Ch 10 Fluid And Electrolytes

Question 1

Acidosis

Answer 1

An acid base imbalance characterized by an increase in hydrogen ion concentration ( decreased blood pH) (Low arterial pH due to increased hydrogen ion concentration or reduced bicarbonate concentration is called metabolic acidosis; a low arterial pH due to increased PCO2 is called respiratory acidosis)

Question 2

Active transport

Answer 2

Physiologic pump that uses energy to move fluid or electrolytes from one region to another

Question 3

Alkalosis

Answer 3

An acid base imbalance characterized by a reduction in hydrogen concentration or increase in bicarbonate concentration (increased blood pH) (A high arterial pH with either decreased hydrogen ion concentration or increased bicarbonate concentration is called metabolic alkalosis; a high arterial pH due to reduced PCO2 is called respiratory alkalosis)

Question 4

Colloid

Answer 4

A fluid containing particles that are non-soluble and evenly distributed throughout the solution

Question 5

colloid Oncotic pressure

Answer 5

Osmotic pressure created by the protein (mainly albumin) in the blood stream (synonym colloid osmotic pressure)

Question 6

Crystalloid

Answer 6

A fluid containing soluble mineral ions and water and in solution

Question 7

Diffusion

Answer 7

The process by which solutes move from an area of higher concentration to one of lower concentration; does not require expenditure of energy

Question 8

Homeostasis

Answer 8

Maintenance of a constant internal equilibrium in a biologic system

Question 9

Hydrostatic pressure

Answer 9

The pressure created by the weight of fluid against the wall that contains it. In the body, hydrostatic pressure in blood vessels results from the weight of fluid itself and the force resulting from cardiac concentration

Question 10

Hypertonic solution

Answer 10

A solution with an osmolality higher than that of serum

Question 11

Hypotonic solution

Answer 11

A solution with an osmolality lower than that of zero

Question 12

Isotonic solution

Answer 12

A solution with the same osmolality as blood

Question 13

Osmolality

Answer 13

The number of milliosmoles (the standard unit of osmotic pressure) Per kilogram of solvent; expressed as milliosmolesper kilogram (mOsm/kg) (The term osmolality is used more often than osmolarity to evaluate serum and urine)

Question 14

Osmolarity

Answer 14

The number of milliosmoles (The standard unit of osmotic pressure) Per liter of solution; expressed as milliosmoles per kg (mOsm/L); describes a concentration of solutes or dissolved particles

Question 15

Osmosis

Answer 15

The process by which fluid moves across a semi permeable membrane from an area of low solute concentration to an area of high solute concentration; the process continues until the salt concentrations are equal on both sides of the membrane

Question 16

Tonicity

Answer 16

Fluid tension or the effect that osmotic pressure of a solution with impermeable solutes exerts on cell size because of water movement across the cell membrane

Question 17

Anion Gap

Answer 17

A measurement of the difference between the sum of routinely measured cation minus the sum of the routinely measured anions in the blood.

A high anion gap indicates metabolic acidosis

Anion gap 8-11

Question 18

Common causes of Respiratory Acidosis

Answer 18

Hypo ventilation

Question 19

Common causes of respiratory alkalosis

Answer 19

Hyperventilation

Question 20

Common causes of metabolic acidosis

Answer 20

HCO3 loss Diarrhea
Renal failure
Salicylates
Drug induced hyperkalemia

Question 21

Common causes of metabolic alkalosis

Answer 21

H+ loss(vomiting) (ng tubes) (Hypovolemia)
HCO3 increase
A compensating COPDer
Thiazides and loop diuretics (Hypokalemia)

Question 22

Kussmal breathing

Answer 22

Rapid shallow breathing

Question 23

Cheyne stoke breathing

Answer 23

Deep labored breathing with decreased LOC and further deterioration

Question 24

Hypokalemia

Answer 24

Due to vomiting, diarrhea, G.I. suction, diuretics, steroids, alkalosis, dig Toxicity, Potassium wasting diuretics i.e. loop and thiazide

Signs and symptoms fatigue, nausea/vomiting, muscle weakness, leg cramps, decreased G.I. motility, decreased BS, abdominal distention

VS decreased blood pressure, EKG changes

Treatment administer oral potassium supplements, administer IVPB potassium, never administer IV push potassium; could be fatal

Question 25

Hyperkalemia

Answer 25

Due to diabetic keto acidosis, metabolic acidosis, kidney disease, potassium sparing diuretics (spironolactone),Burns, NSAIDS, acidosis

Signs and symptoms muscle weakness, placidity,parenthesis

V/S tachycardia bradycardia, EKG changes

Treatment potassium restricted diet, potassium wasting diuretics, diuretics, dialysis, kayexalate (sodium polystyrene)
Glucose and insulin (Moves potassium into the cell)



Question 26

Dehydration

Answer 26

Due to excessive loss or an adequate intake

Labs increased hemoglobin and Hema crit, elevated BUN

Urine decreased urine output

Vital signs tachycardia(To circulate remaining volume faster), Tacypena (In attempt to gain more oxygen), Hypotension owing to decrease and circulating blood volume, hypo thermia

Signs and symptoms thirst, poor skin turgor, sunken eyes

Compensate drink, increase thirst

Nursing actions drink(Replace oral fluids), Monitor electrolytes, monitor vital signs, IV fluids

Question 27

Fluid volume deficit
(Severe dehydration), Shock

Answer 27

Labs Increased as osmolarity, increased sodium increased hemoglobin and Hema crit, increased BUN and creatine

Urine increased osmolality greater than 300 Mili osmosis per liter, increased gravity, decreased sodium in urine, Decreased ADH

Vital signs Hypotension, tachycardia, elevated temperature

Signs and symptoms thirsty, weight loss, poor skin turgor

Compensate SNS trigger to increase thirst, increased ADH to increase Aldosterone Release

Nursing actions Trendelenburg (To return volume to vital organs) Isotonic IV fluids to restore vascularity and perfusion, increasing blood pressure, vasoconstrictors, monitor vitals, monitor urine, monitor labs

Question 28

Fluid volume overload

Answer 28

Due to water and sodium retention, are overhydration due to pulmonary edema, Heart failure due to water replacement without electrolytes, increased ADH

Labs
Hyper volume labs decreased Hema crit, typically sodium is normal range, decreased electrolytes, BUN and creatine

Overhydration labs decreased osmolarity less than 270, decreased electrolytes, BUN and creatine, generally decreased serum osmolarity

Urine decreased urine output, increased water retention, decreased urine osmolality, decreased specific gravity

Vital signs tachycardia due to overload, bounding pulse due to increased vascular, hypertension, increased central venous pressure

Signs and symptoms confusion, muscle weakness, weight gain, ascites, dyspnea, Orthopnea, Crackles, diminished breath sounds, edema, distended neck veins

Compensation diuresis, dialysis

Nursing actions monitor weight, low sodium diet, fluid restriction, intake and output, diuretics, a CE – one, ARB’s

Question 29

Baroreceptors

Answer 29

They respond to changes in blood volume, they regulate SNS & PNS

Increase SNS: increase blood pressure and heart rate

Decrease PNS: Decrease blood pressure and heart rate

Question 30

RAAS

Answer 30

ACE and aldosterone
ACE converts to vasoconstrictor, increases arterial perfusion pressure and stimulates thirst

Aldosterone regulates volume: causes water to be reabsorbed along with sodium to increase blood volume and blood pressure

Question 31

ADH

Answer 31

A vasopressor that causes a decrease in urine output, decrease in plasma osmolarity due to the increase in fluid volume (It’s holding on to water)

Question 32

Dehydration

Answer 32

Not the same as fluid volume deficit
Loss of water alone, with increased serum sodium levels