Electrolytes

Question 1

fluid intake requirements

Answer 1

male = 3500 mL/day
female = 2700 mL/day

20% gained from food alone

Question 2

fluid output

Answer 2

urine = 1500-2000 mL/day

skin, lung, feces = about 300 mL/each/day

Question 3

urination leads to loss of which electrolytes?

Answer 3

sodium, potassium

Question 4

hypovolemia

Answer 4

loss of fluid AND electrolytes

Question 5

dehydration

Answer 5

loss of fluid

Question 6

risks for hypovolemia

Answer 6

emesis
excessive gastric suction
diarrhea
sweating
excessive urination
third spacing
blood loss
poor intake

Question 7

risks for dehydration

Answer 7

hyperventilation
fever
diabetic ketoacidosis
enteral feeding w/poor water intake

Question 8

signs and symptoms of hypovolemia and dehydration

Answer 8

dry skin/mucous membranes
excessive thirst
poor skin turgor
decreased urine output
hypotension
tachycardia
tachypnea
dizziness, confusion, fatigue, syncope
weight loss
slow capillary refill
sunken eyes (fontannels for infants)
no tears

Question 9

hypervolemia

Answer 9

excess water AND sodium which increases blood volume

Question 10

overhydration

Answer 10

excess water > electrolytes

hemodilution d/t imbalance of H20

Question 11

risks for hypervolemia

Answer 11

heart failure
poor kidney function
hypertonic fluid admin
excessive sodium intake

Question 12

risks for overhydration

Answer 12

head injuries
anesthesia
syndrome of inappropriate antidiuretic hormone secretion (SIADH)
replacing loss w/H20 not electrolytes

Question 13

signs and symptoms of hypervolemia and overhydration

Answer 13

high BP
bounding pulse
tachycardia
confusion, muscle weakness
pale, cool skin
edema, ascites
crackles
weight gain
dyspnea
JVD

Question 14

lab test specific to FVD

Answer 14

glucose

Question 15

lab tests specific to FVE

Answer 15

ABG, creatinine

Question 16

major electrolytes

Answer 16

sodium
potassium
calcium
magnesium
chloride
phosphorus
bicarbonate

Question 17

sodium

Answer 17

135-145 mEq/L
ECF
regulates fluid volume
reabsorbed by kidneys

Question 18

hyponatremia

Answer 18

water moves INTO the cell, causing cellular swelling

Question 19

hypernatremia

Answer 19

water moves OUT of cell, causing cellular dehydration

Question 20

S/S sodium imbalance

Answer 20

tachycardia
hypoTN
HA, confusion
decreased DTR
hyperactive bowel, abdominal cramps
N/V

Question 21

potassium

Answer 21

35-5 mEq/L
ICF
regulates muscle contraction, cardiac conduction
eliminated by kidneys

Question 22

S/S hypokalemia

Answer 22

weak, irregular pulse
hypoTN
muscle cramping
confusion
premature ventricular contractions, flattened T waves, ST depression
hypoactive bowel sounds
N/V/D

Question 23

S/S hyperkalemia

Answer 23

slow, irregular pulse
decreased DTR
confusion
ventricular fibrillation, peaked T waves, widened QRS, cardiac arrest
diarrhea

Question 24

calcium

Answer 24

9-10.5 mg/dL

regulates bone and muscle health

Question 25

S/S hypocalcemia

Answer 25

``` numbness, tingling muscle spasms hyperactive DTR facial twitch (Chvostek's sign) BP cuff twitch (Trousseau's sign) prolonged QT interval and ST hyperactive bowel, diarrhea seizures ```

Question 26

S/S hypercalcemia

Answer 26

``` decreased DTR bone pain dysrhythmias increased risk of blood clots lethargy, confusion ```

Question 27

magnesium

Answer 27

1.3-3.1 mEq/L | alcoholism, laxative abuse huge causes of hypomagnesemia

Question 28

S/S hypomagnesemia

Answer 28

``` hyperactive DTR muscle tetany Chvostek Trousseau seizures hypoactive bowel, constipation tachycardia HTN ``` alcoholism, laxative abuse may cause

Question 29

S/S hypermagnesemia

Answer 29

``` decreased DTR muscle paralysis decreased RR bradycardia lethargy ``` laxatives containing Mg may cause

Question 30

chloride

Answer 30

ECF | bound to other ions (like sodium)

Question 31

phosphate

Answer 31

ICF | bound w/calcium in teeth and bones, but has inverse relationship w/Ca2+

Question 32

bicarbonate

Answer 32

ICF and ECF | acid base balance regulated by kidneys; produced to act as a buffer

Question 33

blood pH

Answer 33

nml 7.35-7.45 acidosis <7.35 alkalosis >7.45

Question 34

pCO2

Answer 34

respiratory pH control nml 35-45 resp acidosis (CO2 retention) >45 resp alkalosis (excessive ventilation) <35

Question 35

HCO3

Answer 35

bicarbonate pH control nml 22-26 met acidosis <22 met alkalosis >26