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NUR 122 > Fluid And Electrolyte > Flashcards

Fluid And Electrolyte Flashcards

(83 cards)

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0
Q

What is second spacing?

A

Excess accumulation of interstitial fluid; edema

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1
Q

What is “first spacing”?

A

Normal distribution of fluid both intra and extra cellular

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2
Q

What is third spacing?

A

Occurs when fluid accumulates in areas that normally do not have fluid or only a small amount

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3
Q

What is an isotonic fluid imbalance?

A

When water and electrolytes are lost in equal proportions but osmolality remains unchanged

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4
Q

What adverse conditions can third spacing produce?

A

Hypovolemia

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5
Q

What is an osmolar fluid imbalance?

A

Losses or excess of only water that affect the serum concentration

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6
Q

What is osmolarity?

A

Concentration

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7
Q

What is an isotonic fluid volume deficit?

A

Water and electrolytes lost in equal proportions due to excessive fluid loss or 3rd space shifting

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8
Q

What assessment findings should be expected in a patient with hypovolemia?

A

Increased Hct, BUN and urine specific gravity. Tachycardia, hypotension, weak, thready pulse. (If hypovolemia is caused by hemorrhage: Hct and Hgb will decrease)

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9
Q

What is the alternate name for isotonic fluid volume excess?

A

Hypervolemia

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10
Q

How much fluid is lost from the lungs each day?

A

350-400 mL

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11
Q

What are common causes of hypervolemia?

A

Excessive fluid/sodium intake or fluid/sodium retention.

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12
Q

What assessment findings should be expected in a patient in fluid volume excess?

A

Decreased BUN and Hct. Rapid, bounding pulse, tachycardia, hypertension, JVD

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13
Q

What are the two types of IV solutions?

A

Crystalloids and Colloids

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14
Q

What are the three types of crystalloids?

A

Isotonic, hypotonic and hypertonic

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16
Q

What is hypotonic IV solution used for?

A

To shift fluid from the ECF to ICF

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17
Q

What is intravascular fluid?

A

Plasma (the fluid inside blood vessels)

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18
Q

What are examples of third spacing?

A

acites and pulmonary edema

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19
Q

A change in fluid status (whether excess or deficit) with unchanged osmalaity is what?

A

Isotonic

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20
Q

A change in fluid status that affects the concentration of serum is?

A

Osmolar

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21
Q

What would be the appropriate nursing intervention for hyponatremia due to excess volume?

A

Place the pt on a fluid restriction

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22
Q

A pt who is vomiting would have which acid-base imbalance?

A

Metabolic Alkalosis

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23
Q

A pt with diarrhea would have which acid-base imbalance?

A

Metabolic Acidosis

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24
Q

What is the normal range for a pt’s pH?

A

7.35 to 7.45

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25
What is the normal range for a pt's CO2?
35 to 45
26
What is the normal range for a pt's HCO3?
22 to 26
27
What are the signs of hypercalcemia?
lethargy, headache, weakness, muscle flaccidity, heart block, anorexia, nausea, and vomiting
28
What is the normal range of serum potassium?
3.5 to 5.5
29
What is the normal level of phosphorus in the body?
2.4--4.4
30
DKA is what type of acid-base imbalance?
Metabolic Acidosis
31
When planning care for adult patients, the nurse concludes that which oral intake is adequate to meet the daily fluid needs of a stable patient?
2000-3000 mL
32
What is acites?
extended abdomen
33
What causes acites?
Liver failure
34
What is the first indication of heart failure?
Weight gain
35
What is the amount of weight gain that should trigger concern for heart failure?
2 lbs in 24 hours or 5 lbs in a week
36
What type of IV fluid should be administered for a hypertonic fluid volume deficit?
Hypotonic fluid
37
What are the cations?
Sodium, Potassium, Calcium and Magnesium
38
What is most sodium found?
in the ECF --> extra cellular fluid
39
What is the normal range for sodium levels?
135-145
40
What are the bodies anions?
Bicarbonate, Chloride and Phosphate
41
What is diffusion?
movement of molecules from an area of high concentration to one of low concentration
42
What is osmosis?
water moving, usually through a membrane, from low concentration to high concentration
43
What is normal plasma osmolality?
275-295
44
A pt with decreased pH and increased CO2 has what?
Respiratory acidosis
45
Primary signs of respiratory acidosis is what?
Lethargy and confusion
46
A pt with increased serum pH and decreased CO2 has?
Respiratory alkalosis
47
A pt with respiratory alkalosis will probably be doing what?
Hyperventilating
48
Decreased pH and decreased HCO3 means what?
Metabolic acidosis
49
What is the treatment for metabolic acidosis?
Give IV HCO3, regulate fluid and electrolytes, administer insulin for high blood sugar
50
Increased pH and increased HCO3 means?
Metabolic alkalosis
51
How should metabolic alkalosis be treated?
Administer sodium chloride and treat potassium
52
What system controls carbon dioxide?
cO2/carbon dioxide
53
What body system controls bicarbonate levels?
The renal system
54
An ABG shows pH and one other value are abnormal. The ABG is?
Uncompensated
55
All ABG values are abnormal. The pt is in?
Partial compensation
56
pH is normal, but Co2 and HCO3 are abnormal. Pt is in?
Compensation
57
Normal range for serum Magnesium is?
1.5-2.5
58
Normal range for serum Sodium is?
135-145
59
Serum Calcium range is normally?
8.6-10.2
60
What is the acceptable range of urine specific gravity?
1.010-1.025
61
Why should a patient with an NG tube not be allowed to drink water?
It will increase the loss of electrolytes
62
A short QT interval and a high peaked T wave indicates what?
Hyperkalemia
63
What is the primary ECF cation?
Sodium
64
What are the 2 roles of sodium?
Muscle contraction and fluid balance
65
What is the main cause of hyponatremia?
Loss of sodium-rich fluid or excessive water gain
66
What 3 conditions cause excessive water gain?
HF, liver disease, excessive intake (PO or IV)
67
What are signs/symtoms of hyponatremia?
apprehension, confusion, postural hypotension and tachycardia
68
What can hyponatremia lead to?
convulsions, coma even death
69
What is the most common cause of hypernatremia?
Excessive water loss
70
Signs/symptoms of hypernatremia?
thirst, dry mucous membranes, peripheral/pulmonary edema
71
What is a patient with hypernatremia at risk for?
Seizures
72
What is the role of Potassium?
nerve impulse conduction; aids in muscle contractions
73
What causes hypokalemia?
vomiting, diarrhea, diuretics, uncontrolled diabetes, corticosteriod use or taking digoxin
74
Signs of hypokalemia?
Weakness, N/V/C, postural hypotension, EKG changes, shallow respirations, decreased deep tendon reflexes
75
Drugs that can cause hypokalemia?
Corticosteriods, laxatives, Lasix and Insulin
76
What EKG changes will hypokalemia cause?
Flattened T waves and depressed ST segment
77
What rate should Potassium NEVER exceed?
20 mEq/hour or IV push
78
What is the dosing of Potassium?
40-80 mEq/day in equally divided doses
79
What are nursing interventions for hyperkalemia?
- monitor for EKG changes - give Calcium Gluconate - monitor muscle tone - give Kayexelate - insulin and D5W to move potassium into cells
80
What is Chvostek's sign?
When the facial nerve is tapped, the lip and cheek twitch
81
What is the sign of hypomagnesium?
All body system become hypersensitive
82
How often should the serum mag levels be checked, when caring for a pt with hypomagmesium?
After every 16mEq
83
Diabetes?
Metabolic acidosis

NUR 122 (9 decks)

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