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Health and Illness II > Fluid & Electrolytes > Flashcards

Flashcards in Fluid & Electrolytes Deck (30)
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1

Fluid Intake

2500 ml/day

2

Fluid Output

1400-1500 ml/day

3

Anasarca

associated w/ FVE
extreme generalized edema
swelling of skin/tissue
leading of cellular fluid

4

Lymphedema

chronic swelling collection of protein rich fluid

5

Hypernatremia neuro

restlessness
irritability
lethargy
seizures
confusion to coma
dyspnea
tachycardia
orthostatic hypotension
dryness
flushed skin
low urine
muscle weakness

6

Chlorine to Sodium

attracted to each other (directionally proportional)

7

Hypokalemia s/s

skeletal muscle weakness legs to diaphragm
constipation
PVCs/heart blocks
fatigue

8

Hyperkalemia s/s

v-fib/cardiac arrest
hyperactivity

9

Fluid/Electrolyte Imbalances Assessment

PMH, RF, Meds
Age/lifestyle
i&O
weight changes
renal function/endocrine disease
loc
capillary refill
jugular vein distention
skinn color/temp

10

FVD Teaching

prevention of orthostatic hypotension
maintaing fluid intake
prevntion of fluid deficet

11

FVE Teaching

Sodium restriction
provide alternative mattress/heel protectors
fowler's position
monitor o2/labs
elevate areas of edema

12

ARF common causes

hypoperfusion r/t
prerenal (most common from conditions that lower GFR)
postrenal (obstructive ex BPH)
Intrinsic (r/t ATN kidney diseas, acute glomerulonephritis)

13

ATN

acute tubular necrosis
severe irreversible damage to kidney tubules
caused by prolonged ischemia (ex hypovolemia, dehydration, sepsis, burns, trauma, surgery)

14

ARF Etiology

5% of all hospitalized clients
high mortality
can occur any time of life

15

ARF RF

trauma/surgery
infection
hemorrhage
severe heart failure
severe liver disease
lower urinary tract obstruction
older adults
child w/ renal insufficiency

16

ARF Prevention

counteract vasoconstriction
enhance blood flow via nephron
preempt risks like IV contrast

17

ARF Phases

Initiation
Maintenance
Recovery

18

ARF Initiation s/s

lasts hours to days
begins with event
ends w/ tubular injury
often asymptomatic

19

ARF Maintenance s/s

fall in GFR
tubular necrosis
oliguria
edema
muscle weakness
n/d
EKG changes
possible cardiac arrest
hyperphosphatemia
hypocalcemia
metabolic acidosis
anemia
confusion/agitation/lethargy
seizures/coma
hyperreflexia
anorexia
uremic syndrome

20

ARF REcovery s/s

tubule cell repair
gradual return of GFR to normal
diuresis
creatinine, BUN higher
potassium/phosphate levels high
may take up to a year

21

Chronic Kidney Disease causes

diabetic nephropathy
hypertension
chronic glomerulonephritis
chronic pyelonephritis
polycystic kidney disease
systemic lupus erythematosus
infection
dehydration hypertension

22

CKD Prevention

aggressive management of chronic disease
low-sodium diet
regular exercise
avoid smoking
limit alcohol intake

23

CKD s/s

impaired regulation of F/E
increased potassium and phosphate
decreased calcium
metabolic acidosis

24

CKD Children s/s

gross hematuria
paleness/lethargy

25

CKD younger adults

oliguria most dramatic symptom

26

CKD older adults

might not have oliguria
postural hypotension common
increase in BUN/serum creatinine

27

ARF Pharmacological

Dopamine
loop diuretics
osmotic diuretics
electrolytes
discontinue nephrotoxic drugs
blood volume expanders
IV fluids
GI drugs
adjust drug dosages

28

CKD Pharmacological

Adjust dosages
protein-bound drugs may lead to toxicity
avoid drugs eliminated by kidneys
loop diuretics
ACE inhibitors
electrolyte replacement
bicarbonate glucose and insulin to decrease hyperkalemia
folic acid
iron supplements

29

ARF Fluid management/nutrition

restrict fluids/monitor fluids
limit protein intake
increase carbs watch diabetes

30

CKD dietary modifications

restrict protein intake
increase carbs
regulate water/sodium
avoid salt substitutes/eggs/diary products/meat