Fluid & Electrolytes Flashcards
(115 cards)
1
Q
Too much fluid in the vascular space
A
hypervolemia
2
Q
causes of hypervolemia
A
HF
RF
things with lots of sodium
3
Q
in ___ ___ the heart is weak, decreased CO, decreased UO, decreased kidney perfusion,
volume stays in the vascular space
A
heart failure
4
Q
3 things with lots of sodium
A
efferescent soluble meds (aklaseltzer)
canned foods
IVF with sodium
5
Q
3 hormones that regulate fluid volume
A
adolsterone
ANP
ADH
6
Q
where is aldosterone found?
A
adrenal glands
7
Q
normal action of aldosterone
A
retain sodium AND water
8
Q
aldosterone makes the blood volume go ____
A
up
9
Q
diseases with too much aldosterone
A
cushing’s dx
hyperaldosteronism
10
Q
dx with too little aldosterone
A
addison’s disease
11
Q
where is Atrial Natriuretic Peptide (ANP) found
A
atria of the heart
12
Q
how does ANP work?
A
opposite of aldosterone
13
Q
ANP causes excretion of ??
A
water and sodium
14
Q
ANP is released for ___ ___ patients
A
heart failure
15
Q
anti-diuretic hormone (ADH) makes you ____ water
A
retain
16
Q
too much ADH aka?
A
SIADH
17
Q
with SIADH they are in fluid volume ____
A
excess
18
Q
urine and blood with SIADH
A
concentrated urine
dilute blood
19
Q
not enough ADH aka??
A
DI
20
Q
DI patients are in fluid volume ____
A
deficit
21
Q
urine and blood with DI
A
dilute urine
concentrated blood
22
Q
PC with DI
A
SHOCK….DIE
23
Q
Concentrated makes the #s go ____
A
up
24
Q
dilute makes the #s go ____
A
down
25
which 3 things can go up or down with dilute vs. concentrated?
urine specific gravity
sodium
Hct
26
ADH is found where?
pituitary gland
27
key words to make you think potential ADH problems?
```
craniotomy
head injury
sinus surgery
trassphenoidal hypophysectomy
or any condition that can lead to increased ICP
```
28
another name for ADH =
vasopressin
29
with hypervolemia the vessels can't hold anymore fluids so they start to
3rd space
30
central venous pressure is measured where?
right atrium
31
with hypervolemia....CVP goes ___
up
32
sx of hypervolemia
wet lung sounds
polyuria
increased BP
increased weight
33
hypervolemia can lead to
heart failure then pulmonary edema
34
normal CVP
2-6
| or 5-10
35
fluid retention: think ____ problems first
HEART
36
treatment for hypervolemia
```
low Na+ diet
fluid restriction
I/Os and daily weights
diuretics
bed rest
```
37
loop diuretic
furosemide
38
thiazide diuretic
hydrochlorothiazide
39
potassium sparing diuretic
sprionolactone
40
bed rest induces ____ by the release of ___ and decreased production of ____
diuresis
ANP
ADH
41
fluid volume deficit AKA
hypovolemia
42
causes of hypovolemia
loss of fluid from anywhere
third spacing
diseases with polyuria
43
examples of fluid loss from anywhere
```
thoracentesis
paracentesis
vomiting
diarrhea
hemorrhage
```
44
when fluid is in a place that does you no good
3rd spacing
45
examples of 3rd spacing
burns
| ascites
46
diseases with polyuria
polyuria
oliguria
anuria
47
sx of hypovolemia
```
decreased weight,
decreased skin turgor
dry MM
decreased UO
low BP
increased HR
increased RR
decreased CVP
increased urine specific gravity
```
48
treatment for hypovolemia
prevent further losses
| replace volume
49
fluid that goes into the vascular space and stays there!
isotonic solution
50
exs of isotonic solution
NS
LR
D5W
D5 1/4 NS
51
uses for isotonic solutions
N/V
burns
sweating
trauma
52
when is isotonic solutions C/I
HTN
cardiac disease
renal dx
53
goes into the vascular space and then shifts out into the cells to replace cellular fluid
hypotonic solutions
54
hypotonic solutions rehydrate without causing ____
HTN
55
examples of hypotonic solutions
D2.5W
1/2 NS
0.33% NS
56
uses for hypotonic solutions
client who has HTN
| renal or cardiac disease
57
watch for cellular edema with hypotonic solutions because this fluid is moving out to the cells, which could lead to fluid volume ____ and decreased BP
deficit
58
volume expanders that will draw fluid into the vascular from the cells
hypertonic solutions
59
examples of hypertonic solutions
```
D10W
3% NS
5% NS
D5LR
D5 1/2
D5
TPN
Albumin
```
60
uses for hypertonic
hyponatremia
3rd spacing clients
clients with severe edema, burns, or ascites
61
watch for fluid volume ____with hypertonic solutions
excess
62
ISOTONIC
"stay where I put it"
63
HYPOTONIC
go Out of the vessel
64
HYPERTONIC
Enter the vessel
65
Mg and Ca act like
sedatives
66
Mg is excreted by the ____ or can be lost in the ___ ___
kidneys
| GI tract
67
causes of hypermagnesemia
renal failure
| antacids
68
sx of hypermagnesemia
flushing
warmth
vasodilation
69
treatment for hypermagesemia
ventilator
dialysis
CALCIUM GLUCONATE
70
causes of hypercalcemia
hyperparathyroidism
thiazides
immobilization
71
sx of hypercalcemia
bones are brittle
| kidney stones
72
treatment for hypercalcemia
```
move!!!!!
fluids
add phosphorus to diet
steroids
vitamin D
```
73
sx common with hypermagnesemia and hypercalcemia
```
decreased DTRs
weak muscle tone
arrhythmias
decreased LOC
decreased pulse and RR
```
74
if you want to get Mg and Ca questions right, think ____ first
muscles
75
calcium has an inverse relationship with _____
phosphorus
76
Mg level
1.3-2.1
77
calcium level
9.0-10.5
78
causes of hypomamagnesemia
diarrhea
| alcoholism
79
causes of hypocalcemia
hypoparathyroidism
radical neck
thyroidectomy
(not enough PTH)
80
sx of hypomagnesema and hypocalcemia
```
rigid muscle tone
seizure risk
stridor
positive trousseau's sign and chovestek's sign
arrhythmias
increased DTRs
swallowing problems
mind changes
```
81
treatment of hypomamagnesemia
give some Mg
seizure precautions
eat Mg
82
what to checking before and during Mg infusion?
kidney function
83
what do you do if your client reports flushing and sweating when you start IV Mg?
STOP IT
84
treatment for hypocalcemia
vitamin D
phosphate binders
IV Ca
85
what to make sure to do before administering IV Ca
put patient on the heart monitor
86
foods high in Mg
```
spinach
mustard greens
summer squash
broccoli
halibut
turnip greens
pumpkin seeds
peppermint
cucumber
green beans
celery
kale
sunflower seeds
sesame seeds
flax seeds
```
87
sodium level in your blood is totally dependent on how much ____ you have in the blood
water
88
sodium level
135-145
89
Hypernatremia AKA
dehydration
90
hyponatremia AKA
dilution
91
causes of hypernatremia
hyperventilation
heat stroke
DI
V/D
92
sx of hypernatremia
dry mouth
swollen tongue
thirsty
93
treatment of hypernatremia
```
restrict Na+
dilute client with fluids
daily weights
I/Os
lab work
```
94
causes of hyponatremia
drinking H20 for fluid replacement
psychogenic polydipsia
D5W
SIADH
95
psychogenic polydipsia
loves to drink water
96
sx of hyponatremia
HA
seizure
coma
97
treatment for hyponatremia
client needs Na+
| client doesn't need water
98
if having neuro problems with hypocalcemia they need ______ saline
hypertonic
99
K+ levels
3.5-5.0
100
K+ is excreted by the ____
kidneys
101
causes of hyperkalemia
kidney trouble
| spironolactone
102
spironolactone makes you retain ____
K+
103
sx of hyperkalemia
muscle twitching
then muscle weakness
then flaccid paralysis
arrhythmias
104
treatment for hyperkalemia
dialysis
calcium gluconate
glucose and insulin
sodium polystyrene sulfonate (kayexelate)
105
calcium gluconate decreases _____
arrhythmias
106
insulin carries ____ and ___ into the cell.
glucose and K+
107
anytime you give IV insulin, worry about _____ and ____
hypoglycemia and hypokalemia
108
causes of hypokalemia
vomiting
NG suctioning
diuretics
not eating
109
sx of hypokalemia
muscle cramps
muscle weakness
arrhythmias
110
treatment for hypokalemia
give K+
Spironolactone
eat more K+
111
spironolactone makes you retain ____
K+
112
sodium and ___ have an inverse relationship
K+
113
major problem with oral potassium
GI upset
| give with food
114
assess ___ ____ before and during IV potassium
urinary output
115
always put IV ____ on a pump
K+
