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Fluids and Electrolytes > Fluid and Electrolytes > Flashcards

Fluid and Electrolytes Flashcards

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1
Q

Sodium Range

A

135-145 mEq/L

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2
Q

Hyponatremia Causes

A

Active Losses or Dilution (Excessive Water Intake)

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3
Q

Hyponatremia S/S

A
  • Lethargy and HA
  • Decreased LOC
  • Brain Herniation and Death
  • Seizure and Coma (Cerebral Edema)
  • Nausea and Malaise
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4
Q

Hyponatremia Nursing Interventions

A

SODIUM

  • Sodium intake, Seizure Precautions
  • Overload- Restrict Water Intake
  • Daily Wts., Diuretics
  • I&Os
  • Monitor: BP, N/V, HR, Dry Mucous Membrane, LOC
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5
Q

Hypernatremia Causes

A

Gain of Na or Loss of Fluids

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6
Q

Hypernatremia Mortality

A

> 150 = 30-48% Mortality

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7
Q

Hypernatremia S/S

A

DRIED

  • Decreased urine output, Dry mouth, Dehydrated -> Swollen tongue
  • Restless, Irritable > Confusion > Delusions > Hallucinations
  • Increases in HR, Temp -> Flushed Skin
  • Edema (Peripheral and Pulmonary)
  • Deep muscle reflexes increased
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8
Q

Hypernatremia Treatment

A

-Fluid replacement with hypotonic or isotonic electrolyte solutions

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9
Q

Hypernatremia Nursing Care

A

I&O’s, Daily Weights, Oral Hygiene, Monitor Na Intake, Neuro, Urine Output

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10
Q

Hypovolemia Definition and Causes

A

Fluid Volume Deficit

-Loss of ECF volume > intake of fluids

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11
Q

Hypovolemia Levels

A 
Mild = 2% loss of BW
Moderate = 5% loss of BW
Severe = 8% loss of BW
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12
Q

Hypovolemia S/S

A

Acute Wt loss, Flat neck veins, Postural HypoTN, Weak/rapid HR, Increased temp, Decreased skin turgor, oliguria/[urine], Decreased central venous pressure

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13
Q

Hypovolemia Treatment

A
  • Find Cause
  • Replace Fluids
    - Mild= use oral rt if possible
    - Moderate or Severe = Isotonic or hypotonic IV solutions
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14
Q

Hypovolemia Nursing Considerations

A

I&O’s, Daily wt, VS, Skin turgor, LOC

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15
Q

Hypervolemia

A
  • Fluid Volume Excess

- Abnormal Retention of water and Na

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16
Q

Hypervolemia Contributing Factors

A

CHF, Renal Failure, Cirrhosis of the liver, Excessive Na intake

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17
Q

Hypervolemia S/S

A

JVD, Increased pulse, Increased BP, Increased wt, Increased edema, Increased ascites, Increased crackles in lungs, Increased dyspnea, Increased confusion

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18
Q

Third Space

A

Fluid is trapped in a place where it cannot be used.

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19
Q

Hypervolemia Treatment

A

(Directed at causes)

  • Limit Na intake
  • Restrict fluids
  • Use of diuretics
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20
Q

Hypervolemia Nursing Considerations

A

I&O’s, Daily wt, VS, Edema, LOC

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21
Q

Phosphorous Range

A

Powerpoint = 2.5-4.5 mg/dL

NCLEX Book = 2.7-4.5 mg/dL

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22
Q

Hypophosphatemia Causes

A

Malnutrition, Alcoholism, Anorexia, Hyperparathyroidism, malignancies, severe burns, Vit. D deficiency, Overuse of antacids (Mg based), Post organ transplant, Dehydrated

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23
Q

Hypophosphatemia S/S

A

Muscle weakness, numbness, fatigue, bone pain/facture, altered mental status (anxiety, irritability, confusion, seizures, coma), decreased platelet aggregation (increased brusing)

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24
Q

Hypophosphatemia Treatment

A
  • Educate on Diet ->Grains!
  • Oral supplementation -> Laxative
  • IV replacement (SLOW)
    • watch site
    • monitor Ca and P levels
    • watch for HTN, Tetany, and Necrosis
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25
Hyperphosphatemia Causes
Renal failure, hypoparathyroidism, excessive intake and/or Vit. D toxicity, chemo, acidosis
26
Hyperphosphatemia S/S
RELATED TO HYPOCALCEMIA
27
Hyperphosphatemia Treatment
-Focus on underlying disorder - Diet Pt. education
28
Magnesium Ranges
Powerpoint: 1.3-2.3 mEq/L | NCLEX Book: 1.6-2.6 mg/dL
29
Hypomagnesemia Manifestations (S/S)
NM, Neuropsychotic, Cardiac
30
Hypomagnesemia Causes
- Chronic alcoholism - Decreased intake (TPN, PPN, or Tube feeding) - Lower GI Loss - DKA
31
Hypomagnesemia Treatment
Mg replacement: - diet - PO supplememnt - IV (severe…
32
Hypomagnesemia Nursing Considerations
Pt Education - diet - DKA - Diabetic control - Alcohol consumption
33
Hypermagnesemia Causes
Renal failure, Excessive intake, Lithium therapy, Untreated DKA
34
Hypermagnesemia S/S
- CNS Depression - Muscle Weakness/Paralysis - N/V, Flushed skin (d/t vasodilation) - Cardiac: bradycardia, heart block, arrest
35
Hypermagnesemia Treatment
- IV fluids (w/ or w/o Ca) (NO IV PUSH) - Hold Mg - Dialysis
36
Calcium Ranges
Powerpoint: 8.5-10.5 mg/dL | NCLEX Book: 8.6-10 mg/dL
37
Hypocalcemia Causes
- Inadequate intake - Increased loss - Malabsorption - Increased binding of calcium
38
Hypocalcemia S/S
- Tetany (increased neural excitability/ spasms) - Arrhythmias - Refractory HypoTN - Paresthesia - Seizures
39
Hypocalcemia Treatment
- Ca Replacement - Seizure Precautions - DON’T mix with PO4 or HCO3 - Give in divided doses
40
Hypercalcemia Causes
- Malignancy | - Hyperparathyroidism
41
Hypercalcemia effects
Increased Ca = decreased neuromuscular excitability
42
Hypercalcemia S/S
- Confusion, lethargy, coma - Muscle weakness/uncoordinated - Cardiac arrest - Bone pain - Anorexia, N/V, constipation - Kidney stones, diuresis, thirst
43
Hypercalcemia Treatment
- Treat cause - Increase fluids - Restrict Ca intake - Mobilize the pt. - Monitor cardiac and neuro status - Calcitonin
44
Potassium Range
3.5-5.0 mEq/L
45
Hypokalemia Causes
Active Losses or Insufficient Intake - Urinary Loss - GI loss - Redistribution from extracellular to intracellular
46
Hypokalemia S/S
Cardiac, Respiratory, Muscular (Death through cardiac or respiratory arrest) - Orthostatic HypoTN - EKG: inverted T wave or U wave - Skeletal muscle weakness/cramping - Constipation, paralytic ileus, N/V, hypoactive bowel - Numbness and tingling/Paresthesia - Weak/thread pulse - Toxicity of Digitalus glycosides - Shallow/ineffective breaths
47
Hypokalemia Treatment
IV K must be administered using a PUMP. | - concentrations of 20 mEq/100mL or higher = through central line
48
Hyperkalemia Causes
- Decreased Renal excretion - Increased intake - Medication effects - Cellular shift of K (acidosis or MS)
49
Hyperkalemia S/S
- Slow weak HR, decreased BP - Respiratory failure (d/t muscle weakness) - NM (early= twitches, cramps, tingling; late= profound weakness, ascending flaccid paralysis in arms and legs) - Hyperactive bowel, diarrhea - Tall peaked T waves
50
Hyperkalemia Treatment
- Mild= restrict K intake and K-sparring meds - Severe = cation change resins (Kayexelate) - Emergent = IV HCO3, Ca, and insulin together w/ D50W
51
Hyperkalemia Nursing Considerations
- Lab Values - EKG changes - Urine Output
52
Chloride Range
97-107 mEq/L
53
Hypochloremia Causes
Occurs with: - other electrolyte imbalances - NG tube - Vomiting
54
Hypochloremia S/S
- Hyponatremia - Hypokalemia - Metabolic Acidosis
55
Chloride need
Makes HCl in stomach
56
Hypochloremia Treatment
- Correcting the Cause | - Treating electrolyte involved
57
Hyperchloremia Cause
Other metabolic conditions
58
Hyperchloremia S/S
Related to: - Hypernatremia - HCO3 loss - Metabolic acidosis - Hypervolemia
59
Respiratory Acidosis Ranges
pH 45 mmHg
60
Respiratory Acidosis Cause
Inadequate excretion of CO2 w/ inadequate ventilation
61
Respiratory Acidosis S/S
Vary, but: - Neuro: drowsiness, HA, Coma - CV: decreased BP, Vfib, flushed skin - NM: Seizures - Repiratory: Hypoventilation w/ hypoxia
62
Respiratory Acidosis Treatment
Directed at cause (admin O2, hydrate, etc)
63
Respiratory Alkalosis Ranges
pH > 7.45 | PaCO2
64
Respiratory Alkalosis Causes
Always due to hyperventilation (cause of hyperventilation can vary i.e. fever, hysteria,, etc.)
65
Respiratory Alkalosis S/S
- Neuro: lethargy, lightheadedness, confusion - CV: Tachy, Dysrhythmias - GI: N/V, epigastric pain - NM: tetany, numbness, tingling of extremities, hyperreflexia, seizures - Resp. : hyperventilation
66
Respiratory Alkalosis Treatment
Treat the cause
67
Metabolic Acidosis Ranges
pH
68
Metabolic Acidosis Causes
- GI Loss of HCO3 - Accumulation of fixed acid (lactic acid, ketoacidosis, etc) - Renal failure - Starvation
69
Metabolic Acidosis S/S
- Tachy - Confusion - HypoTN - Decreased cardiac output
70
Metabolic Acidosis Treatment
- Focus on underlying metabolic disorder | - Improve tissue perfusion
71
Metabolic Alkalosis Ranges
pH > 7.45 | HCO3 > 27 mEq/L (NCLEX)
72
Metabolic Alkalosis Causes
Gain of bicarb or loss of H+ | - vomiting or suction
73
Metabolic Alkalosis S/S
- Neuro: Drowsiness, Dizziness, Nervous, confusion - CV: tachy, dysrhythmias - GI: Anorexia, N/V - NM: tremors, hypertonic muscles, muscle cramps, tetany, seizures, tingling in extremities - Resp.: hypoventilation
74
Metabolic Alkalosis Treatment
- Address underlying disorder - K replacement - Fluid volume replacement

Fluids and Electrolytes (1 decks)

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