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Fluid and electrolyte balance Flashcards

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1
Q

Electrolytes

A

substance that ionize once dissolved in solution

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2
Q

Components of electrolytes

A
  • atom
  • proton
  • neutron
  • electron
  • molecule
  • ion
  • cation
  • anion
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3
Q

Metabolic panels

A
  1. basic (BMP)
    - blood test that provides info about metabolism, fluid balance, and kidney function
  2. Comprehensive (CMP)
    - includes BMP and additional labs to evaluate liver function (BUN, Cr)
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4
Q

Electrolyte functions

A
  • regulate fluid balance
  • hormone production and balance
  • strengthen skeletal structure
    metabolism
    nerve response and muscle contraction
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5
Q

Localized edema

A

specific part: traumatic accident, surgical site, burns

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6
Q

General edema

A

in interstitial space throughout body: cardiac, renal, liver failure

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7
Q

Osmolality

A
  • concentration of solution
  • found on metabolic panel
  • plasma range: 275-295 mOsm/kg
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8
Q

Fluid tonicity definition

A

modify volume of cells by altering water content

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9
Q

Hypertonic

A

draws water out of cells to shrink
ex. 3% sodium chloride

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10
Q

Isotonic

A

doesn’t alter cells
ex.0.9% sodium chloride

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11
Q

Hypotonic

A

draws water into cell to plump
ex.0.45% sodium chloride

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12
Q

Third-spacing (“silent killer”)

A
  • accumulation and storage of trapped ECF in body space from disease or injury
  • fluid leaves to address trauma
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13
Q

Areas of fluid trapping

A
  • pericardial
  • pleural
  • peritoneal
  • joint
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14
Q

Signs and symptoms of third spacing

A
  • weight gain
  • decreased urine output
  • hypovolemia
  • increase HR
  • decrease BP
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15
Q

Risk factors of third spacing

A
  • trauma
  • burns
  • sepsis
  • inflammatory conditions
  • kidney disease
  • heart failure
  • lymphatic obstruction
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16
Q

Extracellular

A
  • fluid outside of the cell
  • makes 1/3 of total body water
  • has 2 major divisions and 1 minor division
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17
Q

Intravascular fluid

A

liquid part of blood (plasma)

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18
Q

Interstitial fluid

A

located between cells and outside of vessels (edema)

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19
Q

Transcellular fluid

A
  • cerebrospinal, pleural, peritoneal, synovial
  • secreted by epithelial cells
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20
Q

Intracellular

A

fluid inside the cells

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21
Q

Function of body fluid

A
  • transports nutrients to cells
  • carries waste products out of cells
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22
Q

Total body fluid in humans: intra and extra

A

60% in young adults
55% in older adults
80% in infants

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23
Q

Body fluid if made up of

A

water + electrolytes +insoluble
insoluble: glucose, urea, creatinine

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24
Q

Hypovolemia (isotonic dehydration)

A

lacks water and electrolytes causing a decrease in circulating volume

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25
Body response to hypovolemia by
releasing aldosterone and antidiuretic hormone (ADH)
26
Hypovolemia leads to
seizures and hypovolemic shock
27
risk factors of hypovolemia
- decreased body mass - decreased ability to detect thirst
28
risk factors by body systems
GI: vomiting, diarrhea (increased HR, o2, and tachypnea, decreased BP) Skin: diaphoresis w/o water and na replacement (decreased skin turgor, flat neck veins) Renal: diuretic therapy, kidney/renal disease third spacing burns hemorrhage or plasma loss
29
Interventions of hypovolemia
- assess vitals - monitor I/O - weight - labs - injury prevention (orthostatic hypotension) *notify provider if output is <30mL/hr
30
Hypervolemia
- retaining too much water and Na in ECF - renal system attempts to respond and excrete out more fluid
31
Complications of hypervolemia
- pulmonary edema - heart failure
32
Risk factors of hypervolemia include
- heart failure - liver cirrhosis - kidney failure
33
Expected findings of hypervolemia
- increased BP - bounding pulse - confusion/ altered LOC - increased weight - ascites -distended neck veins - crackles in lungs
34
Interventions of hypervolemia
- assess vitals - monitor I/O - weight - labs - decrease IV flow (need an order) - fluid IV restriction (need an order) - administer diuretic (need an order)
35
Sodium is essential for
- acid base balance - fluid balance - active and passive transport mechanism - conduction of nerve and muscle tissue
36
Hyponatremia causes
- excessive free water intake (diluted) - decreased intake of sodium foods - increased amounts of urine output w/o sodium replacement
37
effects of hyponatremia on the nervous system
- delays/slows down depolarization of nerve communication - water shifts from ECF to ICF and causes cells within brain to swell
38
Effects of hyponatremia on muscoskeletal
- muscle weakness
39
Effects of hyponatremia on neuro
- coma - seizure - decreased LOC, DTR - restlessness
40
Effects of hyponatremia on GI
- n/v - cramping - diarrhea
41
Interventions of hyponatremia
- I/O - weight - vitals LOC monitoring - seizure precautions
42
Treatment for hyponatremia
- PO salt tablets - increase Na foods - administer IV hypertonic saline - free water restrictions
43
Hypernatremia causes
- decreased water intake - increase salt - osmotic diaresis (hyperglycemia)
44
Effects of hypernatremia
- hypertonicity of blood leading to water shifting out of cells - cells become small and dehydrated
45
Potential disturbances of hypernatremia
- neuro - endocrine - cardiac
46
Effects of hypernatremia on muscoskeletal
- muscle weakness - twitching
47
Effects of hypernatremia on neuro
- coma - seizure - decreased LOC - increased DTR - restlessness
48
Effects of hypernatremia on GI
- swollen, red tongue - hyperactive bowel sounds - dry and sticky mucous membranes
49
Intervention of hypernatremia
- I/O - weight - vitals - LOC monitoring - seizure precautions
50
Treatment for hypernatremia
- PO free water intake - IV fluid replacement - decrease NA - administer diuretics (thiazides)
51
Potassium is essential for
- cellular metabolism - transmission of nerve impulses - normal function of heart, lungs, and muscle tissue - acid-base balance
52
causes of hypokalemia
- increase loss of k (vomit, diarrhea, sweat) - decreased intake of k - decreased absorption of k - decreased movement of k into cells
53
Effects of hypokalemia on neuro/musco
- periodic paralysis - respiratory collapse - decreased reflexes
54
Effects of hypokalemia on cardiac/EKG
- dysrhythmias - irregular pulse - orthostatic hypotension - cardiac arrest - ventricular fibrillation
55
Effects of hypokalemia on GI
- decreased motility, bowel sounds - constipation - ileus
56
Interventions of hypokalemia
- monitor K levels - monitor breathing, oxygen, cardiac rhythms - replace k IV/PO
57
Treatment for hypokalemia
- k needs to be diluted
58
Administration (IV) for hypokalemia
- always go slow (5-10 mEq/hr) - never bolus - NEVER PUSH
59
Hyperkalemia causes
- increased k - movement of k out of cells (sepsis, burns, trauma) - renal disease
60
Effects of hyperkalemia on neuro/musco
- confusion
61
Effects of hyperkalemia on cardiac/ EKG
- dysrhythmias - peak T waves - widened PR and QRS - cardiac arrest ASYSTOLE
62
Effects of hyperkalemia on GI
- abdominal cramps - diarrhea
63
Interventions of hyperkalemia
- EKG monitoring - decrease k intake - monitor serum levels
64
Treatment for hyperkalemia
- dialysis - reverse via meds (Kayexalate, k wasting diuretic, IV Ca, insulin, glucose)
65
Calcium is essential for
- cardiovascular - neuro/musco - endocrine - clotting ability -teeth/ bone formation
66
Causes of hypocalcemia
- increase Ca output - decreased intake, absorption - Ca shifts from ECF to bone or to inactive form
67
Effects of hypocalcemia on neuro/musco
- numbness/tingling - increase DTR - positive chvostek/trousseau - seizures
68
Effects of hypocalcemia on cardiac/ EKG
- weak pulse - increase or decrease HR - dysrhythmias
69
Effects of hypocalcemia on GI
- increase bowel sounds - diarrhea - abdominal cramping
70
Interventions of hypocalcemia
- seizure and fall precautions - emergency equipment - EKG monitoring
71
Treatment for hypocalcemia
- increase Ca and vit D supplements - increase Ca, dairy, dark green veggies
72
Causes of hypercalcemia
- increase intake of vit D and Ca - thiazide diuretics - long term glucocorticoids - paget disease - increase thyroidism - bone cancer
73
Effects of hypercalcemia on neuro/musco
- decreased reflexes - bone pain - confusion - decreased LOC - weak
74
Effects of hypercalcemia on cardiac/ EKG
- dysrhythmias - increase blood clots
75
Effects of hypercalcemia on GI
- kidney stone
76
Interventions for hypercalcemia
- monitor neuro/ cardiac status - decrease dietary Ca
77
Treatment for hypercalcemia
- promote ca to be excreted by kidneys - administer diuretics and fluids
78
Chvostek
tapping face and triggering twitching
79
Trousseau
hand/finger spasm w/ BP cuff

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