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Nclex flashcards > fluids and electrolytes > Flashcards

fluids and electrolytes Flashcards

1
Q

what is the purpose of sodium (NA+)

A

to regulate water in the cells

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2
Q

sodium is important in what?

A

the brain, nerves and muscle cells

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3
Q

what is euvolemic hypernatremia

A

sodium stays the same “normal” level but due to water loss it is more concentrated

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4
Q

what causes euvolemic hypernatremia

A

insensible water loss such as fever, excess sweating, hyperventilation, and diabetes insipidus.

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5
Q

what is hypovolemic hypernatremia

A

a loss of both water and sodium, but more water is lost than sodium

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6
Q

what causes hypovolemic hypernatremia

A

dehydration, NPO, diarrhea, vomiting, burns, or diuretics

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7
Q

what is hypervolemic hypernatremia

A

increased sodium and water, but more sodium than water

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8
Q

what causes hypervolemic hypernatremia

A

hypertonic IV fluids, sodium bicarbonate, increased sodium intake, corticosteroids (Cushing’s syndrome) hyperaldosteronism

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9
Q

what are neuro symptoms of hypernatremia

A

restlessness, agitation, lethargy, drowsiness, stupor, coma

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10
Q

what are cardiac symptoms of hypovolemic hypernatremia

A

fever, hypotension, weak and thready pulses

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11
Q

what are cardiac symptoms of hypervolemic hypernatremia

A

fever, edema, hypertension, bounding pulse

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12
Q

what are some other symptoms of hypernatremia

A

dry mouth, flushed/warm and decreased urine output

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13
Q

what is the treatment for euvolemic hypernatremia

A

encourage water intake orally

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14
Q

what is the treatment for hypovolemic hypernatremia

A

normal saline to dilute the sodium

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15
Q

what is the treatment for hypervolemic hypernatremia

A

find the causative agent and discontinue (steroids, sodium bicarbonate, too much IV fluids)
admin loop diuretics
free water administration (water FREE of salutes)

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16
Q

what are the two most important things to remember in regards to a client with hypernatremia

A

always monitor neuro signs and correct the imbalance slowly to avoid cerebral edema

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17
Q

what can happen as a result of cerebral edema

A

swelling of the brain leading to seizures

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18
Q

what is euvolemic hyponatremia

A

water in the body increases but sodium stays the same

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19
Q

what are the causes of euvolemic hyponatremia

A

Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
adrenal insufficiency
addisons disease
polydipsia
excessive hypotonic IVF
low dietary intake of sodium

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20
Q

what is hypervolemic hyponatremia

A

water increases by a lot and sodium remains the same

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21
Q

causes of hypervolemic hyponatremia

A

CHF
kidney failure
nephrotic syndrome
liver failure
water intoxication

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22
Q

what is hypovolemic hyponatremia

A

water and sodium loss

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23
Q

causes of hypovolemic hyponatremia

A

vomiting, diarrhea, NG tube suction, diuretics, burns, excessive sweating

24
Q

what are neuro symptoms of hyponatremia

A

seizures
confusion
lethargy
stupor
cerebral edema
increased ICP

25
Q

what are musculoskeletal symptoms of hyponatremia

A

adbo cramps
weakness
shallow resps
decreased deep tendon reflexes
muscle spasms
orthostotic hypotension

26
Q

what are the cardiac symptoms of hyponatremia

A

in hypovolemic
weak, thready pulse
tachycardia
hypotension
dizziness

in hypervolemic
bounding pulses
hypertension

27
Q

what are GI/GU symptoms of hyponatremia

A

loss of appetite
hyperactive bowel sounds

28
Q

treatment for euvolemic hyponatremia

A

we want to bring water slightly down and sodium slightly up
to keep water down:
restrict free water
osmotic diuretics
to increase sodium:
sodium tablets
high salt diet

29
Q

treatment for hypervolemic hyponatremia

A

we want to bring water way down and sodium way up
restrict free water
osmotic diuretics
sodium tablets
high salt diet

30
Q

treatment for hypovolemic hyponatremia

A

restore water and sodium
in mild cases use 0.9% sodium chloride
in severe use 3% sodium chloride

31
Q

what is the purpose of chloride

A

works with sodium to maintain fluid balance

32
Q

what is hyperchloremia, what are the causes

A

too much chloride
fluid loss (vomiting, sweating, dehydration)
steroids (cushings disease, excess corticosteroid use)
excess chloride admin (NS)

33
Q

treatment for hyperchloremia

A

bicarbonate admin
discontinue sodium containing meds
discontinue NS, consider LR instead
monitor all electrolytes because it is likely not just chloride

34
Q

what is hypochloremia, what are the causes

A

not enough chloride
volume over load (CHF, water intoxication)
salt losses (burns, sweat, vomit, diarrhea, cystic fibrosis, addisons disease)

35
Q

treatment for hypochloremia

A

treat underlying cause
0.9% NS
monitor all electrolytes

36
Q

what has an inverse relationship with chloride

A

bicarbonate

37
Q

chloride is directly related to

A

sodium and potassium

38
Q

potassium is important for what

A

heart and skeletal muscle contraction

39
Q

what are the causes of hyperkalemia

A

burns, tissue damage, DKA, renal failure, excessive potassium intake, medications (ACE inhibitors, potassium sparing diuretics)

40
Q

what are the signs and symptoms of hyperkalemia

A

muscle weakness, numbness, shallow resps, cramping, hyperactive bowels, diarrhea, ecg changes (tall, peaked T waves) weak pulse, bradycardia, hypotension

41
Q

treatment for hyperkalemia

A

D5W + regular insulin
albuterol
bicarbonate
kayexalate
diuretics
dialysis
discontinue potassium supplements and restrict diet

42
Q

what would you do if there were ecg changes in a client with hyperkalemia

A

give IV calcium gluconate or chloride to protect the myocardium

43
Q

causes of hypokalemia

A

DITCH
potassium wasting Drugs (diuretics, corticosteroids, laxative)
Inadequate K+ intake
Too much water
Cushing’s disease
Heavy fluid loss

44
Q

signs and symptoms of hypokalemia

A

the 6 Ls
Lethargy
low/shallow resps
Limp muscles
Lethal dysrhythmias
Leg cramps
Lots of urine out put

45
Q

what ecg changes will you likely see in hypokalemia

A

prominent u waves

46
Q

treatment of hypokalemia

A

POD
Potassium IV
Oral potassium (give with food to prevent GI upset)
Diet rich in potassium

47
Q

calcium is important in what? excreted by?

A

bones, teeth, nerves, muscles and coagulation

48
Q

calcium has an inverse relationship with

A

phosphorous

49
Q

what is hypercalcemia, what are the symptoms

A

MD SPIED
Malignancy
Diuretics

Steroids
Parathyroid hyperparathyroidism
Immobilization
Endocrine (Addison’s)
D vitamin D toxicity

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Nclex flashcards (12 decks)

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