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Med Surg 1 > Fluid And Electrolytes > Flashcards

Fluid And Electrolytes Flashcards

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1
Q

A lack of fluid in the body , either from insufficient intake or excessive loss is called…

A

Dehydration

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2
Q

What is isotonic fluid volume deficit?

A

Also called hypovolemia; lack of both water and electrolytes which causes a decrease in circulating blood volume

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3
Q

List some causes of isotonic fluid volume deficit (hypovolemia)

A

Excessive vomiting, diarrhea, diaphoresis, diuretics, third spacing, anorexia, NPO, impaired swallowing

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4
Q

List some causes of dehydration?

A

Hyperventilation, excessive sweating without water treatment, prolonged fever, DKA, decreased water intake, excessive intake of salt or hypertonic IV fluids

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5
Q

What are some expected findings with hypovolemia?

A

Hypothermia, tachycardia, hypotension, hypoxia, dizziness, confusion, thirst, acute weight loss, oliguria, poor skin turgor

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6
Q

Hematocrit is _____ in hypovolemia

A

Increased

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7
Q

BUN is ______ due to hemoconcentration in hypovolemia

A

Increased (greater than 25mg/dL)

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8
Q

Urine specific gravity is _____ than 1.030 with hypovolemia

A

Greater

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9
Q

Blood sodium is ____ with dehydration

A

Greater than 145 mEq/L

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10
Q

Blood osmolality is _____ with dehydration/hypernatremia

A

Greater than 295 mOsm/kg

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11
Q

Hypovolemic shock

A

Occurs with significant loss of body fluid; patients MAP decreases (slows blood flow and perfusion) and the cells are no longer able to carry oxygen to the blood adequately

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12
Q

What should a nurse do for hypovolemic shock?

A

Give oxygen, monitor VS q15 minutes, give colloid and crystalloids as replacements

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13
Q

What are colloids?

A

Whole blood, packed RBCs, plasma, synthetic plasma expanders. Given with hypovolemic shock

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14
Q

What are crystalloids?

A

Lactated ringers, normal saline

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15
Q

Too much fluid in the body from excessive intake or ineffective removal from the body is….

A

Overhydration

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16
Q

Fluid volume excess

A

Hypervolemia; excess of water and electrolytes in the same proportion

Excessive sodium causes excessive water retention

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17
Q

Patients that have fluid overload are at risk for developing ____ and ____

A

Pulmonary edema, congestive heart failure

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18
Q

What are some causes of hypervolemia?

A

Heart failure, kidney disease, cirrhosis, overdose of fluids, prolonged corticosteroid use, severe stress, hyperdosteronism

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19
Q

What are some causes of over-hydration?

A

Water replacement without electrolyte replacement, excessive water intake, SIADH, excessive administration of IV D5W

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20
Q

What can you expect to find in someone that has fluid volume overload?

A

Tachycardia, bounding pulse, HTN, weakness, visual changes, altered LOC, ascites, crackles, peripheral edema, weight gain, distended veins, increased urine output

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21
Q

What would the lab tests look like for Hct, blood osmolarity, urine specific gravity, and BUN?

A

All would be decreased

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22
Q

A weight gain or loss of 1kg in 24 hr is equivalent to __L of fluid

A

1L

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23
Q

Patients with fluid volume overload should get daily weights. When should you notify the provider of a concerning weight gain?

A

1-2 lb gain in 24hrs or 3lb gain in 1 week

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24
Q

Is magnesium, potassium, sodium, calcium, and hydrogen ions cations or anions?

A

Cations (positive)

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25
Sodium normal lab value
136-145 mEq/L
26
Chloride normal lab value
98-106 mEq/L
27
Calcium normal lab value
9.0-10.5 mEq/dL
28
Potassium normal lab value
3.5-5 mEq/L
29
Phosphorus normal lab value
3.0-4.5 mg/dL
30
Magnesium normal lab value
1.3-2.1 mEq/L
31
What is the major electrolyte found in the ECF?
Sodium
32
Sodium importance in the body
Maintain skeletal muscle contraction, cardiac contraction, and nerve impulse transmission
33
Hyponatremia
Net gain of water or loss of sodium-rich fluids that results in sodium levels less than 136 mEq/L
34
Do cells shrink or swell with hyponatremia?
The cells will swell
35
What can you expect to find with hyponatremia in the patient?
Hypothermia, tachycardia, rapid and threats pulse, hypoTN, HA, confusion, seizures, abd cramping
36
What type of IV fluids would be administered for hyponatremia?
Lactated ringers, 0.9% isotonic saline
37
Severe hyponatremia can cause someone to develop…
Seizures, coma, or respiratory arrest
38
Hypernatremia
Increased sodium causes hypertonicity of the blood. This causes a shift of water out the cells (dehydrated cells)
39
What are some risk factors for developing hypernatremia?
Kidney failure, Cushings, aldosteronism, glucocorticosteriods, excessive intake of oral sodium
40
What are some expected findings for hypernatremia in the patient?
Thirst, hyperthermia, tachycardia, restlessness, irritability, muscle twitching, dry mucous membranes, nausea
41
What is the major cation in the ICF?
Potassium
42
Potassium has an ____ relationship with sodium
Inverse
43
What is potassium’s role in the body?
Cell metabolism, transmission of nerve impulses, acid-base balance, muscle function (heart, lung)
44
Hypokalemia
Blood potassium less than 3.5 mEq/L
45
Risk factors for developing hypokalemia
Overuse of diuretics and corticosteroids, cushings, increased aldosterone, laxatives, NPO
46
What can you expect to find with hypokalemia in patients?
Decreased BP, weak pulse, AMS, lethargy, flattened T wave, prominent U waves, ST depression, prolonged PR interval, hypoactive bowel sounds, shallow breathing
47
Never give potassium via ___ or ___ due to it causing necrosis of the tissues
IM or SQ
48
Foods high in potassium
Avocados, broccoli, dairy products, dried fruits, cantaloupe, bananas, lean meats, milk, whole grains
49
2 main complications that can occur from hypokalemia
Respiratory failure and cardiac arrest
50
Hyperkalemia
Potassium level greater than 5.0 mEq/L
51
What can you expect to find with hyperkalemia in patients?
Slow irregular pulse, hypoTN, restlessness, premature ventricular contractions, v-fib, peaked T waves, wide QRS, diarrhea, oliguria
52
What diuretic would you administer for hyperkalemia?
Loop diuretic like furosemide to help increase the excretion of potassium from the renal system
53
Sodium polystyrene sulfonate is administered with hyperkalemia because of its ability to…
Work in the intestine to excrete excess potassium from the body thru feces
54
What beta-2 agonist would be administered for hyperkalemia?
Albuterol
55
Hypocalcemia
Total blood calcium less that 9.0 mEq/L
56
Expected findings for hypocalcemia are…
Tetany, paresthesia, seizure, charley horse, positive Chvosteks sign (tapping of facial nerve), positive trousseaus sign (hand/finger spasms with sustained BP cuff inflation) prolonged QT interval
57
Foods high in calcium
Dairy products, canned salmon, sardines, fresh oysters, dark leafy green vegetables
58
Hypomagnesemia
Blood magnesium level less than 1.3 mg/dL
59
Risk factors for developing hypomagnesemia include…
Celiac disease, crohns disease, MI, concurrent hypokalemia and hypocalcemia
60
Side effects of hypomagnesemia
Increased BP,hyperactive DTRs, positive chvosteks and trousseaus signs, constipation, depressed mood, agitation
61
Foods high is magnesium
Dark green vegetables, nuts, whole grains, sea food, peanut buttwr

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