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My NUR 325 Flash Cards > Fluid and Electrolytes Exam 3 > Flashcards

Fluid and Electrolytes Exam 3 Flashcards

1
Q

what is osmosis

A

the movement of WATER down a concentration gradient

-moves from a region of LOW solute concentration to a region of HIGH solute concentration THROUGH A SEMIPERMEABLE MEMBRANE

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2
Q

when does osmosis stop

A

when concentration differences disappear
OR
when hydrostatic pressure builds and opposes further movement

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3
Q

what is diffusion

A

movement of MOLECULES from an area of high concentration to a lower concentration

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4
Q

when does movement stop for diffusion

A

when concentrations are equal in both areas

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5
Q

what are colloids

A

substances that increase colloid oncotic pressure

-they move fluid from the interstitial compartment to plasma (blood) compartment

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6
Q

what are the 3 primary colloids

A

albumin, globulin, fibrinogen

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7
Q

does colloid oncotic pressure increase or decrease with age and malnutrition

A

DECREASE

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8
Q

what is hydrostatic pressure

A

force of fluid in compartment pushing against a cell membrane (or vessel wall)

THINK CAPILLARY LEVEL - major force that pushes water OUT of the vascular system into interstitial space

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9
Q

how is hydrostatic pressure generated

A

generated by blood pressure

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10
Q

what is oncotic pressure

A

OR colloid osmotic pressure

caused by plasma colloids in solution

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11
Q

fill in the blank:

Hydrostatic pressure pushed fluid _______ of the capillary

A

OUT

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12
Q

Fill in the blank:

Oncotic pressure pulls fluid ______ the capillary

A

INTO

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13
Q

what are electrolytes

A

substances that are ELECTRICALLY charged when in solution

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14
Q

what do electrolytes influence

A

fluid balance, acid base balance, nerve impulses, muscle contraction, heart rhythm, and other cell functions

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15
Q

what are concentrations of electrolytes dependent on

A

intake, absorption, distribution, excretion

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16
Q

what electrolytes live inside the cell (intracellular)

A

potassium
magnesium
phosphorous

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17
Q

what electrolytes live outside the cells (extracellular)

A

sodium
chloride
bicarbonate

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18
Q

normal sodium lab value

A

136-145meq/L

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19
Q

normal potassium lab value

A

3.5-5.0meq/L

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20
Q

normal magnesium lab values

A

1.7-2.2 mg/dl

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21
Q

normal calcium lab values

A

9-11 mg/dL

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22
Q

normal phosphate lab values

A

3.2-4.3 mg/dL

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23
Q

what is sodium

A

influences water distribution
aids in acid-base balance
activates muscle and nerve cells

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24
Q

Someone has a sodium of < 136 meq/L… what is that called

A

Hyponatremia

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25
Someone has a sodium of > 145 meq/L... what is that called
Hypernatremia
26
what are causes of hyponatremia
GI losses --> diarrhea, vomiting, fistulas, NG suction renal losses --> diuretics, adrenal insufficiency skin losses --> burns, wound damage fasting diets, polydipsia (water intoxication) excess hypotonic fluid
27
S/S of hyponatremia
confusion/altered LOC anorexia, muscle weakness can lead to seizures/coma
28
what is dilutional hyponatremia
``` low sodium because of too much fluid HYPERVOLEMIC this person has too much water/fluid on board -increase BP -weight gain -bounding rapid pulse ```
29
what is depletional hyponatremia
``` not enough volume on board HYPOVOLEMIC -low BP -tachy pulse -weight loss -decreased urine sp. gravity ```
30
hyponatremia treatment
- sodium replacement (SLOWLY) - PO/IV - IV NS (0.9%) - Fluid restriction - treat underlying problem
31
causes of hypernatremia
- IV fluids, tube feeds, near drowning in salt water --> excess sodium intake - not enough water intake or too much water loss --> cognitively impaired, diarrhea, high fever, heatstroke - profound diuresis
32
S/S of hypernatremia
alter LOC/Confusion, seizure, coma extreme thirst (hyperosmolality) dry, sticky mucous membranes muscle cramps
33
treatment for hypernatremia
If H20 loss is cause ADD WATER | if sodium excess is cause REMOVE SODIUM
34
what is potassium
helps regulate cell excitability and electrical status | helps control intracellular osmolality
35
Potassium < 3.5 meq/L is?
Hypokalemia
36
Potassium > 5.0 meq/L is?
Hyperkalemia
37
what is the main source of potassium loss
Kidneys
38
Causes of hypokalemia
renal or GI losses - diuresis | acid base disorders
39
S/S of hypokalemia
Cardiac rhythm disturbances --> can be lethal muscle weakness, leg cramps decreased bowel motility - constipation, nausea, ileus
40
treatment for hypokalemia
GIVE POTASSIUM
41
causes of hyperkalemia
decreased potassium OUTPUT (renal failure, not peeing) burns, crush injuries, sepsis --> anything with massive cell injury drugs - potassium sparing diuretics, ACE, ARBs, NSAIDs
42
S/S for hyperkalemia
cardiac rhythm disturbances muscle weakness, cramps abdominal cramping, diarrhea, vomiting
43
what is D50/Insulin
for hyerkalemia combo shifts potassium into the cell temporarily usually give 10units of regular insulin and 1 ampule of D50
44
what is magnesium
helps stabilize cardiac muscle cells - blocks/controls movement of K+ out of cardiac cells - helps to stabilize smooth muscle
45
what are causes of hypomagnesemia
diuresis, GI or renal losses, limited intake (fasting or starvation), alcohol abuse, pancreatitis, hyperglycemia
46
S/S of hypomagnesemia
hyperactive reflexes, confusion, cramps, tremors, seizures nystagmus -over active muscles
47
treatment for hypomagnesemia
giving magnesium Orally: mylanta, magnesium sulfate IV: magnesium sulfate - replace over several days, can give IV push if necessary
48
causes of hypermagnesemia
increased intake accompanied by renal failure - chronic renal failure who take milk of mag - OB patients
49
S/S of hypermagnesemia
lethargy, floppiness, muscle weakness, decreased reflexes, flushed/warm skin, decreased pulse/BP
50
what is calcium
hormones released by the thyroid and parathyroid glands | -thyroid and parathyroid are controllers for the amount of calcium that is released from and absorbed into the bone
51
causes of hypocalcemia
``` calcium unable to mobilize from bone increased renal loss increased binding decreased intake of absorption (decreased Vitamin D) acute pancreatitis thyroid and parathyroid surgery ```
52
S/S of hypocalcemia
``` increased neuromuscular excitability -parasthesias (numbness/tingling) -muscle cramps -bone pain -tetany -laryngeal spasm -hyperactive reflexes cardiac insufficiency ``` positive Chvostek's -twitching positive Trousseau's - spasm
53
causes of hypercalcemia
hyperparathyroidism, cancers
54
S/S for hypercalcemia
calcium acts like a sedative, fatigue, lethargy, confusion, weakness, leading to seizures, coma
55
treatment of hypercalcemia
adequate hydration increased urine output diuretics and NaCl dialysis in renal failure
56
calcium and phosphate work together, ___ serum calcium = _____ phosphate
low serum calcium = high phosphate
57
phosphorus
role in bone formation essential for ATP formation and enzymes needed for glucose, protein, and fat metabolism acid-base buffer
58
causes of hypophosphatemia
``` decreased absorption antacids overdose severe diarrhea incerased kidney elimination malnutrition ```
59
S/S of hypophosphatemia
``` tremor paresthesia confusion to coma seizure muscle weakness joint stiffness bone pain hemolytic anemia Plt dysfunction impaired WBC function ```
60
causes of hyperphosphatemia
kidney failure laxatives/enemas with phosphorus shift from intra- to extra cellular compartment hypoparathyroidism
61
S/S of hyperphosphatemia
usually asymptomatic | S/S usually related to hypocalcemia
62
Hypophosphatemia treatment
IV or oral replacement -Given IV over a LONG period of time increase oral intake take care with CKD or hypercalcemia -increased risk of calcifications
63
hyperphosphatemia treatment
treat the cause - calcium-based phosphate binders - hemodialysis - renal failure

My NUR 325 Flash Cards (25 decks)

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