F & E Lecture Printouts Flashcards
These are flash cards from the F&E Lectures 1,2, and 3 (91 cards)
1
Q
What are 3 factors that influence the amount and distribution of body fluids?
A
Age, sex, and racial/ethnic origin
2
Q
what percentage of body weight is water in infants?
A
70-80%
3
Q
Elderly have about, what % of body weight from water?
A
about 50%
4
Q
Why are elderly at risk for fluid related problems?
A
Because they have less fluid reserve
5
Q
The young and old both have a ________ ability to compensate for fluid loss.
A
decreased
6
Q
men have ? body water than women because men have fewer ? cells.
A
Men have more body water because of fewer fat cells.
7
Q
What % of dult males weight is fluid weight?
A
60%
8
Q
Woman have about what % of body eight fr fluid?
A
50%
9
Q
Why do african americans have less body water?
A
They often have larger numbers of adipose tissue
10
Q
What % of body fluid loss is considered mild? Moderate? severe?
A
A fluid loss of:
2% is a mild deficit
5% is a moderate deficit
8% or > is severe
11
Q
How do you determine fluid loss?
A
same everything; scale, clothing, time of day
12
Q
1 liter of fluid loss is how much weight?
A
1kg/2.2lbs.
13
Q
What is the best way to determine fluid loss?
A
weighing the patient
14
Q
What is the unit of measurement used t express chemical activity?
A
mEq
15
Q
if the level of Na+ in the blood is 140mEq/L; what does that mean?
A
It means that there are 140 cations available to combine with 140 anions fr each liter of blood
16
Q
Body fluids are contained in what 2 fluid compartments?
A
Intracellular(ICF) and Extracellular (ECF)
17
Q
Where is the intracellular fluid?
A
within the cell. it is about 2/3’s of total body water
18
Q
where is extracellular fluid located?
A
Outside of the cells, about 1/3 of total body fluid water
19
Q
Extracellular fluid can be further divided into what two compartments?
A
Intravascular and interstitial
20
Q
Where is intravascular fluid found?
A
within the blood vessels
21
Q
Where is interstitial fluid found?
A
between the cells, includes lympth, bone and connective tissue water
22
Q
What is the term fluid spacing used for?
A
used to classify distribution of water
23
Q
What is fluid spacing classified as?
A
- First spacing: normal dist. of fluid
- Second spacing: abnormal accumulation of interstitial fluid(edema)
- Third spacing: fluid accumulates in areas that normally do not have fluid
24
Q
What are the normal ranges for Sodium?
A
Na+ 136-145 mEq/l
25
What are some dietary sources for Na?
canned soups, cheese,processed meats, table salt, seafood.
26
How is Na regulated?
By dietary intake and aldosterone secretion
27
Loss or gain of Na is usually accompanied by a loss or gain of what?
water (water is like a total follower of Na. What a loser)
28
What organ regulates Na?
Da kidneys
29
What does sodium bicarbonate do?
it is a acid base buffer
30
low sodium levels will inhibit the secretion of what? and what does that make the kidneys do?
Low Na will inhibit the release of ADH, and NP which triggers aldosterone secretion which will increase kidney rabsorption of Na, and enhance water loss
31
High sodium levels will do what?
high Na will inhibit aldosterone secretion and stimulate ADH and NP.
32
What is the lab value for hyponatremia?
a serum Na level of < 136 mEq/l
33
What are some actual Na defiits?
Excessive diaphoresis, diuretics, wound drainage, KIDNEY DISEASE, decreased aldosterone secretion, n/v/d
34
S&S of Hyponatermia?
usually do not appear until serum Na <125 mEq/L. The s&s depends on how rapid the changes were in Na levels.
35
What are some s&s of hyponatremia for cerebral and neuro?
headache, irritability(which gets worse as Na goes down), disorientation leading to delirium, muscle twitching, tremors, weakness
36
What are some s&s of hyponatremia for GI?
increase motility causing n/v/d
37
What are some s&s of hyponatremia forcardiovascular?
responds to hypovolemia. there will be hypovolemia symptoms
38
A pt has hyponatremia what will happen to their urinary output?
Hyponatremia leads to increased urinary output
39
What is the aim of therapy for hyponatremia?
Not to correct the imbalance to quickly. The goal is to raise or lower the Na levels until the s&s are gone.
40
What is the priority nursing care for a pt c hyponatremia?
Monitor the pt's response to therapy and making sure not to send the pt into hypernatremia
41
What are 2 types of drugs that should be stopped in a pt with hypoNa?
loop and thiazide diuretics
42
A pt c hypoNa you want to restrict fuid intake. What intake level restriction should the pt comply c?
fluid intake of 1000mL-1200mL/24hrs
43
What is the serum levels for Hypernatremia?
Na > 145mEq/L
44
What are some manifestations of hypernatremia?
short attention span, agiation, confusion. With higher Na levels seizures
45
What happens to the muscoskeletal system when a pt is HyperNatreic?
mild increase in muscle twitching and contractions. as it gets higher there is increassed weakness and diminished reflexes
46
What are the affects of hypernatremia on the cardiovascular system?
elevated pulse, hypotension, and orthostatic hypotension c hypovolemia
47
When hyernatremia is caused by fluid loss what type of fluids should be administered?
Give hypotonic IV solution
48
When Hyernatremia is caused by poor renal excretion aka fluid gain, what medicine should be given?
diuretics
49
What are the normal ranges for an adult potassium(K+)?
K+ level 3.5-5.0mEq/L
50
What are some dietary sources for potassium?
Chocolate, dried fruits, nuts, seeds, oranges, bananas, avocado, cantaloupe, meats, beans
51
What are some functions of K+?
helps control intracellular concentration
| -role in the process of electric impulses in nerve, heart, skeletal, intestinal and lung tissue
52
K+ is regulated by? and excreted by?
regulated by aldosterone, and excreted by the kidneys
53
when someone is said to be in hypokalemia what is their serum K+?
K+ < 3.5mEq/L
54
What are some causes of hypoKalemia?
overuse of diuretics, digitalis, d/v, prolonged NG suction, kidney disease,
55
someone who is hypoK what would you see in their GI function?
decreased peristalis, hypoactive bowel sounds
56
What is the drug therapy for a pt in hypoK?
FIRST check the kidney function....
Administer IV K+ after kidney function is determined. administer it slow while checking frequently due to the drug being a severe irritant
57
Which foods have the highest concentration of K+?
meat, fish. Lowest in eggs, cereal, and milk
58
What is the blood serum level of a pt with hyperkalemia?
k+ > 5.0mEq/L
59
What is the primary cause of hyperK?
renal failure due to inability to excrete potassium
60
If a pt is in acidosis which would be higher the pH or the K+?
in acidosis the pt is acidic so pH is low and K+ is high
61
What are the common cardiac factors for hyper- and hypokalemia?
The heart rate slows and becomes thready. the heart rhythm is irregular. In severe hyperK+ v-fib and heat block can occur
62
hyperK does what to the peristalsis of the GI tract?
increases, hyperactive bowel sounds. This is opposite of hypoK
63
What are the priority nursing interventions?
monitor cardiac status, safety, response to therapy, and health teaching
64
Pt in acidosis is given IV sodium bicarb. What is the affect of this drug?
it will shift the K+ into the cells which raises pH and lowers K+. IV dextrose can be given at 10-50% to move the K+ into the cells
65
What are the serum levels of Calcium(Ca2+)?
Ca2+ 9.0-10.5mEq/L
66
What are some dietary sources of calcium?
canned sardines and salmon, dairy products, green leafy vegetables, whole grains
67
What is the function of calcium?
- bone strength and density
- nerve impulse and transmission
- roles in blood clotting
- muscle contraction and relaxation
- regulates the parathyroid hormone and calcitonin
68
If someone has thyroid problems like ca, what might you find with their calcium?
might have calcium issues
69
What are the serum levels of Hypocalcemia?
Ca2+ level <9.0mg/dl
70
What are 2 significant findings of someone who my have Hypocalcemia?
positive Trousseau's sign(carpal spasm when inflating a bp cuff), and positive Chvostek's sign(contraction of facial muscles in response to tap of facial nerve)
71
True or false
| A person c hypocalcemia would have increased peristalsis.
True increased peristalsis hyperactive bowels , diarrhea, abd cramping
72
What is the drug nursing intervention?
Oral calcium replacement or IV and drugs that enhance absorption like aluminum hydroxide and vit D
73
What is the serum level of some with hypercalcemia?
serum Ca2+ level >10.5mg/dL
74
What is the affect of hypercalcemia in a mild case on the cardiovascular system?
increased heart rate and BP
75
What is the affect of hypercalcemia in a severe case on the cardiovascular system?
depression of electrical conduction which slows the heart rate leading to cardiac arrest, blood clots
76
What are the nursing interventions of hypercalcemia?
Stop IV therapy of drugs with calcium, such as ringer's lactate. and give normal saline 0.9% sodium chloride whis will increase kidney excretion
77
True or false
| In a severe case of hypercalcemia dialysis should be given.
True
78
What is the normal serum level of phosphorus/phosphate
phosphorus 3.0-4.5mg/dL
79
What is the main function of phosphorus?
Helps maintain acid-base balance as a hydrogen buffer
80
What are the levels for hypophosphatemia?
<3.0mg/dl
81
what is given for moderate hypophospatemia?
Oral phophate replacement along with vit D
82
what is given for severe hypophospatemia?
IV phosphorus is given when phosphate levels fall below 1mg/dL
83
Who is highest risk for hypophosphatemia?
Alcoholics, diabetic ketoacidosis,
84
What are the levels for hyperphosphatemia?
>4.5 mg/dL
85
what happens to the K levels when you have high phosphorus?
K will go down
86
What is the nursing intervention for hyperphosphatemia?
Correction is aimed at treating hypocalcemia
87
What are the normal levels of Magnesium?
1.3-2.1mEq/dL
88
What are the levels of hypomagnesemia??
<1.3mEq/L
89
What are the levels of hypermagnesemia?
>2.1mEq/L
90
What is given to reverse the cardiac effects of hypermagnesemia?
calcium
91
What are the normal levels of chloride?
98-106mEq/L
