Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

54/64 Unit 2 > Fluid And Electrolytes > Flashcards

Fluid And Electrolytes Flashcards

1
Q

Electrolyte found in extracellular fluid

A

Sodium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Functions of sodium

A

Acid-base balance, fluid balance, active and passive transport, irritability and conduction of nerve muscle tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Normal sodium range

A

135-145 mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

S/S of hypernatremia (>145 mEq/L)

A

FRIED SALT: Flushed skin, Restless/anxious/confused/irritable, Increased BP and fluid retention, Edema (pitting), Decreased UOP, Skin flushed and dry, Agitation, Low-grade fever, Thirst (dry mucous membranes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

S/S of hyponatremia (<135 mEq/L)

A

SALT LOSS: Stupor/coma, Anorexia (n/v), Lethargy, Tachycardia (thready pulse), Limp muscles, Orthostatic hypotension, Seizures/headache, Stomach cramping (hyperactive bowel sounds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Hypernatremia risk factors

A

Increased sodium intake (oral, hypertonic fluids), loss of fluids (fever, v/d, DI, diaphoresis, infection), decreased sodium excretion (kidney problems)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hyponatremia risk factors

A

4 D’s: diaphoresis, diarrhea/vomiting, drains (NGT suction), diuretics (loop & thiazide)
Other: SIADH, inadequate intake, kidney disease, HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hypernatremia management

A

IV infusions NS 0.9% (if d/t fluid loss), diuretics that promote sodium loss (loop and thiazide), restrict sodium and fluid as prescribed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hyponatremia management

A

ADD SALT: Administer IV sodium chloride infusions (if d/t hypovolemia), 3% NS, Diuretics (if d/t hypervolemia), Daily weights, Safety (OHTN = risk for falls), Airway protection, Limit water intake, Teach about foods high in sodium (canned foods, packaged/processed meats)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Potassium and sodium are _________

A

Opposites; if Na is high K+ will be low (vice versa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Role of potassium

A

Cellular metabolism and transition of nerve impulses, cardiac, lung, and muscle tissue function, acid-base balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Normal potassium range

A

3.5-5 mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

S/S of hyperkalemia (> 5 mEq/L)

A

MURDER: Muscle cramps and weakness, Urine abnormalities, Respiratory distress, Decreased cardiac contractility (low HR and BP), ECG changes, Reflexes (increased DTRs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ECG changes related to hyperkalemia

A

Tall peaked T-waves, flat P waves, widened QRS, prolonged QT interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

S/S of hypokalemia

A

Thready/weak/irregular pulse, OHTN, shallow respirations, anxiety/lethargy/confusion/coma, paresthesias, hyporeflexia, constipation, N/V/abdominal distention, ECG changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ECG changes related to hypokalemia

A

ST depression, shallow or inverted T-wave, prominent U wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Potassium imbalance can cause

A

Cardiac dysrhythmias (can be life threatening!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hyperkalemia management

A

Monitor ECG, potassium-restricted diet, potassium excreting diuretics, IV calcium gluconate and IV sodium bicarb, avoid salt-substitutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Hypokalemia management

A

Oral potassium supplements, spironolactone, liquid potassium chloride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Potassium is NEVER administered by

A

IV push, IM, or subq

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How to administer IV potassium

A

Diluted and administered using an infusion device

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where is calcium found?

A

Cells, bones, and teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Electrolyte needed for proper functioning of the cardiovascular, neuromuscular, endocrine systems, blood clotting, and teeth formation

A

Calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Normal calcium range

A

9-11 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

S/S of hypercalcemia (> 11 mg/dL)

A

BACKME: Bone pain, Arrythmias, Cardiac arrest (bounding pulses), Kidney stones, Muscle weakness (decreased DTRs), Excessive urination, seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

S/S of hypocalcemia

A

CATS GO NUMB: convulsions, arrythmias, tetany, spasms and stridor, numbness in fingers, face, and limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Carpal spasm caused by inflating a BP cuff; related to hypocalcemia

A

Positive Trousseau’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Contraction of facial muscles with light tap over the facial muscle; related to hypocalcemia

A

Chvostek’s sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

A client with a calcium imbalance is at risk for

A

Pathological fracture (move them carefully and slowly!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Hypercalcemia management

A

Administration of phosphorus, calcitonin, bisphosphonates, and prostaglandin synthesis inhibitors (NSAIDs), avoid foods high in calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Hypocalcemia management

A

Calcium PO or IV, aluminum chloride and vitamin D, seizure precautions, consume foods high in calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Calcium and phosphate are

A

Inverse; if Ca is high, PO4 is low (vice versa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Most of the magnesium found in the body is found in the

A

Bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Electrolyte that regulates BP, blood sugar, muscle contraction and nerve function

A

Magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Normal magnesium range

A

1.5-2.5 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

S/S of hypermagnesemia (>2.5 mg/dL)

A

Low everything: energy, HR/BP/RR, bowel sound, DTRs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

S/S of hypomagnesemia

A

High everything: HR/BP/DTRs, shallow respirations, twitches/paresthesias, tetany, seizures, irritability and confusion (may also see positive trousseau’s and Chvostek sign)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Hypermagnesemia management

A

Diuretics, IV calcium chloride or calcium gluconate, avoid laxatives and antacids containing mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Hypomagnesemia management

A

IV or PO mag.sulfate, seizure precautions, increase magnesium-containing foods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Magnesium and calcium are

A

The same; if one is increased/decreased, so is the other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What electrolyte would you monitor for in a patient with thyroid disease?

A

Calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Describe what the blood is like when the serum osmolarity is >300

A

Concentrated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Most common electrolyte disorder

A

Hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Tachycardia, flat neck veins, tachypnea, poor turgor, and decreased UOP are signs of

A

Dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the most common route of potassium loss?

A

GI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Absorption of calcium requires

A

Vitamin D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What precautions would you place a patient with hypernatremia?

A

Seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

In a patient with hypercalcemia, the blood will clot faster or slower?

A

Faster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What should you assess first with hypokalemia if the patient has a normal ECG?

A

Respiratory status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Example of potassium-sparing diuretic

A

Spironolactone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

If a patient has hypophosphatemia, they will most likely have what other electrolyte imbalance?

A

Hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What should be the first assessment completed on a patient with hyperkalemia?

A

Cardiac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

A nurse would expect an increased or decreased UOP with hypernatremia?

A

Decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Full and bounding pulse, HTN, JVD, dyspnea, crackles, pale and cool skin are S/S of

A

Over hydration or fluid overload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Which electrolyte maintains extracellular fluid?

A

Sodium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Which electrolytes maintain intracellular fluid?

A

Potassium and magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Water goes with…

A

Sodium (were sodium goes, water flows)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What kind of fluid is normal saline?

A

Isotonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Normal pH range

A

7.35-7.45

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Low pH (<7.35)

A

Acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

High pH (>7.45)

A

Alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

PaCO2 normal range

A

35-45

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

PaCO2 > 45

A

Acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

PaCO2 < 35

A

Alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

HCO3 normal range

A

22-26

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

HCO3 < 22

A

Acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

HCO3 >26

A

Alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

ROME method for ABGs

A

Respiratory Opposite Metabolic Equal

69
Q

CO2 binds to H2O to form

A

Carbonic acid (H2HCO3); H2 (hydrogen ion — acidic), CO3 (bicarbonate — weak)

70
Q

High hydrogen ions mean ___ blood pH

A

Low (acidic)

71
Q

Low hydrogen ions mean ___ blood pH

A

High (alkaline)

72
Q

What can cause alkalosis?

A

NGT suctioning, vomiting, diarrhea

73
Q

What can cause respiratory alkalosis?

A

Hyperventilation, tachypnea, fever, NSAID/salicylate toxicity (Aspirin), high altitude (d/t decreased O2), pneumothorax, anxiety, pain

74
Q

If patient has excessive diarrhea, the main electrolyte loss is

A

Potassium

75
Q

Loop diuretics result in a loss of

A

Potassium

76
Q

Kidney patients should not be given _________ because it is hard for them to excrete

A

Potassium

77
Q

Hypotonic fluids _____ the cell

A

Swells

78
Q

Hypotonic fluids are given for

A

Dehydration

79
Q

Examples of hypotonic fluids

A

1/2 NS (0.45%), 0.33% NS, 2.5%DW

80
Q

Hypertonic fluids _____ the cell

A

Shrinks (pulls water from cells)

81
Q

Hypertonic fluids are given for

A

TBI (d/t swelling and increased ICP)

82
Q

Examples of hypertonic fluids

A

3% saline (TBI/ICP), 5% saline, D51/2NS, D5LR, D5NS

83
Q

_________ fluids do not change the volume of cell and are the go-to fluids for VOLUME

A

Isotonic

84
Q

Isotonic fluids are given for

A

Hypovolemia

85
Q

Examples of isotonic fluids

A

0.9% NS, LR, D5W

86
Q

Best isotonic fluid option for fluid volume deficit

A

0.9% NS

87
Q

Best isotonic fluid option for burns

A

LR

88
Q

Fluid option for treatment of metabolic acidosis

A

Isotonic fluids

89
Q

Priority assessment for patients with hypophosphatemia and hypercalcemia

A

Neuro status

90
Q

IJ line is an example of

A

Central line (“intra”)

91
Q

EJ is an example of

A

Peripheral line (“extra”)

92
Q

PICC lines touch the

A

Heart

93
Q

Why are PICC lines the most convenient central lines?

A

Nurses can insert it, patient can be sent home with PICC line if on long-term antibiotics (single-lumen), milrinone, and remodulin

94
Q

PICC line patient education

A

How to care for PICC lines, come back to hospital or clinic for dressing changes, S/S of infection (pain, redness, fever, swelling)

95
Q

Cardiac drip that can be administered via PICC line given for EF less than 20%

A

Milrinone

96
Q

Drip that can be administered via PICC line used for pulmonary HTN

A

Remodulin

97
Q

PICC line dressings should be changed every

A

7 days

98
Q

___ should be used to wipe PICC lines every shift

A

CHG

99
Q

Flushing a triple lumen PICC line

A

Scrub the hub — new alcohol wipe for each line, flush each line individually, scrub the hubs again, change cap each time you flush

100
Q

What should the nurse do if resistance is felt when flushing PICC line?

A

STOP (could dislodge a clot); alteplase if line is blocked (clot buster; administered by PICC nurse)

101
Q

What should the nurse do if PICC line infection is suspected?

A

Inform the physician (order will be given to removed PICC line); cut the tip of PICC line and send it to lab for culture

102
Q

S/S of sepsis

A

Tachycardia (early sign) and hypotension (late sign)

103
Q

Intervention for sepsis

A

Fluid resuscitation

104
Q

Subclavian lines are for

A

Dialysis access

105
Q

Chest access ports are for

A

Cancer patients

106
Q

S/S of central line infection

A

Redness, drainage, blood around access site (especially in subclavian)

107
Q

If bleeding from central line…

A

Apply pressure and call the physician (DO NOT remove the line)

108
Q

Femoral line priority assessment

A

Infection

109
Q

Key difference between infiltration and infection is

A

Skin temperature (cool to touch with infiltration and warm to touch with infection)

110
Q

Interventions for infiltration

A

Removal is priority (can lead to infection)! Start a new IV site in a different area, cool compress for comfort

111
Q

What are hypertonic solutions used for?

A

Cerebral edema, hyponatremia, metabolic alkalosis, maintenance fluid, hypovolemia

112
Q

Monitor for __________ with hypertonic fluids

A

Fluid volume overload

113
Q

Explain hypertonic solutions

A

More salt than water in solution. The vessel becomes more concentrated than the cell, causing water to leave the cell and the cell shrinks

114
Q

Fluids used to expand intravascular fluid volume and replace fluid loss

A

Isotonic fluids

115
Q

Isotonic fluids are used for

A

Blood loss (hemorrhage, burns, surgery), dehydration (V/D), fluid maintenance

116
Q

What is the only solution compatible to use with blood or blood products?

A

Normal saline

117
Q

Hypotonic fluids are used for

A

DKA, hypernatremia, helping kidneys excrete excess fluids

118
Q

Hypotonic solutions should not be given with

A

Increased ICP, burns, trauma

119
Q

Describe hypotonic solutions

A

More water than salt in solution. The vessel becomes less concentrated than the cell, causing water to enter the cells which swell the cells

120
Q

Fluid inside the cell

A

Intracellular fluid

121
Q

Fluid outside the cell

A

Extracellular fluid

122
Q

Two categories of extracellular fluid

A

Interstitial fluid and intravascular fluid

123
Q

Fluid that surrounds the cell (in the tissues)

A

Interstitial fluid

124
Q

Plasma/fluid in the blood vessels

A

Intravascular fluid

125
Q

Mixtures that have large molecules making it more efficient at increasing fluid volume in the blood (plasma expanders!)

A

Colloids

126
Q

Examples of colloids

A

Albumin, fresh frozen plasma

127
Q

Mixtures that have small molecules and provide immediate fluid resuscitation

A

Crystalloids

128
Q

Examples of crystalloids

A

Hypertonic, isotonic, and hypotonic solutions

129
Q

Colloids are used for

A

Shock, pancreatitis, burns, excessive bleeding

130
Q

IV complication by which air enters the vein through the IV tubing

A

Air embolism

131
Q

S/S of air embolism

A

Tachycardia, chest pain, hypotension, decreased LOC, cyanosis

132
Q

Air embolism treatment

A

Clamp tubing, turn client on side and place in trendelenburg, notify HCP

133
Q

IV complication in which IV fluid leaks into surrounding tissue

A

Infiltration

134
Q

S/S of infiltration

A

Pain, swelling, coolness, and numbness at the site; no blood return

135
Q

Infiltration treatment

A

Remove IV, elevate extremity, apply warm/cool compress, DO NOT rub the area

136
Q

Entry of microorganism into the body via IV

A

Infection

137
Q

Administration of fluids too rapidly

A

Circulatory overload (fluid volume overload)

138
Q

S/S of fluid volume overload

A

HTN, distended neck veins, dyspnea, wet cough and crackles

139
Q

Fluid overload treatment

A

Decrease IV flow rate, elevate HOB, keep client warm, notify HCP

140
Q

Inflammation of the vein that can lead to a clot

A

Phlebitis

141
Q

S/S of phlebitis

A

Heat, redness, tenderness at the site; decreased flow of IV

142
Q

Phlebitis treatment

A

Remove the IV, notify HCP, restart IV on the opposite side

143
Q

Collection of blood in the tissues

A

Hematoma

144
Q

S/S of hematoma

A

Blood, hard and painful lump at the site; ecchymosis

145
Q

Hematoma treatment

A

Elevate extremity, apply pressure and ice

146
Q

Respiratory alkalosis

A

pH high, CO2 low

147
Q

Respiratory acidosis

A

PH low, CO2 high

148
Q

Metabolic alkalosis

A

PH high, HCO3 high

149
Q

Metabolic acidosis

A

PH low, HCO3 low

150
Q

How do kidneys compensate?

A

By excreting excess acid and bicarb (HCO3) OR retaining hydrogen and bicarb

151
Q

How do the lungs compensate?

A

Through hyper or hypoventilation

152
Q

Hyperventilation causes…

A

Decreased CO2 (alkalosis)

153
Q

Hypoventilation causes…

A

Increased CO2 (acidosis)

154
Q

PH is out of range and CO2 or HCO3 is in range

A

Uncompensated

155
Q

CO2, HCO3 and pH are ALL out of range

A

Partially compensated

156
Q

PH is in range

A

Fully compensated

157
Q

causes of respiratory acidosis

A

Drugs (opioids and sedatives), edema (fluid in lungs), pneumonia, pulmonary emboli, asthma, COPD

158
Q

Causes of respiratory alkalosis

A

Losing CO2 (tachypnea): fever, aspirin toxicity, hyperventilation

159
Q

S/S of respiratory acidosis

A

Increased BP, RR, and HR, restlessness, confusion, headache, sleepy/coma

160
Q

S/S of respiratory alkalosis

A

Increased HR, confused and tired, tetany, EKG changes, (+) chvostek

161
Q

Causes of metabolic acidosis

A

DKA, AKI/CKD, malnutrition, severe diarrhea

162
Q

Causes of metabolic alkalosis

A

Excess antacids, diuretics, excess vomiting, hyperaldosteronism

163
Q

S/S of metabolic acidosis

A

Increased RR, hyperkalemia, decreased BP, confusion

164
Q

S/S of metabolic alkalosis

A

Decreased RR, hypokalemia

165
Q

Kidney problem in which there is too much hydrogen and too little bicarb; lungs compensate by blowing off CO2

A

Metabolic acidosis

166
Q

Kidney problem in which there is too much bicarb and too little oxygen. Lungs compensated by retaining CO2

A

Metabolic alkalosis

167
Q

Lung problem in which the lungs are retaining too much CO2. Kidneys compensate by excreting excess hydrogen and retaining bicarb

A

Respiratory acidosis

168
Q

Lung problem in which the lungs are losing too much CO2. Kidneys compensate by excreting excess bicarb and retaining hydrogen

A

Respiratory alkalosis

169
Q

For which acid base imbalance would you want the patient to rebreathe into a paper bag?

A

Respiratory alkalosis

54/64 Unit 2 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions