chapter 6: nursing care of pts w/ fluid, electrolyte and acid base imbalances

Question 1

fluid balance

Answer 1

intracellular fluid
extracellular fluid: interstitial fluid, intravascular fluid, transcellular fluid

Question 2

control of fluid balance

Answer 2

pressure sensors
antidiuretic hormone

Question 3

movement of fluids and electrolytes

Answer 3

active transport
passive transport: diffusion, filtration, osmosis

Question 4

tonicity

Answer 4

isotonic: same osmolarity as blood
hypertonic: lower osmolarity than blood
hypotonic: greater osmolarity than blood

Question 5

fluid gains and losses

Answer 5

gains: food and fluid
losses: sensible, insensible

Question 6

fluid imbalances

Answer 6

dehydration: hypovolemia
fluid overload

Question 7

dehydration signs and symptoms

Answer 7

• thirst
• rapid, weak pulse
• low blood pressure
• dry skin and mucous membranes
• skin tenting
• decreased urine output
• increased temp

Question 8

interventions for deficient fluid volume

Answer 8

• monitor daily weight
• monitor intake and output
• increase fluid intake
• treat underlying cause
• use caution w/ elderly patients

Question 9

fluid excess signs and symptoms

Answer 9

• bounding pulse
• elevated bp
• respiratory changes
• edema
• increased urine output
• weight gain
• heart failure

Question 10

interventions for excess fluid volume

Answer 10

• monitor weight and urine output
• place in Fowlers
• administer oxygen
• administer diuretics
• restrict fluid and sodium

Question 11

electrolytes

Answer 11

cations: positive
anions: negative

Question 12

sodium imbalances

Answer 12

hyponatremia: sodium deficit
hypernatremia: sodium excess

Question 13

food sources of sodium

Answer 13

pizza
canned vegetables
canned soups
salty snacks
prepared foods

Question 14

hyponatremia signs and symptoms

Answer 14

• sodium < 135 mEq/L
• fluid excess or deficit
• mental status changes
• weakness
• nausea and vomiting

Question 15

interventions for hyponatremia

Answer 15

• monitor I & Os
• monitor weight
• restrict fluids
• administer diuretics/steroids

Question 16

hypernatremia signs and symptoms

Answer 16

• sodium > 135 mEq/L
• thirst
• mental status changes
• seizures
• muscle weakness
• respiratory compromise

Question 17

interventions for hypernatremia

Answer 17

• treat fluid imbalance FIRST
• monitor I & Os
• monitor weight
• administer diuretics
• restrict dietary sodium
• treat cause

Question 18

potassium imbalances

Answer 18

hypokalemia: potassium deficit
hyperkalemia: potassium excess

Question 19

food sources of potassium

Answer 19

sweet potatoes
beet greens
potatoes
yogurt
prune juice
bananas
orange juice

Question 20

hypokalemia signs and symptoms

Answer 20

• potassium < 3.5 mEq/L
• muscle weakness
• shallow respirations
• mental status changes
• cardiac arrhythmia and arrest

Question 21

interventions for hypokalemia

Answer 21

• treat underlying cause
• offer potassium rich foods
• administer potassium replacement
• teach pts: signs and symptoms to report, self administration of supplement

Question 22

hyperkalemia signs and symptoms

Answer 22

• K+ > 5 mEq/L
• muscle twitching and cramps: later muscle weakness
• diarrhea
• low bp
• cardiac arrhythmia and arrest

Question 23

interventions for hyperkalemia

Answer 23

• • limit dietary potassium
• hold potassium supplements
• administer medications as ordered: potassium losing diuretic, kayexalate, insulin w/ glucose

Question 24

calcium imbalances

Answer 24

hypocalcemia: low calcium level
hypercalcemia: high calcium level

Question 25

food sources of calcium

Answer 25

fortified cereals canned salmon spinach yogurt cheese milk

Question 26

hypocalcemia signs and symptoms

Answer 26

- calcium < 4.5 mEq/L - mental status changes - hyperactive deep tendon reflexes - diarrhea - cardiac arrhythmia and arrest

Question 27

interventions for hypocalcemia

Answer 27

- treat cause - increase dietary calcium - administer medications as ordered: IV calcium gluconate, oral calcium supplements, aluminum hydroxide to bind phosphate

Question 28

hypercalcemia signs and symptoms

Answer 28

- calcium > 5.5 mEq/L - increased heart rate and bp - skeletal muscle weakness - decreased GI motility

Question 29

interventions for hypercalcemia

Answer 29

- administer fluids - administer medications as ordered: Furosemide, pamidronate, Zoledronic acid, Calcitonin - hemodialysis

Question 30

magnesium imbalances

Answer 30

hypomagnesemia: low magnesium level hypermagenesemia: high magnesium level

Question 31

hypomagnesemia signs and symptoms

Answer 31

- magnesium < 1.5 mEq/L - positive Troussea sign - Positive Chvostek sign - cardiac arrhythmia and arrest

Question 32

interventions for hypomagnesemia

Answer 32

- treat underlying cause - administer magnesium replacement

Question 33

hypermagnesemia signs and symptoms

Answer 33

- magnesium > 2.5 mEq/L - hypotension - lethargy - skeletal muscle weakness - respiratory failure - cardiac arrhythmia and arrest

Question 34

interventions for hypermagnesemia

Answer 34

- administer IV fluids - administer medications as ordered: loop diuretics (Furosemide), dialysis

Question 35

acid-base imbalance

Answer 35

acid: substance that releases a hydrogen ion base (alkali): substance that binds hydrogen normal H 7.35-7.45

Question 36

acid-base control

Answer 36

cellular buffers lungs kidneys

Question 37

types of acidosis

Answer 37

respiratory metabolic

Question 38

types of alkalosis

Answer 38

respiratory metabolic

Question 39

respiratory acidosis has low ____, high ____, neutral ____

Answer 39

ph, PCO, HCO

Question 40

respiratory alkalosis has high ____, low ____, neutral _____

Answer 40

ph, PCO, HCO

Question 41

metabolic acidosis has low ____, neutral ____, low ____

Answer 41

ph, PCO, HCO

Question 42

metabolic alkalosis has high ___, neutral ____, high ____

Answer 42

ph, PCO, HCO