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Exam 4 > Fluid and Electrolytes 2 > Flashcards

Fluid and Electrolytes 2 Flashcards

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1
Q

A client has been taught the need to restrict sodium. Which food selections indicates appropriate choices
A. 1 cup of cottage cheese and sliced tomatoes
B. grilled American cheese on 2 pieces of white bread
C. ham and cheddar cheese sandwich on 2 whole wheat bread
D. chicken leg, 1 slice of whole wheat bread with butter and 1/2 cup of steamed carrots

A

D. chicken leg, 1 slice of whole wheat bread with butter and 1/2 cup of steamed carrots

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2
Q

a nurse is caring for an elderly with renal disease what is NPO. Yesterday the clients serum sodium level was 127 mEq/L. When the nurse assess vital signs , the client states that they are feeling much weaker then earlier in the day . what is the nurses first action
A. call the healthcare provider
B. Assess respiratory effort and circulation
C. raise the head of the bed
D. request dietary consult

A

B. Assess respiratory effort and circulation

BC hyponatermia causes muscle weakness that could affect the respiratory muscles

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3
Q

Active transport

A

occurs when molecules move across cell membranes against a concentration gradient from an area of low concentration to an area of high concentration— requires energy

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4
Q

calcium normal lab value range

A

8.5-10.5

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5
Q

can you give more the 20 mEq/hr for potassium replacement

A

NO

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6
Q

Can you give potassium replacement IM or SC or IV push

A

no it can irritate skin at insertion site, and can cause necrosis
NEVER IV PUSH

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7
Q

Capillary Filtration

A

movement of fluid through a permeable membrane from an area of higher pressure to one of lower pressure

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8
Q

causes of hyperkalemia

MACHINE

A 
medications 
acidosis 
cellular destruction 
hypoaldosteronism 
intake -excess 
nephrons- renal failure
excretion - impaired
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9
Q

chronic fluid overload nutritional therapy means

A

fluid and sodium restrictions

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10
Q

Colloids are…..

A

larger molecules that do not dissolve readily

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11
Q

Common causes of hypokalemia

A

medications - furoseide
vomiting
diarrhea
renal failure

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12
Q

Diffusion

A

passive process by which molecules of a solute move through a cell membrane from an area of higher concentration to an area of lower concentration until equilibrium

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13
Q

each pound of weight = ____ ml of retained water

A

500ml

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14
Q

Excess fluid within the interstitial space is called _____

A

Edema

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15
Q

Extracellular Fluid (ECF) is found _____

A

outside the cells.

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16
Q

Filtration

A

The movement of both water and smaller particles from an area of high pressure to one of low pressure

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17
Q

Fluid and electrolyte balance is the process of regulating…..

A

extracellular fluid volume,

body fluid osmolality,

plasma concentration of electrolytes.

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18
Q

fluid is regulated primarily by

A

the thirst mechanism

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19
Q

Fluid volume depends on ____, _____, and _____

A

age
body fat
gender

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20
Q

functions of calcium

A
  • bone strength and density
  • activates enzymes
  • skeletal muscle and cardiac muscle to contract
  • nerve transmission
  • blood clotting
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21
Q

Hemoconcentration

A

is a decrease in plasma volume, which causes a simultaneous increase in the concentration of red blood cells

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22
Q

Hydrostatic pressure

A

The force created by fluid within a closed system and is responsible for normal circulation of blood.

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23
Q

hypercalcemia interventions

A 
drug therapy to reduce calcium 
monitor EKG 
ROM to muscles 
evaluate mental status 
seizure precaution  
injury prevention
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24
Q

hypercalcemia symptoms

A 
severe muscle weakness 
LOC changes 
increased BP 
decreased peristalsis 
bone pain
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25
hyperkalemia symptoms
``` bradycardia hypotension EKG changes decreased breath sounds muscle weakness increased bowel sounds ```
26
hypernatemia symptoms
``` changes in LOC short attention span agitation confusion thirst twitching muscles diarrhea tachycardia ```
27
Hypernatermia interventions
monitor I and O assess muscle activity push PO water salt restriction
28
hypertonic solution contains...
a higher concentration of solutes than does blood
29
hypervolemia
fluid excess
30
Hypocalcemia symptoms
``` Trousseaus sign chvosteks sign parathesia weak pulse increase peristalsis bone pain or fractures ```
31
hypokalemia interventions
check EKG potassium replacement by IV, PO, or NG spirolactone
32
Hypokalemia symptoms | A SIC WALT
``` Alkalosis shallow respirations irritability confusion weakness, fatigue arrhythmia lethargy thready pulse ```
33
Hypotonic solution is of _____ osmolarity then blood
of lower osmolality than blood
34
Hypovolemia
fluid deficit
35
if there is an decreased in blood osmolarity how will ADH (Antidiuretic Hormone) react
inhibits release | which causes concentration of blood
36
If there is an increased blood osmolarity how will ADH (Antidiuretic Hormone) do
stimulates release and causes dilution of blood
37
Interstitial fluid lies _____
in the spaces between the body cells
38
Interventions for Hypocalcemia
oral or IV replacement of calcium seizure precaution decrease environment stimuli injury prevention
39
Interventions for hyponatermia
assess neuro every 1 hour monitor sodium level reduce water intake seizure precautions
40
interventions of hyperkalemia
monitor EKG changes assess muscle strength potassium restriction
41
Intracellular Fluid (ICF) is where
is contained within the cells
42
Intravascular fluid is the _____ within the ____
the plasma within the blood
43
low calcium =
high phosphorus
44
low calicum levels increase sodium movement across membranes which increases _____
Excitability
45
mild fluid overload nutritional therapy means
no salt added
46
normal intake for food
800-1000
47
normal intake for oral fluids
around 2,000
48
normal output
2,200-2,700
49
Osmosis
involves movement of water across a membrane from an area of a less concentrated solution to an area of high concentrated solution.
50
Potassium normal lab value range
3.5-5
51
Purpose of fluids
- transport nutrient to and wastes from cells - transport hormones, enzymes, blood cells, and platelets - facilitate cellular metabolism and proper cellular chemical functioning - Act as a solvent - Maintain body temperatures - Facilitate digestion, promote elimination - Act as tissue lubricant
52
serum osmolarity range
270-300
53
severe fluid overload nutritional therapy means
restricted: 2g/day to 4g/day of sodium
54
signs of hypervolemia
``` Hypertension Tachycardia Raised JVP on lying Edema Plural effusions Pulmonary edema Ascites Organ failure ```
55
Signs of hypovolemia
``` Postural/supine hypotension Tachycardia Absence of JVP@45o Decreased turgor Dry mucosa Oliguria Organ failure ```
56
sodium normal lab value range
135-145
57
Solute
substances that are dissolved in a solution
58
Solvents
liquids that hold substances in solution – water is primary solvent
59
``` The following are functions of what Maintains bone strength and density Activates enzymes, Allows skeletal muscle and cardiac muscle to contract Controls nerve impulse transmission Facilitates blood clotting. ```
Calcium
60
The particle concentration ......
the number of particles dissolved in the solvent
61
Transcellular fluid includes _______
specialized fluids that are contained in body spaces (ex.plureal space)
62
What are Crystalloids
are solutes that readily dissolve
63
What are electrolytes
substances (e.g., sodium, potassium) that develop an electrical charge when dissolved in water
64
what are some foods high in potassium
leafy vegtables dried fruits nuts
65
what are some functions of potassium
- Helps control intracellular volume - Chief regulator of cellular enzyme activity - Vital role in transmission of nerve impulses - Protein and carbohydrate metabolism, - cellular building - Assists in acid-base regulation
66
what are some Hyponatermia symptoms
``` lethargy headache confusion apprehension seizures coma muscle weakness ```
67
what are some objective assessments for fluid deficit
``` weight loss fever urine concentration tachycardia tachypnea neck vein collapse weak pulse increased labs ```
68
what are some objective assessments for fluid overload
``` dependent edema, facial swelling, changes in VS – Increase heart rate, bounding pulses, BP, inrease weight gain, change in loc ```
69
What are some risk factors to consider when assessing imbalances
Presence of other illness (acute or chronic) – renal, respiratory, cardiac, mental status change, burns, trauma, Nausea and vomiting and/or diarrhea Inability to communicate fluid needs Age Medications (including IV fluids) – adverse effects, under or over treatment
70
what are some situations you will see hyponatermia
- stomach suctioning - vomiting - diarrhea - inadequate salt intake - hypertonic solutions (leads to dilution) - diuretics
71
what are some subjective assessments for fluid deficit/overload
nutritional assessment report of acute/chronic conditions medications illness recent and past
72
what does ADH (Antidiuretic Hormone)
cause kidney to retain fluid
73
what does aldosterone do
retains sodium (and thus water), excrete potassium
74
What does ANP do
increases sodium and water loss -- which decreases volume and osmolarity
75
what does tachycardia occur in hypervolemia
cardiac output has increased and heart rate must increased to handle excess volume.
76
what hormone regulates calcium balance
parathyroid hormone
77
what is Insensible fluid loss
is loss that we do not perceive and is not easily measured
78
What is a colloid
fluids with large molecules that do not pass through semi-permeable membranes - volume expander
79
What is a crystalloid
easily mixed solutions with molecules small enough to cross semipermeable membranes
80
what is actual dehydration
decrease in total body water from too little intake or too great a loss
81
what is fluid
water plus the substances dissolved and suspended in it.
82
what is ionized calicum
calcium in the blood that is not attached to protein (free)
83
What is non electrolytes
are substances that do not conduct electricity
84
What is obligatory urine output
minimum output of urine necessary to remove wastes
85
what is relative dehydration
non-total loss but water shifts from plasma to interstitial fluid
86
what is Sensible fluid loss
is measurable and/or perceived. (urine)
87
What is solubility
the ability to be dissolved
88
what is the cause of hyponatermia internally
excess H2O or loss of sodium
89
what is the ionized lab value range
4.5-5.1
90
what is the most abundant mineral in the body
calcium
91
what is the normal albumin level
3.5-5.0
92
what is third spacing
conditions cause fluid to move into an area that makes it physiologically unavailable, such as into the peritoneal space (in ascites), the pericardial space (with pericardial effusion), or into the vesicles (blisters) with a burn wound.
93
what populations are at risk for fluid imbalances
the very young the very old those with serious injury those with significant health conditions
94
When a hypertonic solution is infused, water moves by osmosis from where to where
from the cells into the ECF.
95
When a hypotonic solution is infused, water moves by osmosis from the ______ into the ____
vascular system | into the cell
96
when serum osmolarity is elevated (above 300) that means
volume deficit bc it is more concentrated
97
when serum osmolarity is reduced (below 270) that means
volume overload
98
When taking the blood pressure of a very ill client , the nurse observes that the clients hand undergoes flexion contractions. What is the nurses primary intervention? A. placing the client in high fowlers and administering IV fluid B. Deflating the BP cuff and administer O2 C. Document the finding as the only action D. Notify the health care provider
B. Deflating the BP cuff and administer O2
99
where does second fluid spacing occur
interstitial edema
100
why does tachycardia occur in hypovolemia
heart is trying to compensate for lower volume to circulate enough O2 to tissues

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