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Adult Nursing Final > Fluid and Electrolyte balances > Flashcards

Fluid and Electrolyte balances Flashcards

(52 cards)

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1
Q

What is the goal of fluid & electrolyte balance?

A

To maintain homeostasis

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2
Q

What is the nursing role when dealing with fluid & electrolyte imbalances?

A

anticipate potential for alterations

recognizing the S&S of imbalances with appropriate action

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3
Q

Composition of fluids in the body

A 
intracellular fluid (2/3)
Extracellular fluid (1/3)
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4
Q

Sodium

A

135-145 mEq/L

  • essential for muscle contractions, transmission of nerve impulses and acid-base balance
  • kidneys regulate and it is influenced by ADH & aldosterone
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5
Q

Potassium

A
  1. 5-5.0 mEq/L

- essential for skeletal, cardiac, muscle contraction; maintains acid-base balance

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6
Q

Chloride

A

98-106 mEq/L

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7
Q

Bicarbonate

A

24-31 mEq/L

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8
Q

Calcium

A
  1. 5-10.5 mg/dL
    - Role in transmitting nerve impulses, regulates muscle contraction & relaxation that includes cardiac
    - Activates enzyme, role in coagulation
    - Vitamin D needed for absorption from the GI track
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9
Q

Phosphate

A
  1. 5-4.5 mg/dL
    - essential to the function of muscle, RBCs, & the nervous system
    - Deposited with calcium for bone & tooth structure
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10
Q

Magnesium

A
  1. 8-3.0 mg/dL
    - Role in carbohydrate & protein metabolism
    - Regulated by GI absorption & renal excretion
    - Important for normal cardiac function
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11
Q

Hydrostatic pressure

A

pressure exerted by the fluid on the walls of the blood vessels by the heart
pressure within the arterial end of the capillary pushes water into the interstitial space

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12
Q

Oncotic pressure

A

exerted primarily by albumin

osmotic force of plasma proteins draws fluid back into the capillary at the venous end

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13
Q

Osmosis

A

fluid shifts through membranes from low solute concentration to high solute concentration

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14
Q

Diffusion

A

solutes moves from area of higher concentration to a lower concentration

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15
Q

Filtration

A

passage through a filter that prevents passage of certain molecules

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16
Q

Active transport

A

sodium moves out of the cell & potassium moves into the cell to maintain concentration

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17
Q

Kidneys

A

regulate by adjusting urine volume

  • filter plasma
  • Excrete urine
  • Regulates: ECF volume, electrolyte levels in ECF, pH of ECF, excretion of metabolic wastes & toxic substances
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18
Q

Skin (sensible perspiration) & Lungs (insensible loss)

A
  • invisible vaporization from lungs & skin assists in regulating body temperature
  • Excessive sweating (sensible perspiration) from fever or high environmental temperatures
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19
Q

GI

A
  • water intake, food metabolism, solid foods
  • GI tract secretes & reabsorbs
  • In healthy people, daily average intake & output of water are approximately equal
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20
Q

Renin-Angiotensin-Aldosterone System

A

-Renin released in response to decreased blood flow (decrease CO) or decreased renal pressure (sensed by receptors in the nephrons)

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21
Q

Antidiuretic Hormone (vasopressin)

Study These Flashcards
A

a fluid deficit or increase in plasma osmolality is sensed by osmoreceptors in the hypothalamus which in turn stimulate thirst & ADH release

22
Q

Heart

Study These Flashcards
A

rate, conduction, contractility & blood vessel resistance affects blood circulation to the kidney affecting renal perfusion

23
Q

what is released in response to increased fluid volume (HF) & high serum sodium levels?

Study These Flashcards
A

ANP- a hormone secreted by cells in the lining of the atria

BNP- a hormone secreted by cells in the lining of the ventricles

24
Q

Lungs

Study These Flashcards
A

approximately 400 mL water removed daily through exhalation

25
Parathyroid
- regulates calcium & phosphate - PTH regulates movement of calcium out of bone to the blood, calcium absorption from intestines, and calcium reabsorption from the renal tubules
26
Osmolality
measures the solute concentration per kilogram in blood & urine
27
Osmolarity
also describes the concentration of solutions measured in milliosmoles per liter
28
Urine Specific Gravity
(1.010-1.025) SG varies inversely with urine volume -increase SG= concentrated urine (FVD) -decrease SG= dilute urine (FVE)
29
BUN
10-20 mg/dL -end product of the metabolism of protein from muscle & diet by the liver "PROTEIN ON A BUN"
30
Creatinine
0. 7-1.4 mg/dL | - end product of muscle metabolism
31
Isotonic Fluid
solutions with the same osmolality as the cell interior; about equal to serum; stays in the intravascular space after administration USE: replace ECF losses, expand the intravascular volume Example: NS (0.9%), LR, 5% dextrose in water (DSW)
32
Hypotonic Fluid
solutions in which the solutes are less concentrated than the cells USE: expands the intracellular space, rehydrates the cells, treats gastric fluid loss & dehydration Example: 0.33% NaCl, 0.45% NaCl
33
Hypertonic Fluid
solutions more concentrated than cells USE: draws fluid out of cells to restore circulating volume, decreases cellular swelling, treats severe hyponatremia Example: 3% NaCl, 5% NaCl, D10%W
34
Gerontologic Considerations
structural changes in the kidney: decrease in GFR & creatinine clearance, inability to concentrate urine, & inability to conserve water & electrolytes - hormone changes - loss of SC tissue & dermis - Decreased thirst mechanism - Musculoskeletal barriers - Mental status changes - medications
35
FVD
(Hypovolemia) water & electrolyte are lost in equal proportion -loss of body fluids or inadequate fluid intake
36
Who are susceptible to having FVD?
elderly and very young children because of the inability to care for themselves properly
37
Dehydration
loss of pure water alone without corresponding loss of sodium
38
Management of FVD
- encourage oral fluids - isotonic or Hypotonic IV fluids - Blood replacement if needed - Complication: hypovolemic shock
39
Nursing role with FVD
monitor S&S of cerebral edema & pulmonary edema, IV site, VS, lab, daily weight
40
FVE
(Hypervolemia) is an excess of isotonic fluid (water & sodium) in the extracellular (interstitial or intravascular compartment.
41
Management of FVE
- identify primary cause & treat - Hypertonic solutions followed by diuretics - Fluid & sodium restrictions - Hemodialysis
42
Nursing role with FVE
fluid and dietary restrictions, O2 therapy, assess S&S of hypovolemia, monitor O2 sat, ABGs, VS, monitor potassium level, heart & lung sounds, daily weight
43
Vital signs FVD vs FVE
FVD- hyperthermia, tachycardia, hypotension, orthostatic hypotension and an increase H&H FVE- bounding pulse, increased BP, SOA, increased respiratory rate and a decreased H&H
44
Neuromuscular FVD vs FVE
FVD- dizziness, syncope, confusion, weak, fatigue, muscle cramps and increased BUN & creatinine FVE- confusion, headache, seizures, coma and decreased serum osmolarity and sodium
45
Respiratory FVE
cough, dyspnea, crackles, pulmonary edema, distended jugular veins and decreased urine sodium & specific gravity
46
GI FVD`
thirst, dry furrowed tongue, weight loss and increased urine specific gravity & osmolarity
47
Renal FVD
oliguria, concentrated urine and increased serum sodium, osmolality, & specific gravity
48
Water intoxication
occurs when excess fluid moves from the extracellular space to the intracellular space
49
What can cause water intoxication?
- SIADH - Rapid infusion of a hypotonic solution - Excessive use of tap water as an NGT irrigant or enema - Pyschogenic polydipsia
50
What are symptoms of water intoxication?
- increased ICP - change in LOC - Muscle cramps & weakness - Headache
51
What are the major electrolytes in ECF?
sodium and chloride
52
what are the most plentiful intracellular electrolytes?
potassium, phosphate, and magnesium

Adult Nursing Final (13 decks)

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