
  • Diabetes insipidus
  • Kidney failure
  • Burns
  • Heatstroke
  • Corticosteroids
27
Q

Hypernatremia manifestations (13)

A
  • Fever
  • Swollen, dry tongue
  • Hallucinations
  • Lethargy
  • Restlessness
  • Irritability
  • Seizures
  • Tachycardia
  • HTN
  • Hyperreflexia
  • Twitching
  • Pulmonary edema
  • Sticky mucous membranes
28
Q

Hypocalcemia risk factors (6)

A
  • Hypoparathyroidism
  • Hypomagnesemia
  • Kidney failure
  • Vitamin D deficiency
  • Inadequate intake
  • GI loss
29
Q

Hypocalcemia disease process risk factors (4)

A
  • Celiac disease
  • Lactose intolerance
  • Crohn’s disease
  • Alcohol use disorder
30
Q

Hypocalcemia manifestations (9)

A
  • Tetany
  • Cramps
  • Paresthesia
  • Dysrhythmias
  • Trousseau’s sign
  • Chvostek’s sign
  • Seizures
  • Hyperreflexia
  • Impaired clotting time
31
Q

Hypercalcemia risk factors (12)

A
  • Hyperparathyroidism
  • Malignant disease
  • Prolonged immobilization
  • Dehydration
  • Vitamin D excess
  • Thiazide diuretics
  • Lithium
  • Glucocorticoids
  • Digoxin toxicity
  • Over use of calcium supplements
  • Hyperthyroidism
32
Q

Hypercalcemia manifestations (14)

A
  • Muscle weakness
  • Kidney stones
  • Dysrhythmias
  • Lethargy
  • Coma
  • Hyporeflexia
  • Pathological fractures
  • Flank pain
  • Deep bone pain
  • Polyuria
  • Polydipsia
  • Dehydration
  • HTN
  • N/V
33
Q

Hypercalcemia medication interventions (5)

A
  • Furosemide
  • Calcitonin
  • Glucocorticoids
  • Bisphosphonates
  • Calcium chelators
34
Q

Hypomagnesemia risk factors (10)

A
  • GI loss
  • Alcoholism
  • Hypocalcemia
  • Hypokalemia
  • DKA
  • Hyperparathyroidism
  • Malabsorption
  • TPN
  • Laxative abuse
  • Acute MI
35
Q

Hypomagnesemia medication risk factors (5)

A
  • Cisplatin
  • Cyclosporine
  • Aminoglycoside antibiotics
  • Diuretics
  • Amphotericin B
36
Q

Hypomagnesemia manifestations (13)

A
  • Paresthesias
  • Dysrhythmias
  • Trousseau’s sign
  • Chvostek’s sign
  • Agitation
  • Confusion
  • Hyperreflexia
  • HTN
  • Insomnia
  • Irritability
  • Anorexia
  • N/V
  • Dysphagia
37
Q

Hypomagnesemia medication interventions (2)

A
  • IV magnesium sulfate
  • PO magnesium salts
38
Q

Hypermagnesemia risk factors (6)

A
  • Renal failure
  • Excessive Mg therapy
  • Adrenal insufficiency
  • Laxative over use
  • Lithium toxicity
  • Excessive soft tissue injury/necrosis
39
Q

Hypermagnesemia manifestations (9)

A
  • Hypotension
  • Drowsiness
  • Bradycardia
  • Bradypnea
  • Coma
  • Cardiac arrest
  • Hyporeflexia
  • N/V
  • Facial flushing
40
Q

Hypermagnesemia medication interventions (3)

A
  • IV lactated ringers, NS
  • IV calcium gluconate
  • Loop diuretics
41
Q

Hypophosphatemia risk factors (9)

A
  • Vitamin D deficiency
  • Re-feeding after starvation
  • Alcohol use disorder
  • DKA
  • Alkalosis
  • Hypomagnesemia
  • Hypokalemia
  • Burns
  • TPN
  • Overuse of antacids
42
Q

Hyphosphatemia excessive loss of body fluids risk factors (4)

A
  • Sweat
  • Diarrhea
  • Vomiting
  • Hyperventilation
43
Q

Hypophosphatemia manifestations (6)

A
  • Paresthesia
  • Muscle weakness
  • Bone pain, deformities
  • Chest pain
  • Confusion
  • Seizures
  • Nystagmus
44
Q

Hyperphosphatemia risk factors (8)

A
  • Renal failure
  • Chemo
  • Acute pancreatitis
  • High vitamin D
  • High phosphorus intake
  • Hypoparathyroidism
  • Excessive enema use
  • Acidosis
45
Q

Hyperphosphatemia manifestations (10)

A
  • Tetany
  • Cramps
  • Paresthesias
  • Dysrhythmias
  • Trousseau’s sign
  • Chvostek’s sign
  • Hyperreflexia
  • Anorexia
  • N/V
  • Soft tissue calcifications
46
Q

Hyperphosphatemia medication interventions (4)

A
  • Vitamin D
  • Aluminum hydroxide
  • Diuretics
  • IV NSc x