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Hesi 2 > fluid and electrolytes archer > Flashcards

fluid and electrolytes archer Flashcards

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1
Q

normal sodium levels

A

135-145

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2
Q

causes of euvolemic hypernatremia

A

increased insensible water loss
diabetes insipidus

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3
Q

treatment of euvolemic hypernatremia

A

give po water

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4
Q

causes of hypovolemic hypernatremia

A

dehydration
diarrhea
burns
NPO
vomiting
diuretics

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5
Q

treatment of hypovolemic hypernatremia

A

give isotonic fluids “NS”

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6
Q

causes of hypervolemic hypernatremia

A

hypertonic IV
increased sodium intake
cushings
sodium bicarb
corticosteroids
hyperaldosteronism

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7
Q

treatment of hypervolemic hypernatremia

A

stop sodium and water
find cause
loop diuretics
free water administration

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8
Q

Neuro changes in hypernatremia

A

restless
agitated
lethargic
drowsy
stupor
coma

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9
Q

musculoskeletal signs of hypernatremia

A

twitching
cramps
weakness

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10
Q

cardiovascular signs of hypernatremia

A

fever
HYPERVOLEMIC-
edema
hypertension
bounding pulse
HYPOVOLEMIC
hypotension
weak pulse

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11
Q

misc signs of hypernatremia

A

flushed skin
decreased top
dry mouth

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12
Q

causes of euvolemic hyponatremia

A

SIADH
adrenal insufficiency
addisons
polydipsia
excessive hypotonic IVF
low dietary sodium

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13
Q

causes of hypervolemic hyponatremia

A

CHF
kidney failure
liver failure
water intoxication

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14
Q

treatment for euvolemic/hypervolemic hyponatremia

A

restrict free water
osmotic diuretics
sodium tablets
increased sodium in diet

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15
Q

causes of hypovolemic hyponatremia

A

vomiting
diarrhea
ng suction
diuretics
burns
excessive sweating

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16
Q

treatment for hypovolemic hyponatremia

A

mild 0.9 NS
severe 3 NS

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17
Q

near signs of hyponatremia

A

seizures
confusion
lethargy
stupor
cerebral edema
increased ICP

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18
Q

musculoskeletal signs of hyponatremia

A

abdominal cramps
weakness
shallow respirations
decreased deep tendon reflexes
muscle spasm
orthostatic hypotension

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19
Q

cardiovascular signs of hyponatremia

A

HYPOVOLEMIC
weak pulse
tachycardia
dizziness
HYPERVOLEMIC
bounding pulses
hypertension

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20
Q

what rate should you replace sodium

A

0.5%meq/hr too fast causes cerebral edema and increased icp

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21
Q

characteristics of chloride

A

inversely related to bicarb
directly related to sodium and potassium

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22
Q

chloride lab values

A

96-108

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23
Q

causes of hypochloremia

A

FLUID LOSS
sweating
dehydration
vomit
STEROIDS
cushings
excess corticosteroids
excessive normal saline

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24
Q

treatment of hyperchloremia

A

treat underlying cause
correct imbalance
give bicarb
discontinue sodium products
use LR instead of NS
monitor all electrolytes

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25
causes of hypochloremia
CHF water intoxication SALT LOSS sweating burns vomiting diarrhea cystic fibrosis addisons
26
treatment of hypochloremia
treat underlying cause correct imbalance (0.9% ns) monitor all electrolytes
27
normal potassium levels
3.5-5
28
characteristics of potassium
responsible for nerve impulse conduction acidotic has increased potassium
29
causes of hyperkalemia
too much potassium from intercellular to extracellular -burns -tissue damage -dka too much total potassium -renal failure excessive potassium intake medications -ace inhibitors potassium sparing diuretics
30
signs hyperkalemia
muscle weakness numbness increased bowel sounds impaired contractility EKG CHANGES shallow respirations cramping diarrhea decreased CO
31
treatment for hyperkalemia
DRIVE POTASSIUM INTO CELLS d5w + regular insulin albuterol bicarb REDUCE TOTAL BODY K kayexalate diuretics dialysis if other treatment doesn't work MONITOR CARDIAC RHYTHM IV calcium gluconate or chloride
32
causes of hypokalemia
POTASSIUM WASTING DRUGS laxatives diuretics corticosteroids cushings INADEQUATE PO INTAKE NPO, poor diet anorexia, bulimia, alcoholism DILUTING K IN BLOOD-TOO MUCH WATER FLUID LOSS NG suction vomiting wound drainage
33
signs of hypokalemia
weak muscles cramps decreased deep tendon reflexes facility shallow respirations decreased bowelsounds constipation increased uop orthostatic hypotension weak thready pulse cardiac arrhythmia
34
treatment of hypokalemia
prevent arrhythmia/ hold digoxin give potassium orally with food to prevent GI upset IV diet with potassium
35
normal calcium levels
9.0-10.5
36
characteristics of calcium
important for bones, teeth, nerves and muscles important for coagulation controlled by PTH and vitamin D inverse relationship with phosphorus
37
cause of hypercalcermia
excessive intake of calcium excessive vitamin D vitamin D toxicity bone cancer immobility glucocorticoids
38
neuromuscular sinus of hypercalcemia
weakness flaccidity decreased deep tendon reflexes
39
cardiovascular signs of hypercalcemia
bradycardia cyanosis dVT
40
gastrointestinal signs of hypercalcemia
decreased peristalsis decreased bowel sounds abdominal pain nausea vomiting constipation kidney stones
41
treatment of hypercalcemia
reduce dietary calcium cardiac monitoring IVF (NS) loof diuretics encourage oral hydration dialysis calcium binders
42
causes of hypocalcemia
renal failure acute pancreatits malnutrition alcoholism bulemia vitamin d deficiency hypoparathyroid hyperphophatemia
43
neuromuscular signs of hypocalcemia
irritability hallucinations paresthesia tetany seizures muscle spasm CHVOSTEKS SIGNS TROUSSEAUS SIGNS
44
gastrointestinal signs of hypocalcemia
increased bowel sounds cramping diarrhea
45
misc signs of hypocalcemia
weak bones weak brittle nails arrhythmias-V-TACh
46
treatment of hypocalcemia
PO supplements with vitamin d to increase absorption IV calcium supplement calcium rich diet
47
normal phosphorus levels
3.0-4.5
48
characteristics of phosphorus
inverse relationship with calcium component of bones and teeth makes phospholipid bilayer
49
causes of hyperphophatemia
excesive dietary intake tumor lysis sundrome renal failure hypoparathyroid
50
treatment of hyperphophatemia
phosphate binders (give with food) manage hypocalcemia
51
causes of hypophosphatemia
malnutrition alcoholism TPN hyperparathyroidism
52
treatment of hypophosphatemia
phosphorus replacement PO IV- give slowly phosphorus rich diet diet low in calcium
53
magnesium lab values
1.6-2.6
54
characteristics of magnesium
stored in bone and cartilage role in muscle contraction activates vitamins directly related to calcium
55
causes of hypermagnesemia
excessive dietary intake too many magnesium containing meds- antacids overcorrection hypomagnesemia renal failure (time not friends with calcium)
56
neuromuscular signs of hypermagnesemia
weakness shallow breathing
57
cardiovascular signs of hypermagnesimia
bardycardia hypotension vasodilation
58
near signs of hypermagnesemia
drowsy lethargic coma
59
treatment of hypermagnesmia
hold fluids and meds containing magnesium loop diuretics calcium gluconate dialysis
60
causes of hypomagnesemia
ALCOHOLISM malnutrition malabsormed hypoparathyroid hypocalcemia diarrhea
61
neuromuscular signs of hypomagnesemia
numbness tingling cramping tetany seizures increased deep tendon reflexes
62
neuro signs of hypomagnesemia
psychosis confusion
63
cardiovascular symptoms
torsades de pointes
64
Gi signs of hypomagnesemia
nausea vomiting abdominal cramps anorexia
65
treatment of hypomagnesemia
monitor cardiac rhythm give IV magnesium very slowly PO magnesium
66
characteristics of isotonic IV fluids
osmolarity similar to blood does not cause fluid shift
67
uses of isotonic IVF
increase volume blood loss surgery isotonic dehydration fluid loss maintenance fluid NPO client
68
types of isotonic fluid
0.9% NS lactated ringers D5W
69
What is special about D5W
it is isotonic on its own but hypotonic in the body
70
Characteristics of hypotonic IV fluid
osmolarity lower than blood molders fluid out of blood and into cells
71
uses for hypotonic IVF
DKA HHSN hypernatremia
72
types of hypotonic fluids
0.45% sodium chloride (1/2 NS) 0.33% or 0.2% sodium chloride D5W D2.5W
73
characteristics of hypertonic IV fluid
osmolarity higher than blood moves fluid out cells and into vascular/interstitial space
74
uses of hypertonic IVF
hyponatremia cerebral edema
75
types of hypertonic IVF
1.5%, 3%, 5% sodium chloride D5NS D5LR D10W

Hesi 2 (10 decks)

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