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NURS 252 (Pharmacology 2) > Fluid and Electrolytes > Flashcards

Fluid and Electrolytes Flashcards

1
Q

What is the composition of total body water?

A

ICF: 67%
Interstitial Fluid: 25%
Plasma Volume: 8%

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2
Q

_________ of the adult human body is water

A

60%

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3
Q

Interstitial fluid + Plasma (Intravascular fluid) =

A

ECF

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4
Q

What is ICF

A

Cytosol inside cells

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5
Q

Plasma proteins exert constant ________ pressure
What is the pressure normally?

A

Osmotic
24mmHg

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6
Q

Interstitial fluid exerts _________ pressure
What is the pressure normally?

A

Hydrostatic
17mmHg

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7
Q

What is a hypotonic solution?
What is a way to describe its action?

A

Solute concentration outside the cell is lower than the concentration inside the cell
Water moves from H to L concentration (Out to in)
Water enter cells via osmosis
Cell swells and eventually bursts
AKA bursting balloon

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8
Q

What is a hypertonic solution?
What is a way to describe its action?

A

Solute concentration outside the cell is higher than the concentration inside the cell
Water moves from H to L concentration (In to out)
Cell loses water, gets smaller and eventually shrinks
AKA Crenates

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9
Q

What is a crystalloid?

A

Solutions containing fluids and electrolytes that are normally found in the body
They do not contain proteins (colloids)

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10
Q

What are crystalloids used as maintenance fluids for?

A

Compensation for insensible fluid losses
Replacing fluids
Managing specific and electrolyte disturbances
Promoting urinary flow

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11
Q

Name six types of crystalloids

A

Normal saline (NS): 0.9% NaCl isotonic; 0.45% hypotonic
3.3% dextrose and 0.3% NS (isotonic)
Hypertonic saline (3% NaCl)
Lactated ringer’s solution (isotonic)
Dextrose 5% in water(D5W) (isotonic)
D5W and 0.45% NS (hypertonic)

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12
Q

What are the indications for crystalloids?

A

Acute liver failure
Acute nephrosis
Adult respiratory distress syndrome
Burns
Cardiopulmonary bypass
Hypoproteinemia
Hemodialysis
DVT
Shock

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13
Q

What are the adverse effects of crystalloids?

A

Edema (Peripherally and Pulmonary)
Dilution of plasma proteins which would reduce colloid oncotic pressure
Effects are short-lived
Prolonged infusions may worsen alkalosis or acidosis

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14
Q

What is a contraindication of crystalloids?

A

Fluid Overload

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15
Q

What are colloids and what do they do?

A

Protein substances that increase colloid osmotic pressure
They move fluid from interstitial compartment to plasma compartment

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16
Q

Name 3 types of colloids

A

Albumin 5% (Children) and 25% (Adults)
Dextran 40 or 70
Hetastarch

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17
Q

What are the adverse effects of colloids?

A

Altered coagulation
No clotting factors or oxygen-carrying capacity
Dextran Therapy may cause anaphylaxis or kidney failure

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18
Q

What is albumin prepared from?

A

Pooled blood, plasma, serum or placentas obtained from healthy donors

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19
Q

Blood products increase ___________ and _____________

A

Tissue oxygenation and Plasma volume

20
Q

What is the only class of fluids that are able to carry O2

A

Blood products

21
Q

What are the indications of cryoprecipitate and plasma protein factors?

A

Management of acute bleeding (greater than 50% slow blood loss or 20% acutely)

22
Q

What are the indications of fresh frozen plasma?

A

Increase clotting factor levels in patients with demonstrated deficiency

23
Q

What are the indications of packed red blood cells?

A

Increase o2-carrying capacity in patients with anemia, substantial HB deficits and patients that have lost up to 25% of the total blood volume

24
Q

What are the indications for whole blood?

A

Same as packed RBC except its more beneficial in cases of extreme blood loss (>25%) because it contains plasma

25
Q

What are the adverse effects of blood products?

A

Incompatibility with recipients immune system
Cross-match testing
Transfusion reaction
Anaphylaxis
Transmission of pathogens to recipient

26
Q

Name an example of a principal ECF electrolyte and a principal ICF electrolyte

A

Sodium cation
Potassium cation

27
Q

What is the normal potassium range outside of cells?

A

3.5 to 5 mmol/L

28
Q

What excretes excess dietary K+?

A

The kidneys
Impaired kidney function can lead to toxicity

29
Q

What are the causes of hyperkalemia?

A

K supplements
ACE inhibitors
Renal failure
Excessive loss from cells
K-sparing diuretics
Burns
Trauma
Metabolic acidosis
Infections

30
Q

What are the causes of hypokalemia?

A

Alkalosis
Corticosteroids
Diarrhea
Ketoacidosis
Hyperaldosteronism
Increased secretion of mineralocorticoids
Burns
Thiazide and loop diuretics
Vomiting and malabsorption

31
Q

What can happen if hypokalemia occurs while a patient is on digoxin therapy?

A

Digoxin toxicity resulting in serious ventricular dysrhythmias

32
Q

What is K responsible for?

A

Muscle contraction
Transmission of nerve impulses
Regulation of heartbeat
Maintenance of acid-base balance
Isotonicity
Electrodynamic characteristics of cells

33
Q

What is the main indication of potassium?

A

Treatment or prevention of K depletion when dietary solutions are inadequate

34
Q

What are other therapeutic uses of Potassium?

A

Stopping irregular heartbeats
Management of tachydysrhythmias that can occur after cardiac surgery

35
Q

What are the adverse effects of oral , IV and excessive administration of potassium?

A

Oral: Diarrhea, nausea, vomiting, GI bleed, ulceration
IV: Pain at site, Phlebitis
Excessive: Hyperkalemia, Toxic effects, Cardiac arrest

36
Q

What are the manifestations of hyperkalemia?

A

Muscle weakness, paresthesia, paralysis, cardiac rhythm irregularities

37
Q

What is the treatment of severe hyperkalemia?

A

IV sodium bicarbonate
Sodium polystyrene sulphonate or hemodialysis to remove excess K.

38
Q

What is the normal concentration range of sodium outside cells?

A

135 to 145 mmol/L

39
Q

What are the symptoms and causes of hyponatremia?

A

Symptoms: Lethargy, Stomach Cramps, Hypotension, Vomiting, diarrhea and seizures
Causes: Some of the same conditions that cause hypokalemia and excessive perspiration, prolonged diarrhea or vomiting, kidney disorders, and adrenocortical impairment

40
Q

What are the symptoms and causes of hypernatremia?

A

Symptoms: Edema, HTN, red flushed skin, dry, sticky mucous membranes, increased thirst, elevated temp, decreased urinary output
Causes: Poor kidney excretion stemming from kidney malfunction; inadequate water consumption and dehydration

41
Q

What is sodium responsible for?

A

Control of water distribution
Fluid and electrolyte balance
Osmotic pressure of body fluids
Participation in acid-base balance

42
Q

What is the main indication of sodium

A

Sodium depletion when dietary options are inadequate.
Mild: Treated with Oral NaCl or fluid restriction
Severe: Treated with IV NS or lactated ringer’s solution

43
Q

What are the adverse effects of oral and IV sodium admin?

A

Oral: Nausea, vomiting, cramps
IV: Venous phlebitis

44
Q

IV potassium must not be given at a rate faster than 10 mmol/hr to patients who are not on cardiac monitors. What is the rate of for patients on cardiac monitors?

A

For critically ill patients on cardiac monitors, rates of 20 mmol/hr may be used.

45
Q

Potassium must never be given as an ___________ or ___________

A

IV bolus or undiluted

46
Q

Oral forms of K must be diluted with how many mL of water or fruit juice?

A

100 to 250mL

NURS 252 (Pharmacology 2) (23 decks)

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