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Fluid and Electrolytes Flashcards

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1
Q

Sodium

A

135-145 mEq/L

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2
Q

Potassium

A

3.5-5.0 mEq/L

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3
Q

Chloride

A

98-106 mEq/L

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4
Q

Bicarbonate

A

24-31 mEq/L

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5
Q

Calcium

A

8.5-10.5mg/dL

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6
Q

Phosphorus

A

2.5-4.5 mg/dL

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7
Q

Magnesium

A

1.8-3.0 mg/dL

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8
Q

Isotonic Solution

A

solutions are equally concentrated

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9
Q

Hypotonic Solution

A

Lower solute concentration

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10
Q

Hypertonic solution

A

higher solute concentration

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11
Q

Baroreceptor Reflex

A

responds to a fall in arterial blood pressure

located in the artrial walls, vena cava aortic arch and sinus

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12
Q

What does the baroreceptor reflex do?

A

Constricts afferent arterioles of the kidney resulting in retention of fluid.

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13
Q

Volume receptors

A

respond to fluid in the atria and great vessels.

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14
Q

what do volume receptors create?

A

they create a strong renal response that increases urine output

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15
Q

renin

A

responds to low blood pressure

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16
Q

antidiuretic horomone

A

also called vasopressin

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17
Q

dehydration

A

loss of body fluids, increased concentration of solutes in the blood

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18
Q

what happens to the cells in dehydration?

A

fluid shifts out of the cells into the blood stream to restore balance. Cells shrink from fluid loss and can no longer function properly.

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19
Q

what does a dehydrated person present with

A

irritability, confusion, dizziness, weakness, extreme thirst, decreased urine output, fever, dry mucous membranes, sunken eyes, poor skin turgur, tachycardia

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20
Q

What do we do?

A

fluid replacement, monitor symptoms and vitals, maintain I&O, maintain IV access, skin and mouth care.

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21
Q

hypovolemia

A

isotonic fluid loss from the extracellular space

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22
Q

what is hypovolemia caused by

A

excessive fluid loss, decreased fluid intake, third space fluid shift

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23
Q

what do you see in hypovolemia

A

mental status deteoriation, tachycardia, delayed cap refill, cool pale extremities, weight loss, orthostatic hypotension, urine output less than 30 mll/ hour

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24
Q

What do we do for a patient with hypovolemia

A

fluid replacement, albumin replacement, blood transfusions for hemmorhage, dopamine to maintain BP, assess for overload with treatment.

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25
hypervolemia
excess fluid in the extracellular compartment as a result of fluid or sodium retention, excessive intake, or renal failure.
26
what does hypervolemia lead to
CHF and pulmonary edema
27
what do you see in a hypervolemia patient
tachypnea, dyspnea, crackles, rapid bounding pulse, hypertension, JVD, acute weight gain, edema.
28
anasarca
severe generalized edema
29
edema
fluid is foced into tissues by the hydrostatic pressure
30
what do we do for patients with edema
fluid and Na+ restriction, diuretics, monitor vital signs, hourly I & O, breath sounds, monitor ABG's, Daily weights
31
water intoxication
hypotonic extracellular fluid shifts ino cells to attempt to restore balance, Cells swell
32
what are some causes of water intoxication
SIADH, rapid infusion of hypotonic solution
33
what do you see with patients with early water intoxication
cahnges in loc, muscle weakness, twitching, cramping
34
what do you see with patients with late water intoxication
bradycardia, widened pulse pressure, seizures, coma
35
what do you do for patients with water intoxication
prevention is the best treatment, assess neuro status, monitor I&O and vital signs, fluid restrictions, IV access, daily weights, monitor serum Na+, seizure precautions
36
cations
sodium, potassium, calcium, magnesium
37
anions
chloride, bicarbonate, phosphate, sulfate
38
major cations in the ECF
sodium
39
Major cations in the ICF
potassium
40
Sodium function
attracts fluid and helps preserve fluid volume. Combines with chloride and bicarbonate to help regulate acid-base balance
41
SIADH
syndrome of inappropriate antidiuretic hormone--when ADH is released and the body doesn't need it causing water retention and sodium excretion.
42
Hypornatremia
Sodium level less than 135 mEq/L
43
dilutional hyponatremia
results from Na+ loss, water gain
44
depletional hyponatremia
insufficient Na+ intake
45
hypovolemic hyponatremia
Na+ loss is greater than water loss; can be renal (diuretic use) or non-renal ( vomiting)
46
Hypervolemic hyponatremia
water gain is greater than Na+ gain; edema occurs
47
Isovolumic hyponatremia
normal Na+ level, too much fluid
48
what do you expect your patients to present with in hyponatremia
headache, Nausea and vomiting, muscle twitching, altered mental status, stupor, seizures ,coma
49
What do you expect to see in Hypervolemic hyponatremia
edema, hypertension, wiehg gain, bounding tachycardia
50
what do you expect to see in hypovolemic hyponatremia
poor skin turgor, tachycardia, decreased BP, orthostatic hypo-tension
51
what do we do for a mild case of hyper/isovolumetric hyponatremia
restrict fluid intake
52
what do we do for a mild case of hypovolemic hyponatremia
Iv fluids or increase po Na+ intake
53
What do we do for a severe case of hyponatremia
infuse hypertonic NaCl solution, furosemide to remove excess fluid, monitor client in the ICU
54
hypernatremia
More sodium in the blood than water, when this occurs fluid shifts outside the cells.
55
What is hypernatremia caused by
water deficit or over-ingestion of Na+
56
What do you see in Hypernatremic patients
``` S-A-L-T Skin flushed Agitation Low grade fever Thirst ```
57
What do we do for hypernatremic patients
correct underlying disorder, gradual fluid replacement, monitor for s/s of cerebral edema, monitor serum Na+ levels, seizure precautions
58
untreated changes in potassium levels can lead to serious
neuromuscular and cardiac problems
59
most potassium ingested is excreted by
the kidneys
60
what are the three other influential factors in potassium
Na+/K+ pump, renal regulation, pH level
61
sodium potassium pump
uses ATP to pump potassium into cells, pumps sodium out of cells and creates a balance
62
Renal Regulation
aldosterone secretion causes Na+ reabsorption and K+ excretion
63
what happens to potassium in acidosis
K+ moves out of cells
64
what happens to potassium in alkalosis
K+ moves into cells
65
Hypokalemia
too little potassium
66
what can cause hypokalemia
GI losses, diarrhea, insufficient intake, non K+ sparing diuretics
67
what are non K+ sparing diuretics
thiazide, furosemide
68
what do you see in a patient with hypokalemia
``` SUCTION Skeletal muscle weakness Uwave (EKG changes) Constipation, ileus Toxicity of digialis glycosides Irregular, weak pulse Orthostatic hypotension Numbness (paresthesias) ```
69
What do we do for patients with hypokalemia
``` increase dietary k+ oral KCl supplements IV and K+ replacements Change to K+ sparing diuretics Monitor EKG changes ```
70
Hyperkalemia
Too much serum potassium | Caused by altered kidney function, increased intake, blood transfusions, meds
71
What do you see in a patient with hyperkalemia
irritability, paresthesia, muscle weakness, EKG changes, irregular pulse, hypotension, nausea, abdominal cramps, diarrhea
72
what do we do for a patient with mild hyperkalemia
give them loop diuretics and put them on dietary restrictions
73
what do we do for a patient with moderate hyperkalemis
kayexalate
74
what do we do with someone who is in emergency hyperkalemia
calcium gluconate for cardiac effects and sodium bicarbonate for acidosis,
75
magnesium function
helps produce ATP, role in protein synthesis and carbohydrate metabolism, regulates muscle contractions
76
Hypomagnesemia
Too little magnesium | Caused by poor dietary intake, poor GI absorption, excessive GI/urinary losses
77
Who is at risk for hypomagnesemia
chronic alcohol users, Sepsis, burns wounds needing debridement.

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