Fluid & Electrolytes

Question 1

pH

Answer 1

7.35-7.45

Question 2

PaCO2

Answer 2

35-45

Question 3

PaO2

Answer 3

80-100

Question 4

HCO3

Answer 4

22-26

Question 5

Metabolic Acidosis S/S

Answer 5

Weakness & fatigue
Anorexia, N/V
Decreased LOC
Warm, flushed skin

Question 6

Metabolic Acidosis Risk Factors

Answer 6

Tissue hypoxia
DKA
Renal failure
Diarrhea, intestinal suction/drainage

Question 7

Metabolic Alkalosis S/S

Answer 7

Altered LOC
Tetany
Respiratory failure
Dysrhythmias

Question 8

Respiratory Acidosis Risk Factors

Answer 8

Acute or chronic lung disease COPD
Narcotics
Neuromuscular disease

Question 9

Respiratory Acidosis S/S

Answer 9

Hypoventilation
Headache
Blurred vision
Confusion

Question 10

Respiratory Alkalosis Risk Factors

Answer 10

Anxiety, hyperventilation
Fever, infection
Mechanical ventilation

Question 11

Respiratory Alkalosis S/S

Answer 11

Hyperventilation
Lightheaded
Chest tightness
Palpitations
Tetany
Numbness and tingling around mouth

Question 12

Aldosterone

Answer 12

Retains Na+ therefore retaining water, and excretes K+

Secreted when Na+ decreased, K+ increased, or increased BP or volume

Question 13

Natriuretic Peptides

Answer 13

Synthesized in the kidney
Antagonists to RAAS
Causes vasodilation, sodium & water excretion, decreasing BP

Question 14

ADH

Answer 14

Secreted when:
- Plasma osmolality increases
- Circulating blood volume decreases & BP drops
Increases water reabsorption into plasma

Question 15

S/S of SIADH

Answer 15

Cerebral edema
Muscle twitching
Headache
Weight gain

Question 16

Fluid Volume Deficit S/S

Answer 16

Thirst
Dizziness
Fatigue
Altered LOC
Anxiety
Oliguria
Dry mucous membranes
Weak, thready pulse
Tachycardia

Question 17

Fluid Volume Deficit Risk Factors

Answer 17

NG Suctioning
Burns
Vomiting
DKA
Fever
Vomiting
Inadequate fluid intake

Question 18

Fluid Volume Excess Risk Factors

Answer 18

CHF
Renal or hormonal failure
Excessive Na+ Intake
Liver disease

Question 19

Fluid Volume Excess S/S

Answer 19

Weight gain
Edema
Crackles & dyspnea
Ascites
Headache
Confusion
Bounding pulse
Decreased hematocrit

Question 20

D5W, D10W

Answer 20

Provides free water
No electrolytes
Small amount of calories
Treats water losses and hypernatremia

Question 21

D5.225, D5.45, D5.9, LR

Answer 21

Replaces electrolytes

Question 22

Colloids

Answer 22

Contains albumin

Increases oncotic pressure in vascular space

Question 23

Dextran

Answer 23

Synthetic sugar

Metabolized slowly pulling fluid & maintaining it in vascular space

Question 24

Causes of Hyponatremia

Answer 24

Increased Na+ excretion
Inadequate intake
Dilution of serum Na+

Question 25

Hyponatremia S/S

Answer 25

Lethargy, headache, confusion, coma Muscle weakness Anorexia, N/V, abdominal cramping

Question 26

Causes of Hypernatremia

Answer 26

Decreased Na+ excretion Increased Na+ intake Decreased water intake or loss of H2O

Question 27

Hypernatremia S/S

Answer 27

Thirst Fever, dry mucous membranes Restlessness, agitation Convulsions, hyperreflexia

Question 28

Causes of Hypokalemia

Answer 28

Increased K+ excretion (N/V, diarrhea, NG suction, diuretics, increased aldosterone) Inadequate K+ intake Increased K+ into cells (from insulin, H+ exchange like DKA because K+ goes out but is still excreted)

Question 29

Hypokalemia S/S

Answer 29

Cardiac dysrhythmias Skeletal muscle weakness Smooth muscle atony Glucose intolerance

Question 30

Causes of Hyperkalemia

Answer 30

Increased K+ sparing Decreased renal secretion Increased shift of K+ into ECF

Question 31

Hyperkalemia S/S

Answer 31

Restlessness Intestinal cramping, diarrhea Muscle weakness Cardiac conduction changes

Question 32

Urine Osmolality values

Answer 32

1.005-1.030

Question 33

BUN level

Answer 33

7-18

Question 34

Creatinine level

Answer 34

0.6-1.5