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Fundamentals of Nursing > Fluid and Electrolytes > Flashcards

Fluid and Electrolytes Flashcards

1
Q

What is the intracellular space ?

A

space within the cell
- holds about 67% of the body’s water

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2
Q

What is the extracellular space ?

A

space outside the cell (includes the interstitial and intravascular)
- holds 25% of the body’s water

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3
Q

How much water does the intravascular space hold ?

A

8% of the body’s water

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4
Q

What is the interstitial fluid ?

A

fluids between cells and outside the blood vessels
- include lymph

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5
Q

What is the intravascular fluid ?

A

blood plasma found in the vascular system

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6
Q

What is the transcellular fluids ?

A

secreted by epithelial cells and include cerebrospinal, pleural, peritoneal, and synovial fluids

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7
Q

What does the hemoglobin test measure ?

A

the amount of hemoglobin in blood and is a good measure of the blood’s ability to carry oxygen throughout the body

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8
Q

What does the hematocrit test measure ?

A

amount of space (volume) red blood cells take up in the blood
- value is given as a % of RBCs in a volume of blood
- Ex.) hematocrit of 38 means that 38% of the blood’s volume is made of RBCs

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9
Q

What is the best indicator of fluid retention and overload ?

A

weight gain
- congestive heart failure and renal failure and great examples of diseases that can retain large amounts of fluid

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10
Q

How much of weight gain does one gain per liter ?

A

2.2 lbs= 1 L (1000mL)

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11
Q

What are some causes of hypervolemia ?

A
  • excessive intake of fluids
  • abnormal retention of fluids
  • heart failure
  • renal failure
  • long term corticosteroid therapy
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12
Q

What is hypervolemia ?

A

where the liquid portion of the blood (plasma) is too high
- or fluid in the body is too high

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13
Q

What are signs and symptoms of hypervolemia ?

A
  • increased pulse: full and bounding distended neck veins
  • increased BP
  • polyuria/nocturia
  • edema
  • SOB
  • moist crackles
  • headache
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14
Q

What is a classic sign of hypervolemia ?

A

full and bounding distended neck veins

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15
Q

What are some nursing consideration for hypervolemia ?

A
  • maintain oxygenation (semi or full fowler’s to improve gas exchange)
  • fluid restriction: I & O
  • promote excretion of excess fluids
  • monitor electrolytes (prevent tissue injury)
  • evaluate feet for edema and discoloration when pt is OOB (out of bed)
  • observe suture line on surgical pt’s (potential evisceration due to fluid retention)
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16
Q

What are some causes of hypovolemia ?

A
  • abnormal fluid loss
  • diarrhea
  • hemorrhage
  • fever (increased perspiration)
  • inadequate intake
  • DKA (diabetic ketoacidosis)
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17
Q

What are some signs and symptoms of hypovolemia ?

A
  • increased HR (due to SNS: sympathetic NS)
  • weak/thready pulses
  • change in position may cause increased HR or decreased BP
  • dizziness/light-headedness
  • UO <500 mL/day
  • altered mental status
  • restlessness
  • lethargy
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18
Q

What are some RN considerations for hypovolemia ?

A
  • maintain pt’s safety
  • Skin care: edematous tissues protected from extreme temps, pressure, and trauma
  • frequent skin care and changes in position
  • elevate edematous extremities to promote venous return and fluid reabsorption
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19
Q

What is the goal of IV therapy ?

A
  • correct or prevent fluid and electrolyte disturbances
  • provide direct access to the vascular system
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20
Q

What is isotonic fluid ?

A

fluid with the same concentration of normal blood
- most common

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21
Q

What is isotonic fluid used for ?

A

used for volume replacement (after prolonged vomiting)
- 0.9% sodium chloride (normal saline)
- LR

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22
Q

What is hypotonic fluid ?

A

fluid that is more dilute than blood

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23
Q

What is hypotonic fluid used for ?

A

used to rehydrate the cells
- 0.45% NaCl
- D5 0.45% NaCl (once infused, dextrose enters cells rapidly leaving free water)

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24
Q

What is hypertonic fluid ?

A

fluid is more concentrated than normal blood

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25
What is hypertonic fluid used for ?
to increase vascular volume - use with caution due to risk for fluid overload - 3% normal saline (NS)
26
Why should Potassium Chloride (KCl) be given cautiously ?
it can cause hyperkalemia which can cause fatal cardiac dysrhythmias - NEVER GIVE IV PUSH (can stop heart) - must be given slowly - KCl irritates the veins and pt's will complain of pain (can be given with other fluids to reduce irritation)
27
What is the primary extracellular electrolyte ?
sodium
28
How does sodium work in the body ?
- helps maintain BP by balancing the volume of water in the body - works with other electrolytes to promote nerves, muscles, and other body tissues to work properly
29
What are the causes of hypernatremia ?
- inadequate water intake - NPO status - excessive water loss - gastroenteritis/vomiting/watery diarrhea - NG suction - severe burns - high fever - diuretic therapy - excessive sweating - disease states (kidney disease or failure, uncontrolled DM)
30
What are the symptoms of hypernatremia ?
- restlessness - agitation - confusion - seizures - thirst - dry, swollen tongue - hypotension - flushed skin - edema (peripheral and pulmonary) - weight gain
31
What is hypernatremia ?
too much sodium in the body - >145
32
What are the treatments for hypernatremia ?
- treat underlying cause - water replacement: oral, Na-free isotonic fluids to dilute serum NA, then 0.45% NS to prevent hyponatremia - diuretics (to promote excretion of Na) - dietary NA may be restricted
33
What are some causes of hyponatremia ?
- vomiting - diarrhea - NG suctioning - diuretic - burns - wounds - excessive water gain - tap water enemas
34
What are some symptoms of hyponatremia ?
- N, V, D - lethargy - confusion - headache - restlessness - irritability - tremors, seizures, coma - weight gain - increased BP
35
What are some treatments for hyponatremia ?
- treat underlying cause - potential fluid restriction
36
What is the largest intracellular electrolyte ?
potassium - contributes to intracellular osmotic pressure
37
How does Potassium get used in the body ?
- supports transmission of electrical impulses in the nerves and muscles (skeletal, cardiac, and smooth muscle contractions) - regulates glucose use and storage - small changes have a profound effect and is poorly tolerated - kidneys eliminate approx. 90% of K
38
What are the causes of hyperkalemia ?
- failure to eliminate K (renal disease, K+ sparing diuretics, ACE inhibitors) - excess K intake - excessive or rapid parenteral administration - shift of K out of cells (acidosis, crushing injury, tissue catabolism fever, sepsis, burns)
39
What are the symptoms of hyperkalemia ?
- irritability - abdominal cramping, diarrhea - weakness of lower extremities - irregular pulse - cardiac arrest if hyperkalemia sudden or severe - EKG: Vfib, V standstill
40
What is hyperkalemia ?
high potassium levels
41
What are treatments of hyperkalemia ?
- eliminate K intake, both oral and IV - dialysis (if due to renal failure) - diuretics (K wasting) - insulin (pushes K into the cell)
42
What is given to treat mild to moderate hyperkalemia ?
Kayexalate - ion-exchange resin - used if kidney function is not normal
43
What are some causes of hypokalemia ?
- Potassium loss - GI losses (D, V, fistulas, NG suction, NPO status) - renal losses: diuretics - skin losses: diaphoresis - dialysis - shift of K into cells (alkalosis) - lack of K intake (starvation, diet let in K, fail to include K in parenteral fluids if NPO, TPN)
44
What are symptoms of hypokalemia ?
- fatigue - constipation - muscle weakness, leg cramps - N, V, paralytic ileus - soft, flabby muscles - dysrhythmias (PVCs) - bradycardia
45
What are treatments for hypokalemia ?
- treat underlying cause - K supplementation - NEVER IV PUSH K
46
Where is Calcium found in the body ?
blood and cells - but 99% is stored in the bones and teeth
47
What is calcium need for in the body ?
mineralization of bones, muscle contractions, nerve transmission, clotting, hormone secretion, and cardiac function
48
What are some causes of hypercalcemia ?
- increased total calcium - cancer - hyperparathyroidism - prolonged immobilization - thiazide diuretics - renal failure
49
What are some symptoms of hypercalcemia ?
- GI (1st to occur): constipation, abdominal pain, N, V, anorexia - lethargy, weakness - depressed reflexes (DTR) - confusion, personality changes, psychosis - bone pain, fractures - flank pain/renal calculi - ventricular dysrhythmias
50
What are some treatments for hypercalcemia ?
- phosphate - admin of IV fluids followed by loop diuretics (excretion of Ca is followed by excretion of Na) - calcitonin via IV to promote renal excretion of Ca - stool softeners given for constipation - cardiac monitoring - dialysis: for severe hypercalcemia - management of renal calculi
51
What are cause of hypocalcemia ?
- vita. D deficiency - hypoparathyroidism - hormonal changes (menopause) - chronic renal failure - loop diuretics (furosemide) - multiple blood transfusions
52
What are symptoms of hypocalcemia ?
- Chvostek's & Trousseau's sign - chest pain, dysrhythmias, heart failure, syncope - numbness and tingling in extremities around mouth, hyperreflexia, muscle cramps - confusion lethargy, seizures, personality changes - wheezing, laryngeal spasm, dysphagia
53
Where is magnesium found in the body ?
intracellular - 50 to 60% in the bones
54
What is the use of Magnesium in the body ?
- regulation of nerve and muscle function - maintain BP, glucose - bone/teeth health
55
What are the causes of hypermagnesemia ?
- renal failure - pt's who ingest large amounts of Mg- containing antacids such as Tums, Maalox, Mylanta
56
What are some symptoms of hypermagnesemia ?
- nausea, dizziness, weakness, confusion - bradycardia, hypotension - severe hypermagnesemia: cardiac arrest - lethargic - coma - deep tendon reflexes- reduced or absent - skeletal muscle contractions because progressively weaker and finally stop
57
What are treatments of hypermagnesemia ?
- treat underlying cause - IV diuretics
58
What are some causes of hypomagnesemia ?
- malabsorption disorders - inflammatory bowel disease (IBD) - diarrhea/pancreatitis - certain abdominal surgeries - alcoholism - diuretics
59
What are some symptoms of hypomagnesemia ?
- N, V, decreased appetite - weakness, fatigue - confusion - neuromuscular changes - tremors/seizures - hyperactive deep tendon reflexes - painful muscle contractions
60
What are some treatments for hypomagnesemia ?
- treat underlying cause - Mg supplement

Fundamentals of Nursing (14 decks)

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