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Med-Surg Exam 2 > Fluid and Electrolytes > Flashcards

Fluid and Electrolytes Flashcards

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1
Q

what is osmolality defined as?

A

is determined by the number of dissolved particles (sodium, urea, & glucose) per kilogram of water or solvent (sodium being the largest contributor).

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2
Q

what is osmolarity defined as?l

A

is the number of osmoles of solute in a liter of solution.

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3
Q

what is normal serum osmolality?

A

270-300 mOsm/L

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4
Q

what does aldosterone release promote?

A

-sodium reabsorption and potassium excretion
-(water follows Na) decreased water loss

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5
Q

what does ADH promote?

A

water reabsorption

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6
Q

what is an example of hypotonic fluids?

A

-1/2 NS or 0.45NS, 0.45% Na Cl
-D5W

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7
Q

when should hypotonic fluids be cautioned? why in these patients?

A

Beware of administration of Hypotonic fluids to patients with Intra Cellular Fluid Volume Excess (ICFVE).
-Cerebral edema may result.

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8
Q

what is an example of isotonic fluids?

A

-NS, 0.9% Na Cl
-LR

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9
Q

what are some examples of hypertonic fluids?

A

-D51/2NS
-D5NS
-D5LR
-3% NS
-D10
-D50

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9
Q

what are some s/s of dehydration?

A

-thirst
-dry membranes
-lethargy, confusion
-hypotension
-tachycardia
-low-grade temp
-weight loss
-decreased UO
-metabolic acidosis
-hypoxia (viscous RBC)

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9
Q

what are some causes of dehydration?

A

-vomiting/diarrhea
-low Na or no Na intake
-diabetes insipidus
-no H2O intake or fluid loss
-diuretics
-constipation medication

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10
Q

what are the lab values expected for those with dehydration?

A

-concentrated
-increased solutes

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11
Q

what are some interventions for dehydration?

A

-encourage fluids
-IV fluids: LR, D5NS, 0.9% NS
-supplemental O2 (hypoxia)
-monitor I & O
-monitor daily weights
-monitor BP

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12
Q

what are some s/s of hypervolemia?

A

-edema
-Pulmonary edema: crackles
-JVD
-lethargy, confusion
-alterations in NA
-hypertension
-tachycardia
-hypoxia, low Hgb
-weight gain
-decreased UO

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13
Q

what are the causes of hypervolemia?

A

-CHF
-too much fluid (PO or IV)
-renal injury or disease

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14
Q

what are the expected lab values of hypervolemia?

A

-diluted
-decreased solutes, increased fluids

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15
Q

what are some interventions for hypervolemia?

A

-diuretics
-Na and H2O restrictions
-monitor daily weights
-monitor I & O
-assess IV fluids (rate? stop?)
-monitor BP

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16
Q

what is the power of 3 CBC?

A
  1. RBC= 5
  2. Hgb= 15
  3. Hct= 45
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17
Q

what is the normal range for Mg? what is the memory key?

Study These Flashcards
A

-1.8-2.6
-M for muscle

18
Q

what is the normal range for Phos?

19
Q

what is the normal range for K? what is the memory key?

Study These Flashcards
A

-3.5-5
-K for Kardiac

20
Q

what is the normal range for Ca? what is the memory key?

Study These Flashcards
A

-9-10.5
-Ca for calm

21
Q

what is the normal range for CL?

22
Q

what is the normal range for Na? what is the memory key?

Study These Flashcards
A

-135-145
-N for neuro

23
what is addisons disease? how is it treated?
an adrenal gland disorder where the patient lacks appropriate cortisol and aldosterone to maintain body function. (this can be treated/activated with corticosteroids)
24
what are some causes of hyponatremia?
-diarrhea -vomiting -burns -sweating -GI suctioning
25
s/s of hyponatremia
-neuro! lethargy, headache, confusion, seizures, coma -N/V, muscular weakness, diminished reflexes
26
how do we treat hyponatremia?
-assessments (neuro) -IV NS or D5NS -increase Na in diet -daily weights -admin steroids
27
what are some causes of hypernatremia?
-severe N/V -steroids or Cushing syndrome -stress (cortisol release)
28
what is Cushing syndrome?
promotes Na retention and K excretion because of additional release of aldosterone and cortisol)
29
what are the s/s of hypernatremia?
-thirst -s/s of dehydration -orthostatic hypotention -N/V & anorexia
30
how do we treat hypernatremia?
-Na free IV fluids -daily weight -Na restrictions
31
causes of hyperkalemia?
-Oral K supplements: too much intake -K sparing diuretics (spironolactone), ACE inhibitors, NSAIDS -↓ renal function -Metabolic acidosis -Addison’s disease
32
what are some s/s of hyperkalemia?
-abd cramping -EKG changes (peaked T-wave) -bradycardia -muscle weakness -oliguria
33
how do we treat hyperkalemia?
meds: -ca gluconate -furosemide -Polystyrene sulfonate (Kayexalate) -insulin + D50 -hold K-containing meds monitor EKG Dialysis
34
what are some causes of hypokalemia?
-Malnutrition, -Vomiting, diarrhea, -K-wasting diuretic: furosemide -Metabolic Alkalosis -Steroid use/Cushing syndrome - increased secretion of cortisol and aldosterone
35
what are some s/s of hypokalemia?
-early: weakness, leg cramping -dysrhythmias -irregular HR
36
how do we treat hypokalemia?
-IV KCL -monitor EKG -monitor for dig toxicity (low K enhances the action of dig) -oral K replacement in rich foods
37
when Ca levels are high _____ levels are low.
Phos
38
what are some causes of hypercalcemia?
-hyperparathyroidism -↓ serum phosphorus -some cancers -steroid therapy-Steroids promote Ca loss from the bone -medications
39
hypercalcemia s/s?
*↓ neuromuscular excitability → ↓ GI motility (constipation & diminished bowel sounds), lethargy, depression – progressing to stupor and coma *Calcium containing kidney stones (#1 cause of kidney stones) *Pathologic fractures *AV heart blocks
40
how do we treat hypercalcemia?
-calcitonin -biophosphonates -loop diuretics -fluids -safety: weakness, neuro checks
41
what are some causes of hypocalcemia?
*Parathyroid or thyroid surgery; Hypoparathyroidism *↓ Ca consumption & Vitamin D deficiency *Abuse of antacids & laxatives *Diarrhea & diuretics *CKD, ESRD *↓ albumin (liver disease, alcoholism) *Prolonged NG suction leads to Metabolic Alkalosis. Alkalosis ↑ Ca binding to albumin, which ↓ Ca *Magnesium imbalances
42
s/s of hypocalcemia?
CNS excitability leads to the following: *Irritability; numbness and tingling around the mouth, hands, and feet; *Tetany of the face and extremities oChvostek’s sign: facial tap causes cheek tetany. *Hyperactive deep tendon reflexes *Abd distention/cramps
43
how do we treat hypocalcemia?
*Medications: V Calcium Gluconate or Calcium chloride oCorrection of magnesium deficiency; Vit D therapy *Monitor Ca level following thyroid and parathyroid surgery
44
what is the major cause of hypophosphatemia?
- increased renal excretion (kidney injury or renal disease)
45
what is one major cause of hypermagnesemia?
-Rare, but usually caused by renal injury/renal disease or excessive intake of magnesium containing antacids/laxatives

Med-Surg Exam 2 (4 decks)

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