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Med Surg 2 > Fluid & Electrolytes > Flashcards

Fluid & Electrolytes Flashcards

1
Q

Diuretics are commonly used to treat _____

A

FVE

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2
Q

FVE, Diuretics inhibit/action is to:

A

They inhibit sodium and water transport ion, increasing urine output.

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3
Q

What are the three major types of diuretics?

A

Loop
Thiazides
Potassium-Sparing

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4
Q

Furosemide (Lasix)

A

Loop Diuretic

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5
Q

Bumetadine (Bumex)

A

Loop Diuretics

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6
Q

Mannitol (Osmitrol)

A

Osmotic Diuretic

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7
Q

Hydrochlorothiazide (Microzide)

A

Thiazides Diuretic

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8
Q

Chlorothiazide (Diuril)

A

Thiazides Diuretic

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9
Q

Metalazone (Zarolxolyn)

A

Thiazides Diuretic

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10
Q

Sprinolactone (Aldactone)

A

Potassium-Sparing Diuretics

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11
Q

Captopril (Capoten)

A

ACE Inhibitors

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12
Q

Enalapril (Vasotec)

A

ACE Inhibitors

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13
Q

Lisinopril (Zestril)

A

ACE Inhibitors

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14
Q

Can Potassium be given via IV push

A

No. Overdose is lethal

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15
Q

Losartan (Cozaar)

A

ARB

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16
Q

Valsartan (Diovan)

A

ARB

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17
Q

Irbesartan (Avapro)

A

ARB

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18
Q

Hydralazine (Apresoline)

A

Vasodilators

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19
Q

Nitroglycerin

A

Vasodilators

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20
Q

Heparin

A

Thrombin Inhibitors

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21
Q

Low Molecular Weight Heparins (Enoxaparin/Lovenox)

A

Thrombin Inhibitors

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22
Q

Fodaparinux (Arixtra)

A

Thrombin Inhibitors

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23
Q

What is the most powerful diuretic

A

Loop

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24
Q

Symptoms of fluid overload

A

Increased pulse rate, increased blood pressure, increased respiratory rate

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25
Q

Signs and symptoms of early indications for fluid volume access

A

Edema

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26
Q

Normal urinary output

A

1400 to 1500 mL per day

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27
Q

What is third spacing

A

When fluid shifts from vascular space to other areas

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28
Q

Isotonic dehydration may result from What

A

Normal sodium level

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29
Q

What is hypovolemia

A

Loss of ECF

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30
Q

True or false SaltSubstitutes have high potassium levels

A

True

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31
Q

Normal range for specific gravity

A

1.010-1.030

Measures the kidneys ability to concentrate urine

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32
Q

Fatigue weakness nausea and vomiting or signs of which problem

A

Hypokalemia

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33
Q

How slow should blood run in an IV transfusion

A

Two To 5 mL per minute for the first 15 minutes

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34
Q

Where is potassium stored

A

Cells

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35
Q

Where is calcium stored

A

Bones

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36
Q

The body does not store which two electrolytes

A

Sodium and chloride

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37
Q

Anti-diuretic hormone

A

Regulates water excretion from the kidney

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38
Q

A client is admitted with an stage renal disease and has a K Level of 7.1. The nurse anticipates which medication to be used to treat this electrolyte in balance

A

Insulin and glucose

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39
Q

The nurse is preparing to administer 20 MEQ of potassium chloride to a client who has been vomiting. What should the nurse explained to the client about the purpose of this medication

A

It is needed to maintain skeletal, cardiac, and neuromuscular activity

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40
Q

True or false

Fluid volume excess was calm and due to the increased levels of ADH in response to stress of the surgery

A

True

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41
Q

Which condition is known to result in fluid loss that is characterized by a proportionately greater loss of sodium and water

A

Hypotonic dehydration

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42
Q

Which interventions and the nurse implement to decrease the clients possibility of developing hypercalcemia

A

Assist the client to ambulate around the room at least three times daily

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43
Q

A nurse is caring for a client who has lost a large percent of circulating body fluids as a result of excessive diuresis. Which medication with the nurse anticipate this client needing

A

Crystalloid

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44
Q

The nurse is monitoring the fluid and electrolyte status of a client receiving IV Colloids. For which in balance to the nurse assessed client’s

A

Fluid overload

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45
Q

Movement of fluid across cell membranes from an area of less concentration to an area of higher concentration

A

Osmosis

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46
Q

The healthcare provider prescribes calcium gluconate for a client. For Rich electrolyte in balance should the nurse assess this client for

A

Hypomagnesemia

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47
Q

A client is experiencing symptoms of severe gastroenteritis. Which IV fluid order should the nurse anticipate being prescribed for this client

A

Lactated ringer’s

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48
Q

A client is experiencing fatigue, headache, nausea, vomiting, and has a decrease in deep tendon reflexes. Which electrolyte in balance to the nurse suspect is causing this client symptoms

A

Hypercalcemia

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49
Q

Will hematocrit be increased or decreased with fluid volume deficit

A

Increased

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50
Q

A client is prescribed her as mine. Which information should the nurse provide about this medication

A

Check daily weight

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51
Q

Intake and output should be within how much of each other

A

200 to 300 mL

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52
Q

Which electrolyte in balance is most frequently associated with tetany

A

Hypocalcemia

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53
Q

Nasal gastric drainage, vomiting, diarrhea, and the use of diuretics likely cause which electrolyte in balance

A

Hypokalemia

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54
Q

Dyspnea indicates

A

Circulatory overload

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55
Q

Hypertonic dehydration may result from

A

Proportionately less sodium lost then water loss

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56
Q

Hypotonic dehydration may result from

A

Fortunately more sodium lost and water loss

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57
Q

A patient with fluid volume excess has hypokalemia which collaborative intervention therapy should the nurse nurse expect to implement for this patient

A

Diuretics

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58
Q

A patient is experiencing a fluid and balance caused by excessive blood loss. What fluid is expected to be prescribed

A

Colloid

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59
Q

Intracellular fluid

A

About 2/3 of the bodies water is located within the body cells which makes up approximately 40% of body weight. Located in the cells of the body

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60
Q

Extra Cellular Fluid

A

Consist of interstitial fluid and is composed of fluid in the interstitum. Between cells

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61
Q

Where is sodium located

A

ECF

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62
Q

Hyper nature is may develop as a result of

A

Dehydration

Excess intake

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63
Q

Signs and symptoms of hyper natremia

A

Irritability, restlessness, confusion, twitching, increased thirst, dry mucous membranes, decreased urinary output, pulmonary Adema, dyspnea, flush skin, and orthostatic hypotension

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64
Q

Mnemonic for hyper natremia signs and symptoms

A 
Fried
F: fever(low grade) flushed skin
R: Restless (irritable)
I: Increased fluid rentention and BP
E: Edema 
D: Decrease urine output, dry mouth
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65
Q

Mnemonic for the causes of hyper natremia

A 
Model
Medication, Meals
Osmotic diuretics
Diabetes insipid is
Excessive H2O loss
Low H2O intake
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66
Q

Hyponatremia signs and symptoms

A

Lethargy, headache, confusion, apprehension, seizures, coma

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67
Q

When does hypo natremia occur

A

A decrease in sodium is caused by dilution as a result of excess water or increased sodium loss. There are some situations.
Gastro intestinal suctioning, diarrhea, in adequate salt intake, fluid shift from intracellular to extracellular by hypertonic solution’s, diuretics, and vomiting

68
Q

Nursing management for hyponatremia

A

Intake and output record, urine specific gravity, pulses, blood pressure and respiratory changes, cerebral edema, compare daily weights, and check for pitting Adema with fluid access

69
Q

Potassium is necessary to maintain

A

Cardiac rhythm

70
Q

Potassium is lost through what

A

The Gastro intestinal system

71
Q

True or false

Potassium and sodium are necessary for a nerve impulses in the smooth muscle

A

True

72
Q

Hyperkalemia signs and symptoms Mnemonic

A 
Murder
Muscle weakness
Urine, Oliguria, Anuria
Reap Distress/failure
Decrease cardiac contractility
ECG changes
Reflexes
73
Q

Causes of increased serum potassium levels. Mnemonic

A 
Machine
Medications, ace inhibitors, NSAIDS
Acidosis
Cellular destruction-burns, traumatic injury
Hypoaldosteronism
Intake-excessive
Nephrons, renal failure
Excretion-impaired
74
Q

True or false

Insulin forces Potassium from Extra Cellular Fluid to the intracellular fluid

A

True

75
Q

What will help pull the access potassium from the blood

A

Kayexalate

76
Q

Hypocalcemia mnemonic s/s

A 
CATS
Convulsions
Arrhythmias
Tetany
Spasms and strider
77
Q

Common causes of hypo kalemia

A

Diarrhea, vomiting, diuretic therapy, excessive sweating, refeeding syndrome

78
Q

Common causes of hyperkalemia

A

Burns, renal failure, in response to injury

79
Q

When a burn damages sells you would expect us selves to release the major electrolyte

A

Potassium. This puts a patient at risk for hyperkalemia

80
Q

Diuretics affect the kidney by alternating the reabsorption and excretion of

A

Water and electrolytes. Diuretics generally affect how much water in sodium the body excretes. At the same time other electrolytes such as Potassium can also be excreted in the urine

81
Q

The main Extra Cellular cation is

A

Sodium. It helps regulate fluid balance in the body

82
Q

Potassium is essential for conducting electrical impulses because it causes ions to

A

Shift in and out of the sales to conduct a current

83
Q

Older adults are at an increased risk for electrolyte in balance because, with age, the kidneys have

A

If you were functioning nephrons

84
Q

What is hypovolemia

A

Isotonic fluid loss from the Extra Cellular space

85
Q

One sign of hypervolemia is

A

A rapid, bounding pools

86
Q

In addition to it’s responsibility for fluid balance, sodium is also responsible for:

A

Impulse Transmission

87
Q

Signs and symptoms of hypo natremia include

A

Change in level of consciousness, abdominal cramps, and muscle twitching

88
Q

The minimum daily requirement for sodium for an average adult is

A

2 g

89
Q

Increase serum sodium levels cause Thursday in the release of what

A

ADH into the bloodstream

90
Q

The sodium potassium pump transports sodium ions

A

Out of cells

91
Q

Potassium is responsible for

A

Maintaining a heartbeat

92
Q

When the hormone aldosterone is secreted, the kidneys reabsorb

A

Sodium, and excrete potassium when aldosterone is secreted

93
Q

Neuromuscular signs and symptoms of hypo kalemia include

A

Deep tendon reflexes. They may be decreased or absent.

94
Q

Medications to help treat severe hyperkalemia include

A

Calcium Gluconate and regular insulin

95
Q

A hallmark ECG characteristic of hyperkalemia is the presence of

A

Tall, tented T waves

96
Q

When administering IV potassium for severe hypokalemia, you should

A

Verify that the concentration of the solution does not exceed 40 MEQ per liter

97
Q

Magnesium is an important electrolyte because it

A

Assists in neuromuscular transmission. It is vital to nerve and muscle activity

98
Q

True or False

Does hypomagnesemia increase neuromuscular excitability

A

True.

Expect to see hyper active deep tendon reflexes

99
Q

When teaching your patient with hypomagnesemia, about proper diet, you should recommend that he consume plenty of

A

Seafood

100
Q

The doctor prescribes IV magnesium sulfate for your patient with hypomagnesemia. Before giving the magnesium preparation, you review the practitioners order to make sure it specifies the

A

Number of grams or milliliters to give

101
Q

Your patient is diagnosed with hyper Magnis MIA. To treat this imbalance of practitioner is likely to order

A

Both oral and IV fluids. By causing diuresis, the fluids promote excretion of excess magnesium by the kidneys

102
Q

Hypocalcemia involves a dysfunction of

A

PTH

103
Q

If you’re patient is hypercalcemic, you would expect to

A

Hydrate the patient with oral or IV fluids increase the year and excretion of calcium and help lower serum calcium levels

104
Q

Which signs are associated with hypocalcemia

A

Chvostek’s and Trousseau’s

105
Q

Phosphate and which electrolyte have an inverse relationship

A

Calcium

106
Q

Calcium in which electrolyte have an inverse relationship

A

Phosphate

107
Q

Chloride is primarily produced by the

A

Stomach

108
Q

If the levels of bicarbonate ions increase, the level of chloride ions

A

Decrease.

109
Q

Sodium and what electrolyte move together throughout the body

A

Chloride

110
Q

Chloride and which electrolyte move together Throughout the body

A

Sodium

111
Q

Hypertonic solution’scause fluid to move from the

A

Intracellular space to the Extra Cellular space

112
Q

Isotonic fluids should not be used for a patient with

A

Increased ICP

113
Q

Isotonic solution examples

A

D5 W, normal saline, dextrose 5% of normal Saline solution

114
Q

Hypotonic solution examples

A

Half normal saline

115
Q

Hypertonic solution examples

A

Dextrose 5% and half normal saline, 3% sodium chloride, dexterose 10% in NS

116
Q

Hypotonic crystalloids

A

Moves from the bloodstream into the cell and causes the cell to expand with fluid

117
Q

Hypertonic solution should be used cautiously and patience with

A

Reno in cardiac disease. It draws fluid from the intracellular space into the bloodstream.

118
Q

Dextrose 5% in NS is an example of

A

Hypertonic solution

119
Q

Dehydration is a what kind of state

A

Hypertonic state

120
Q

Hypokalemia ECG changes

A

Flattened or inverted T-wave, a depressed ST segment, and a characteristic U wave

121
Q

Hypermagnesimia cause

A

Muscle weakness

122
Q

True or false

Hypocalcemia may be treated with IV calcium gluconate

A

True

123
Q

Serum phosphate levels will fall below normal range in patients who

A

Abuse alcohol

124
Q

FVD at risk for

A

Hypovolemia

Loss of both water and electrolytes

125
Q

Dehydration

A

Just the loss of water

No electrolytes lost

126
Q

Cause of FVD

A 
GI losses, vomiting, diarrhea
Diuretics
Hemorrhaging
Diaphoresis
Diabetes insipidus ( peeing a lot)
Kidney disease
DKA
Hyperventilation
127
Q

Symptoms for FVD

A

Don’t have a lot of volume
Hypotension
To compensate for this
Increase RR and HR

Weak pulses
Fatigue
Weakness
Thirst 
Dry mucous membranes
Possible GI upset
Oligiuria (Amal amount of urine)
Decreased skin turgor 
Decreased cap refill
Diaphoresis
Flattened neck veins
128
Q

Labs for FVD

A 
Increase in:
Blood is more concentrated
Increased Hct
Increased blood osmolarity
Serum sodium
BUN (also with dehydration)
Urine specific gravity (due to very little urine that is concentrated
129
Q

Nursing Care

A 
Fluid replacement
Monitor patient weight daily
I & O
Notify if output falls below 30mL/hours
Fall risk
130
Q

Complications for FVD

A

Hypovolemic shock (legs elevated, pt flat, oxygen, replace volume, vasoconstrictors, colloids)

131
Q

FVE causes:

A 
HF (due to heart not pumping correctively)
Steroids
Kidney difunction
Cirrhosis
Burns
Excess sodium intake
132
Q

Symptoms of FVE

A 
Hypertension due to too much fluid, makes heart work hard
Tachycardia
Tachpnea
Weight gain
Edema
Ascites
Bounding pulses
Dyspnea
Crackles
Distended neck veins
133
Q

Labs for be FVE

A 
All decreased: due to dilution
Hct
Hgb 
Serum osmolarity
BUN
Diluted urine
Urine osmolarity
Urine specific gravity
134
Q

Monitor what for FVE

A 
High Fowler’s or semi Fowler’s position
Monitor weight daily (1 to 2 lb in 24 hours, 3 lbs in a week)
I&O
Limit fluid and sodium intake as ordered
Fluid restriction
Diuretics
Oxygen if difficulty breathing
135
Q

Complications of FVE

A

Pulmonary edema dyspnea pink frothy sputum
High risk for skin breakdown
Skin care, caution with repositions

136
Q

Calcium has an inverse relationship with

A

Phosphorus

If one is high other will be low

137
Q

Calcium

Normal level

A

9-11

138
Q

Calcium

Function

A

Bone and teeth formation
Clotting
Nerve and muscle functioning

139
Q

Hypocalcemia

Causes

A

Vit. D deficiency (allows for absorption of Ca in the body)
Hypoparathyroidism
Too much phosphorus
Pancreatitis

140
Q

Signs and symptoms of hypocalcemia

A

Positive chvosteck(taping on cheek and facing switching)and trousseau (inflat BP cuff and it causes finger spasming)
Muscle spasms (due to lots of action potentials)
Numbness and tingling in lips and fingers
GI upset
Hypotension
Decreased HR

141
Q

Nursing Care for hypocalcemia

A

Increase intake of calcium

Supplements

142
Q

Hypercalcemia cause

A

Long term steriod use
Bone cancer
Hyperparathyroidism

143
Q

Symptoms of Hypercalcemia

A 
Constipation
Decreased deep tendon reflexes
Weakness
Lethargy
Kidney stones
144
Q

Magnesium function

A

Nerve and muscle
Bone formation
Heart function

145
Q

Normal range for magnesium

A

1.3-2.1

146
Q

Hypomagnesimia

Causes

A

GI losses
Alcohol abuse
Diuretics
Malnourtrition

147
Q

Symptoms of hypomagnesmia

A

Hyperactive DTR
Tetany
Seizures
Constipation

148
Q

Hypomagnesmia

Management

A

Increased intake of foods

Supplements (can cause diarrhea)

149
Q

Hypermagnesmia

Causes

A

Kidney disease

Excessive intake of laxatives or antacids

150
Q

Hypermagnesimia

Signs and symptoms

A

Muscle weakness
Lethargy
Hypotension
Respiratory or cardiac arrest

151
Q

Diminished deep tendon reflex’s

Hyper or hyponatremia

A

Hyponatremia

152
Q

Signs and symptoms of hyponatremia are often what in ____ in nature

A

Neurological

153
Q

A patient with hyponatremia will typically have a increased or decreased level of consciousness

A

Decreased

154
Q

Renal failure

Considered that sodium levels will be too high or too low

A

Too high with renal failure

155
Q

What are the three classifications of hyponatremia

A

Hypovolemic
Hyper
Uvolemic

156
Q

Cardiac output will be increased or decreased with hyperchloremia

A

Decreased

157
Q

Hyperchloriemia

A

Peripheral vasodilation

158
Q

Chloride level below what is considered hypo

A

95

159
Q

High aerial chloride level

Brady or tachycardia

Hypo or hypertension

A

Brady

Hypo

160
Q

What causes the muscle weakness in hypokalemia

A

Due to decreased impulse conduction

161
Q

What GI symptoms will be seen in hyperkalmia

A

Diarrhea
Hyperactive bowel sounds
Nausea

162
Q

GI symptoms with hypokalemia

A

Constipation
Ilieus
Nausea
Vomiting

163
Q

Ekg with hypokalemia

A

St depression
Q wave enlarged
T wave fat or inverted

164
Q

True or false

Confusion, restlessness and irritability are associated with hyperkalmia

A

True

165
Q

Serum osmolarity

A

280-300

166
Q

Calcium and what have an inverse relationship

A

Phosphorus

Med Surg 2 (22 decks)

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