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Fluids and Electrolytes > Fluid and Electrolytes > Flashcards

Fluid and Electrolytes Flashcards

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
Q

Hyperphosphatemia Causes

A

Renal failure, hypoparathyroidism, excessive intake and/or Vit. D toxicity, chemo, acidosis

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26
Q

Hyperphosphatemia S/S

A

RELATED TO HYPOCALCEMIA

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27
Q

Hyperphosphatemia Treatment

A

-Focus on underlying disorder
- Diet
Pt. education

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28
Q

Magnesium Ranges

A

Powerpoint: 1.3-2.3 mEq/L

NCLEX Book: 1.6-2.6 mg/dL

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29
Q

Hypomagnesemia Manifestations (S/S)

A

NM, Neuropsychotic, Cardiac

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30
Q

Hypomagnesemia Causes

A
  • Chronic alcoholism
  • Decreased intake (TPN, PPN, or Tube feeding)
  • Lower GI Loss
  • DKA
31
Q

Hypomagnesemia Treatment

A

Mg replacement:

  • diet
  • PO supplememnt
  • IV (severe…
32
Q

Hypomagnesemia Nursing Considerations

A

Pt Education

  • diet
  • DKA
  • Diabetic control
  • Alcohol consumption
33
Q

Hypermagnesemia Causes

A

Renal failure, Excessive intake, Lithium therapy, Untreated DKA

34
Q

Hypermagnesemia S/S

A
  • CNS Depression
  • Muscle Weakness/Paralysis
  • N/V, Flushed skin (d/t vasodilation)
  • Cardiac: bradycardia, heart block, arrest
35
Q

Hypermagnesemia Treatment

A
  • IV fluids (w/ or w/o Ca) (NO IV PUSH)
  • Hold Mg
  • Dialysis
36
Q

Calcium Ranges

A

Powerpoint: 8.5-10.5 mg/dL

NCLEX Book: 8.6-10 mg/dL

37
Q

Hypocalcemia Causes

A
  • Inadequate intake
  • Increased loss
  • Malabsorption
  • Increased binding of calcium
38
Q

Hypocalcemia S/S

A
  • Tetany (increased neural excitability/ spasms)
  • Arrhythmias
  • Refractory HypoTN
  • Paresthesia
  • Seizures
39
Q

Hypocalcemia Treatment

A
  • Ca Replacement
  • Seizure Precautions
  • DON’T mix with PO4 or HCO3
  • Give in divided doses
40
Q

Hypercalcemia Causes

A
  • Malignancy

- Hyperparathyroidism

41
Q

Hypercalcemia effects

A

Increased Ca = decreased neuromuscular excitability

42
Q

Hypercalcemia S/S

A
  • Confusion, lethargy, coma
  • Muscle weakness/uncoordinated
  • Cardiac arrest
  • Bone pain
  • Anorexia, N/V, constipation
  • Kidney stones, diuresis, thirst
43
Q

Hypercalcemia Treatment

A
  • Treat cause
  • Increase fluids
  • Restrict Ca intake
  • Mobilize the pt.
  • Monitor cardiac and neuro status
  • Calcitonin
44
Q

Potassium Range

A

3.5-5.0 mEq/L

45
Q

Hypokalemia Causes

A

Active Losses or Insufficient Intake

  • Urinary Loss
  • GI loss
  • Redistribution from extracellular to intracellular
46
Q

Hypokalemia S/S

A

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
Q

Hypokalemia Treatment

A

IV K must be administered using a PUMP.

- concentrations of 20 mEq/100mL or higher = through central line

48
Q

Hyperkalemia Causes

A
  • Decreased Renal excretion
  • Increased intake
  • Medication effects
  • Cellular shift of K (acidosis or MS)
49
Q

Hyperkalemia S/S

A
  • 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
Q

Hyperkalemia Treatment

A
  • Mild= restrict K intake and K-sparring meds
  • Severe = cation change resins (Kayexelate)
  • Emergent = IV HCO3, Ca, and insulin together w/ D50W
51
Q

Hyperkalemia Nursing Considerations

A
  • Lab Values
  • EKG changes
  • Urine Output
52
Q

Chloride Range

A

97-107 mEq/L

53
Q

Hypochloremia Causes

A

Occurs with:

  • other electrolyte imbalances
  • NG tube
  • Vomiting
54
Q

Hypochloremia S/S

A
  • Hyponatremia
  • Hypokalemia
  • Metabolic Acidosis
55
Q

Chloride need

A

Makes HCl in stomach

56
Q

Hypochloremia Treatment

A
  • Correcting the Cause

- Treating electrolyte involved

57
Q

Hyperchloremia Cause

A

Other metabolic conditions

58
Q

Hyperchloremia S/S

A

Related to:

  • Hypernatremia
  • HCO3 loss
  • Metabolic acidosis
  • Hypervolemia
59
Q

Respiratory Acidosis Ranges

A

pH 45 mmHg

60
Q

Respiratory Acidosis Cause

A

Inadequate excretion of CO2 w/ inadequate ventilation

61
Q

Respiratory Acidosis S/S

A

Vary, but:

  • Neuro: drowsiness, HA, Coma
  • CV: decreased BP, Vfib, flushed skin
  • NM: Seizures
  • Repiratory: Hypoventilation w/ hypoxia
62
Q

Respiratory Acidosis Treatment

A

Directed at cause (admin O2, hydrate, etc)

63
Q

Respiratory Alkalosis Ranges

A

pH > 7.45

PaCO2

64
Q

Respiratory Alkalosis Causes

A

Always due to hyperventilation (cause of hyperventilation can vary i.e. fever, hysteria,, etc.)

65
Q

Respiratory Alkalosis S/S

A
  • Neuro: lethargy, lightheadedness, confusion
  • CV: Tachy, Dysrhythmias
  • GI: N/V, epigastric pain
  • NM: tetany, numbness, tingling of extremities, hyperreflexia, seizures
  • Resp. : hyperventilation
66
Q

Respiratory Alkalosis Treatment

A

Treat the cause

67
Q

Metabolic Acidosis Ranges

A

pH

68
Q

Metabolic Acidosis Causes

A
  • GI Loss of HCO3
  • Accumulation of fixed acid (lactic acid, ketoacidosis, etc)
  • Renal failure
  • Starvation
69
Q

Metabolic Acidosis S/S

A
  • Tachy
  • Confusion
  • HypoTN
  • Decreased cardiac output
70
Q

Metabolic Acidosis Treatment

A
  • Focus on underlying metabolic disorder

- Improve tissue perfusion

71
Q

Metabolic Alkalosis Ranges

A

pH > 7.45

HCO3 > 27 mEq/L (NCLEX)

72
Q

Metabolic Alkalosis Causes

A

Gain of bicarb or loss of H+

- vomiting or suction

73
Q

Metabolic Alkalosis S/S

A
  • 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
Q

Metabolic Alkalosis Treatment

A
  • Address underlying disorder
  • K replacement
  • Fluid volume replacement

Fluids and Electrolytes (1 decks)

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