Fluid & Electrolytes Flashcards
(80 cards)
1
Q
What is Aldosterone?
A
Steroid
2
Q
Where is Aldosterone secreted?
A
Adrenal gland
3
Q
Where is the adrenal gland?
A
Above kidneys
4
Q
What does Aldosterone do?
A
Retain Na & water, Lose K
5
Q
What diseases have too much Aldosterone?
A
- Cushing’s
2. Conns Syndrome (Hyperaldosteronism)
6
Q
Disease with not enough Aldosterone?
A
Addison’s
7
Q
What does ANP do?
A
Excretes Na & water
8
Q
How does ANP work?
A
When preload increases (laying down) the atria secretes ANP
9
Q
Disease with too much ADH
A
Syndrome of Inappropriate ADH Secretion (SIADH)
10
Q
Disease with not enough ADH
A
Diabetes Insipidus
11
Q
What do you worry about with Diabetes Insipidus?
A
Shock, bc decreased blood volume
12
Q
Where is ADH found?
A
Pituitary gland
13
Q
What drug is similar to ADH?
A
Vasopressin, Desmopressin acetate
14
Q
In SIADH, does Na follow water?
A
No, Na levels increase
15
Q
Where is the pituitary gland?
A
Behind the eyes
16
Q
ADH problems are associated with what?
A
Head surgeries, increased ICP
17
Q
CVP levels
A
2-6
18
Q
Pulses in hypervolemia
A
Full, bounding
19
Q
NS
A
Isotonic
20
Q
LR
A
Isotonic
21
Q
D5W
A
Isotonic
22
Q
D51/4NS
A
Isotonic
23
Q
Don’t use isotonic solutions with who?
A
HTN, cardiac dz, renal dz
24
Q
Another name for isotonic fluids?
A
Balanced solutions
25
Best fluid for shock pts
LR
26
Hypotonic fluids do what?
Rehydrate, move into cells. Don't raise BP bc they don't stay in vascular space
27
0.5 NS
Hypotonic
28
0.33 NS
Hypotonic
29
D 2.5 W
Hypotonic
30
Besides heart and renal dz, what are hypotonic solutions for?
Hypernatremia to dilute, and for rehydrating
31
Hypertonic fluids, think what?
Packed with particles
32
D10W
Hypertonic
33
3%NS
Hypertonic
34
D5LR
Hypertonic
35
TPN
Hypertonic
36
Albumin
Hypertonic
37
Hypertonic fluids are for what?
Hyponatremia, 3rd space w burns, ascites
38
How is magnesium excreted?
Kidneys, also lost in GI tract
39
Mg and Ca act like what?
Sedatives
40
Causes of hypermagnesemia
Renal dz, antacids
41
First signs of hypermagnesemia and why
Flushing, warmth, vasodilate
42
S/S of hypermag
Decreased LOC, DTR, RR, HR, flaccid, arrhythmia
43
Tx of hypermag
Vent, safety precautions
44
Antidote of mag
Calcium Gluconate
45
Cause of hypercalcemia
Too much PTH
| Immobilization
46
What does PTH do?
Pulls Ca from bone and puts it in the blood when blood levels are low
47
S/S of hypercalcemia
Kidney stones, brittle bones, decreased LOC, DTR, RR, HR, flaccid, arrhythmia
48
Tx of hypercalcemia
Move, bear weight, fluids to prevent kidney stone, fleets enema (lots of phos), phos soda, foods with protein has phos, safety precautions bc sedate, vitamin D to use calcuim
49
Ca and Ph are what?
Inverse relationship
50
What can decrease serum calcium?
Steroids, calcitonin (treats osteoporosis)
51
Causes of hypomag
Alcohol, diarrhea
52
Why does alcohol cause hypomag?
Suppresses release of ADH, hypertonic, not eating
53
S/S of hypomag and hypocalcemia?
Rigid/tight muscles, seizures, stridor/laryngospasm, positive Chostevicks, positive trousseaus, arrhythmias, increase DTR, mind changes, swallowing problems/aspiration
54
Tx of hypomag
Give IV mag, check kidney function first, seizure precautions
55
Foods w/ mag
Green veggies, seeds, peppermint
56
Causes of hypocalcemia
Hypoparathyroidism, radical neck, thyroidectomy
57
Tx of hypocalcemia
Vitamin D, phos binders (Ca acetate), IV Ca
58
How to give IV Ca
Give slowly, keep pt on heart monitor
59
Causes of hypernatremia
Dehydration, hyperventilation, heat stroke, DI
60
S/S of hypernatremia
Dry mouth, thirsty, swollen tongue
61
Tx of hypernatremia
Restrict Na, dilute with fluids
62
Clients on feeding tubes tend to get what?
Dehydrated, the tube feedings have all the electrolytes they need but no water. Ask the doc if you can give them more water.
63
Causes of hyponatremia
Drinking water, D5W (sugar and water), SIADH
64
S/S of hyponatremia
HA, seizure, coma
65
Tx of hyponatremia
Give Na, not water, if neuro problems: give hypertonic saline (packed w/ particles)
66
K is excreted how?
Kidneys
67
Causes of hyperkalemia
Kidney dz, spironolactone
68
S/S of hyperkalemia
Muscle twitching, then weakness, then flaccid paralysis. Also arrhythmias.
69
ECG changes with hyperkalemia
Bradycardia, tall/peaked T waves, prolonged PR intervals, flat/absent P waves, widened QRS complex, conduction blocks, v fib
70
Tx of hyperkalemia
Dialysis, calcium gluconate to decrease arrhythmias, glucose and insulin (insulin carries glucose and K into cell), sodium sulfonate (gives sodium ions which will bring K down, inverse relationship)
71
Any time you give IV insulin, worry about what?
Hypokalemia and hypoglycemia
72
Causes of hypokalemia
Vomiting, NG suction (lots of K in stomach), diuretics, not eating
73
S/S of hypokalemia
Muscle cramps, weakness, arrhythmias
74
ECG changes with hypokalemia
U waves, PVCs, v tach
75
Tx of hypokalemia
Give K, spironolactone, eat K
76
Major problem with oral K
GI upset, so give with food
77
How to give IV K
Assess urinary output before and during, put on a pump, mix well, never give as a push
78
What relationship do Na and K have?
Inverse
79
Does K burn during infusion?
Yes, eats up peripheral veins
80
Foods high in K
Green veggies, oranges, any potatoes ginger, apricots, strawberries, avocado, banana, tuna, cantaloupe, tomatoes, lima beans, parsley
