Fluid & Electrolytes Flashcards
1
Q
Furosemide assessment priority…
A
I and O
2
Q
SSA signs of dehydration
A
12 irregular HR, sunken eyes, dry mucosa
3
Q
SSA chronic kidney disease excoriation skin…
A
Dry skin, sensory neuropathy, and calcium-phosphate skin
4
Q
What is the normal range for sodium?
A
135-145
5
Q
What is the normal range for potassium?
A
3.5-5.3
6
Q
What is the normal range for calcium?
A
9-11
7
Q
What is the normal range for magnesium?
A
1.5-2.5
8
Q
What is the normal range for chloride?
A
95-105
9
Q
What is the normal range for phosphate?
A
2.4-4.5
10
Q
What is the acronym for HYPERcalcemia symptoms?
A
BACKME
11
Q
What does BACKME stand for?
A
Bone pain Arrhythmias Cardiac arrest Kidney stones Muscle weakness Excessive urination
12
Q
What is the acronym for HYPERcalcemia causes?
A
CHIMPAN
13
Q
What does CHIMPAN stand for?
A
Calcium supplements Hyperparathyroidism Iatrogenic, immobilization Multiple myeloma Parathyroid hyperplasia Alcohol Neoplasm
14
Q
What is the acronym for HYPOcalcemia symptoms?
A
CATS
15
Q
What does CATS stand for?
A
Convulsions
Arrhythias
Tetany
Strider and spasms
16
Q
What is the acronym for HYPERkalemia symptoms?
A
MURDER
17
Q
What does MURDER stand for?
A
Muscle cramps Urine abnormalities Respiratory distress Decreased cardiac contractions EKG changes Reflexes
18
Q
What is the acronym for HYPOkalemia?
A
A SIC WALT
19
Q
What does A SIC WALT stand for?
A
Alkalosis Shallow respirations Irritability Confusion and drowsiness Weakness and fatigue Arrhythmias Lethargy Thready pulse
20
Q
What are the acronyms for HYPERnatremia?
A
FRIED or SALT
21
Q
What do FRIED and SALT mean?
A
Flushed skin/low-grade fever Restless, irritable, anxious, confused Increased BP and fluid retention Edema: peripheral pitting Decreased urine output and dry mouth
Skin Flushed
Agitation
Low-grade fever
Thirst
22
Q
What is the acronym for HYPOnatremia?
A
SALTLOSS
23
Q
What does SALTLOSS stand for?
A
Stupor/com Anorexia Lethargy Tendon reflexes (decreased) Limp muscles Orthostatic hypotension Seizures/headaches Stomach cramping
24
Q
Are potassium and magnesium intracellular or extracellular?
A
Intracellular
25
How many liters of fluids should adults take in/ day?
2 1/2 L/day
26
Why are infants and children under the age of 2 risk factors for F&E imbalances?
1. kids have a greater body surface area
2. higher percentage of body water
3. breathing and metabolic rate is faster
4. kidneys are immature
27
Why are older adults risk factors for F&E imbalances?
1. kidney function declining
2. loss of sensation
3. meds that can cause electrolyte imbalances
4. increased sensitivity to salt
28
What ethnic group has a higher sensitivity to sodium?
African Americans
29
What are some causes of dehydration?
1. Diarrhea
2. vomiting
3. Severe weather
4. burns
5. trauma and crush injury (potassium can be shifted out of the cell at this time)
30
What are some causes of HYPOkalemia?
1. diuretics (with no supplement)
2. Vomiting
3. anorexia
4. bulimia
5. diarrhea
6. excessive insulin
31
What are some causes of HYPERkalemia?
1. lack of insulin
2. kidney issues
3. overcorrection of IV infusions
4. Potassium-sparing diuretics
5. Massive sudden cell death
6. Tumor Lysis syndrome
32
What are some causes of HYPOcalcemia?
1. poor absorption
2. not enough in diet
3. diuretics
4. meds that help push calcium back into bones (takes it away from blood causing a deficit)
5. hypoparathyroidism
33
How do you assess for HYPOcalcemia?
1. check for facial twitching
2. check for other muscle twitching
3. pump up a BP cuff on the arm and wait for 3-5 min and if the hand starts twitching, then they probably have hypocalcemia
34
What are some causes of HYPOmagnesemia?
1. chronic diarrhea
| 2. alcoholism
35
What are some causes of HYPERmagnesemia?
1. renal disease
36
When should you take your pts weight?
First thing in the morning
37
What is the normal range for urine specific gravity?
1.015-1.030
38
What should you teach your pt to decrease their sodium intake?
1. don't eat processed foods
2. no canned soups
3. decrease fast foods
4. be careful with salt substitutes because they can be high in potassium (make sure they are safe before taking)
39
Should you give caffiene to a patient who has hypovolemia?
No because this constricts blood vessels and increases urination. If they are hypovolemic, then they have a fluid deficit.
40
What interventions should a nurse take to decrease dry mouth if the pt is on fluid restriction?
1. ice chips
2. wet sponge (do not suck water out of sponge)
3. Teach them what they should not do (drink out of the faucet)
41
What interventions should a nurse take for someone with fluid deficit?
1. replace fluids
2. monitor electrolytes
3. ice chips
4. at least 2 L of fluid could be needed
5. watch skin integrity
42
What is the earliest sign of dehydration
Thirst
43
What are components of dehydration in infants?
1. sunken eyes
2. sunken fontanels
3. tachycardia
4. weight loss
5. lack of tears
44
What are 3 serum lab tests for chronic renal failure?
1. urinalysis
2. BUN and creatinine
3. GFR
45
What should be listed on I & O sheet?
Intake: oral fluids, ice chips, food that is liquid at room temp
Tube feedings: Parenteral fluids, IV meds, Cath/tube irrigations
Output: urine, vomitus, liquid feces, GI tube drainage, wound drainage, draining fistulas
46
What are 3 late symptoms for sodium imbalance?
1. seizures
2. coma
3. death
47
What are some some lifestyle risk factors for Fluid and electrolyte imbalance?
1. stress: Increases your cellular metabolism and increases ADH
2. Exercise: Overexcercising can deplete electrolytes. Weight baring affects calcemia
48
What are some modifiable risk factors for fluid and electrolyte imbalance?
1. head injuries: bleeding and altered cognitions
| 2. Heat-related injuries: Fatigue, weakness, GI (Ex: do slow rewarming with frost-bite)
49
What are some health-related illnesses that are risk factors for fluid and electrolyte imbalance?
1. panreotitis: loosing insulin, typically need to be NPO
2. Liver disease
3. cancers
4. Heart failures
