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Nurs 216 > fluid balance > Flashcards

fluid balance Flashcards

1
Q

how does fluid loss by excretion occur

A

through urine and stool

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2
Q

average fluid loss- urine

A

500 ml

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3
Q

average fluid loss- stool

A

200 ml

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4
Q

average fluid loss- respiration

A

400ml

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5
Q

how does body balance fluid loss

A

by activating thirst and hunger

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6
Q

homeostasis happens when

A

normal fluid replacement occurs

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7
Q

why cant someone replace fluid losses

A

bc of disease or trauma

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8
Q

IV therapy is used when

A

someone cant replace fluid loss due to disease or trauma

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9
Q

basic fluid requirements for “maintenance “ of homeostasis

A

35ml/kg/day

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10
Q

how to calculate patients fluid requirements per hour to maintain adequate intake

A

4x10 + 2x10 + 1x (x)

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11
Q

normal serum osmolality

A

around 280 mOsm/kg

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12
Q

major determinant of osmolarity

A

sodium

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13
Q

how do fluids move between circulation and cells

A

osmosis

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14
Q

when to asses fluid therapy

A

during patient physical assessment

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15
Q

when is iv therapy used

A

when fluid loss isnt replaced adequately due to disease or trauma

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16
Q

reasons IV fluids are used

A

maintenance & resuscitation

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17
Q

when are maintenance IV fluids used

A

when a patient is not eating drinking but otherwise has stable vital signs

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18
Q

when are resuscitation IV fluids used

A

when a patient has a major trauma/acute illness creating body fluid shifts within ICF and ECF

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19
Q

hypertonic fluids

A

fluids high in sodium and/or glucose

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20
Q

IV fluid restriction patients

A

patients with pounding pulses, high BP, edema

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21
Q

how to choose fluid type

A

according to BP and electrolyte results (sodium)

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22
Q

2 types of IV therapy

A

maintenance and resuscitation

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23
Q

maintenance IV therapy

A

replaces normal losses via osmosis

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24
Q

resuscitation IV therapy

A

replaces deficits

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25
Q

fluid restriction

A

no iv therapy required, restrict fluid intake

26
Q

reasons a patient is NPO (not by mouth)

A

acute severe illness & unable to eat, awaiting surgery, ventilated patients

27
Q

osmolality

A

concentration of an osmotic solution.
high osmolality= more solute than solvent
low osmolality= more solvent than solute

28
Q

IV fluids are categorized based on

A

based on tonicity

29
Q

tonicity of fluids with high protein content in the body

A

hypertonic

30
Q

fluids with high dextrose in the body

A

dextrose is quickly used so the other half of the solution determines tonicity in the body

31
Q

fluid maintenance: water, electrolyte & glucose requirements

A

water: 35 ml/kg/day
electrolytes: potassium, sodium and chloride
glucose: 500-100g/day

32
Q

colloids

A

supply proteins to ECF, stay in circulation

33
Q

crystalloids

A

supply h20 & electrolytes, can move between ECF & ICF

34
Q

colloids tx

A

hypovolemic shock, not used in other cases due to no passing via capillaries

35
Q

isotonic fluids ex

A

lactated ringers, NS (0.9%)

36
Q

NS (0.9%) contents, category & s/e

A

contents- 154 na, 154 cl
category- isotonic, #1 maintenance fluid in adults
s/e- hypokalemia if long term use

37
Q

Lactated ringers LR contents, category, & s/e

A

contents- more electrolytes than NS include potassium and calcium
category- isotonic
s/e- hyperkalemia, not used in children bc too many electrolytes

38
Q

isotonic fluids fx

A

ecf=icf, no fluid movement

39
Q

hypertonic fluids fx

A

icf–>ecf, draws fluid from cells into ecf

40
Q

hypertonic fluids ex

A

D51/2NS, 25% albumin

41
Q

D51/2NS contents, category, s/e

A

contents: dextrose + 1/2 NS (na&cl)
category: hypertonic (in the bag), draws fluid from cells, dextrose is used up fast so becomes hypotonic
s/e: cellular dehydration, hyponatremia

42
Q

best IV fluid for children

A

D5+1/2NS, check K+

43
Q

25% albumin contents, category, s/e, when is it used

A

contents: 25% albumin + Na
category: hypertonic, colloid stays in circulation
s/e: intravenous volume expander
uses: for patients who are on fluid and sodium restriction

44
Q

when is hypertonic Iv used

A

when a patient is in fluid overload and needs electrolytes. patients with heart failure or severe edema

45
Q

when is hypotonic IV used

A

when a patients cells are dehydrated and fluid needs to go back into ICF

46
Q

hypotonic IV fluid fx

A

draws ECF fluid into ICF

47
Q

resuscitation fluid tx’s

A

hypovolemic shock, dehydration, trauma (hemorrhage)

48
Q

1st choice resuscitation fluid

A

NS normal saline (0.9%) (isotonic)

49
Q

monitoring NS

A

check VS and circulation

50
Q

NS s/e

A

high amounts cause fluid overload & edema

51
Q

2nd choice resuscitation

A

colloids

52
Q

colloids fx monitoring & s/e

A

increase BP faster to avoid peripheral edema
plasma expander, stays in circulation
monitor for fluid overload

53
Q

why are electrolytes essential

A

nerve conduction, membrane permeability, water balance

54
Q

electrolyte issues ex

A

sodium and potassium imbalances

55
Q

hyponatremia causes and tx

A

diuretic use

D5NS

56
Q

hypernatremia causes and tx

A

kidney failure, high sodium intake

restrict salt intake, diuretic use

57
Q

hypokalemia causes and tx

A

loop diuretics, N&V

KCL

58
Q

hyperkalemia causes and tx

A

potassium sparing diuretics or renal disease

kayexalate

59
Q

iv for dehydrated pt dt vomiting and diarrhea

A

isotonic: lactated ringers

60
Q

maintenance fluid in children

A

require electrolytes and dextrose: D51/2NS with KCL

Nurs 216 (6 decks)

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