Fluid & Electrolytes Flashcards
1
Q
Diuretics are commonly used to treat _____
A
FVE
2
Q
FVE, Diuretics inhibit/action is to:
A
They inhibit sodium and water transport ion, increasing urine output.
3
Q
What are the three major types of diuretics?
A
Loop
Thiazides
Potassium-Sparing
4
Q
Furosemide (Lasix)
A
Loop Diuretic
5
Q
Bumetadine (Bumex)
A
Loop Diuretics
6
Q
Mannitol (Osmitrol)
A
Osmotic Diuretic
7
Q
Hydrochlorothiazide (Microzide)
A
Thiazides Diuretic
8
Q
Chlorothiazide (Diuril)
A
Thiazides Diuretic
9
Q
Metalazone (Zarolxolyn)
A
Thiazides Diuretic
10
Q
Sprinolactone (Aldactone)
A
Potassium-Sparing Diuretics
11
Q
Captopril (Capoten)
A
ACE Inhibitors
12
Q
Enalapril (Vasotec)
A
ACE Inhibitors
13
Q
Lisinopril (Zestril)
A
ACE Inhibitors
14
Q
Can Potassium be given via IV push
A
No. Overdose is lethal
15
Q
Losartan (Cozaar)
A
ARB
16
Q
Valsartan (Diovan)
A
ARB
17
Q
Irbesartan (Avapro)
A
ARB
18
Q
Hydralazine (Apresoline)
A
Vasodilators
19
Q
Nitroglycerin
A
Vasodilators
20
Q
Heparin
A
Thrombin Inhibitors
21
Q
Low Molecular Weight Heparins (Enoxaparin/Lovenox)
A
Thrombin Inhibitors
22
Q
Fodaparinux (Arixtra)
A
Thrombin Inhibitors
23
Q
What is the most powerful diuretic
A
Loop
24
Q
Symptoms of fluid overload
A
Increased pulse rate, increased blood pressure, increased respiratory rate
25
Signs and symptoms of early indications for fluid volume access
Edema
26
Normal urinary output
1400 to 1500 mL per day
27
What is third spacing
When fluid shifts from vascular space to other areas
28
Isotonic dehydration may result from What
Normal sodium level
29
What is hypovolemia
Loss of ECF
30
True or false SaltSubstitutes have high potassium levels
True
31
Normal range for specific gravity
1.010-1.030
Measures the kidneys ability to concentrate urine
32
Fatigue weakness nausea and vomiting or signs of which problem
Hypokalemia
33
How slow should blood run in an IV transfusion
Two To 5 mL per minute for the first 15 minutes
34
Where is potassium stored
Cells
35
Where is calcium stored
Bones
36
The body does not store which two electrolytes
Sodium and chloride
37
Anti-diuretic hormone
Regulates water excretion from the kidney
38
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
Insulin and glucose
39
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
It is needed to maintain skeletal, cardiac, and neuromuscular activity
40
True or false
| Fluid volume excess was calm and due to the increased levels of ADH in response to stress of the surgery
True
41
Which condition is known to result in fluid loss that is characterized by a proportionately greater loss of sodium and water
Hypotonic dehydration
42
Which interventions and the nurse implement to decrease the clients possibility of developing hypercalcemia
Assist the client to ambulate around the room at least three times daily
43
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
Crystalloid
44
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
Fluid overload
45
Movement of fluid across cell membranes from an area of less concentration to an area of higher concentration
Osmosis
46
The healthcare provider prescribes calcium gluconate for a client. For Rich electrolyte in balance should the nurse assess this client for
Hypomagnesemia
47
A client is experiencing symptoms of severe gastroenteritis. Which IV fluid order should the nurse anticipate being prescribed for this client
Lactated ringer’s
48
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
Hypercalcemia
49
Will hematocrit be increased or decreased with fluid volume deficit
Increased
50
A client is prescribed her as mine. Which information should the nurse provide about this medication
Check daily weight
51
Intake and output should be within how much of each other
200 to 300 mL
52
Which electrolyte in balance is most frequently associated with tetany
Hypocalcemia
53
Nasal gastric drainage, vomiting, diarrhea, and the use of diuretics likely cause which electrolyte in balance
Hypokalemia
54
Dyspnea indicates
Circulatory overload
55
Hypertonic dehydration may result from
Proportionately less sodium lost then water loss
56
Hypotonic dehydration may result from
Fortunately more sodium lost and water loss
57
A patient with fluid volume excess has hypokalemia which collaborative intervention therapy should the nurse nurse expect to implement for this patient
Diuretics
58
A patient is experiencing a fluid and balance caused by excessive blood loss. What fluid is expected to be prescribed
Colloid
59
Intracellular fluid
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
60
Extra Cellular Fluid
Consist of interstitial fluid and is composed of fluid in the interstitum. Between cells
61
Where is sodium located
ECF
62
Hyper nature is may develop as a result of
Dehydration
| Excess intake
63
Signs and symptoms of hyper natremia
Irritability, restlessness, confusion, twitching, increased thirst, dry mucous membranes, decreased urinary output, pulmonary Adema, dyspnea, flush skin, and orthostatic hypotension
64
Mnemonic for hyper natremia signs and symptoms
```
Fried
F: fever(low grade) flushed skin
R: Restless (irritable)
I: Increased fluid rentention and BP
E: Edema
D: Decrease urine output, dry mouth
```
65
Mnemonic for the causes of hyper natremia
```
Model
Medication, Meals
Osmotic diuretics
Diabetes insipid is
Excessive H2O loss
Low H2O intake
```
66
Hyponatremia signs and symptoms
Lethargy, headache, confusion, apprehension, seizures, coma
67
When does hypo natremia occur
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
Nursing management for hyponatremia
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
Potassium is necessary to maintain
Cardiac rhythm
70
Potassium is lost through what
The Gastro intestinal system
71
True or false
| Potassium and sodium are necessary for a nerve impulses in the smooth muscle
True
72
Hyperkalemia signs and symptoms Mnemonic
```
Murder
Muscle weakness
Urine, Oliguria, Anuria
Reap Distress/failure
Decrease cardiac contractility
ECG changes
Reflexes
```
73
Causes of increased serum potassium levels. Mnemonic
```
Machine
Medications, ace inhibitors, NSAIDS
Acidosis
Cellular destruction-burns, traumatic injury
Hypoaldosteronism
Intake-excessive
Nephrons, renal failure
Excretion-impaired
```
74
True or false
| Insulin forces Potassium from Extra Cellular Fluid to the intracellular fluid
True
75
What will help pull the access potassium from the blood
Kayexalate
76
Hypocalcemia mnemonic s/s
```
CATS
Convulsions
Arrhythmias
Tetany
Spasms and strider
```
77
Common causes of hypo kalemia
Diarrhea, vomiting, diuretic therapy, excessive sweating, refeeding syndrome
78
Common causes of hyperkalemia
Burns, renal failure, in response to injury
79
When a burn damages sells you would expect us selves to release the major electrolyte
Potassium. This puts a patient at risk for hyperkalemia
80
Diuretics affect the kidney by alternating the reabsorption and excretion of
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
The main Extra Cellular cation is
Sodium. It helps regulate fluid balance in the body
82
Potassium is essential for conducting electrical impulses because it causes ions to
Shift in and out of the sales to conduct a current
83
Older adults are at an increased risk for electrolyte in balance because, with age, the kidneys have
If you were functioning nephrons
84
What is hypovolemia
Isotonic fluid loss from the Extra Cellular space
85
One sign of hypervolemia is
A rapid, bounding pools
86
In addition to it’s responsibility for fluid balance, sodium is also responsible for:
Impulse Transmission
87
Signs and symptoms of hypo natremia include
Change in level of consciousness, abdominal cramps, and muscle twitching
88
The minimum daily requirement for sodium for an average adult is
2 g
89
Increase serum sodium levels cause Thursday in the release of what
ADH into the bloodstream
90
The sodium potassium pump transports sodium ions
Out of cells
91
Potassium is responsible for
Maintaining a heartbeat
92
When the hormone aldosterone is secreted, the kidneys reabsorb
Sodium, and excrete potassium when aldosterone is secreted
93
Neuromuscular signs and symptoms of hypo kalemia include
Deep tendon reflexes. They may be decreased or absent.
94
Medications to help treat severe hyperkalemia include
Calcium Gluconate and regular insulin
95
A hallmark ECG characteristic of hyperkalemia is the presence of
Tall, tented T waves
96
When administering IV potassium for severe hypokalemia, you should
Verify that the concentration of the solution does not exceed 40 MEQ per liter
97
Magnesium is an important electrolyte because it
Assists in neuromuscular transmission. It is vital to nerve and muscle activity
98
True or False
| Does hypomagnesemia increase neuromuscular excitability
True.
| Expect to see hyper active deep tendon reflexes
99
When teaching your patient with hypomagnesemia, about proper diet, you should recommend that he consume plenty of
Seafood
100
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
Number of grams or milliliters to give
101
Your patient is diagnosed with hyper Magnis MIA. To treat this imbalance of practitioner is likely to order
Both oral and IV fluids. By causing diuresis, the fluids promote excretion of excess magnesium by the kidneys
102
Hypocalcemia involves a dysfunction of
PTH
103
If you’re patient is hypercalcemic, you would expect to
Hydrate the patient with oral or IV fluids increase the year and excretion of calcium and help lower serum calcium levels
104
Which signs are associated with hypocalcemia
Chvostek’s and Trousseau’s
105
Phosphate and which electrolyte have an inverse relationship
Calcium
106
Calcium in which electrolyte have an inverse relationship
Phosphate
107
Chloride is primarily produced by the
Stomach
108
If the levels of bicarbonate ions increase, the level of chloride ions
Decrease.
109
Sodium and what electrolyte move together throughout the body
Chloride
110
Chloride and which electrolyte move together Throughout the body
Sodium
111
Hypertonic solution’scause fluid to move from the
Intracellular space to the Extra Cellular space
112
Isotonic fluids should not be used for a patient with
Increased ICP
113
Isotonic solution examples
D5 W, normal saline, dextrose 5% of normal Saline solution
114
Hypotonic solution examples
Half normal saline
115
Hypertonic solution examples
Dextrose 5% and half normal saline, 3% sodium chloride, dexterose 10% in NS
116
Hypotonic crystalloids
Moves from the bloodstream into the cell and causes the cell to expand with fluid
117
Hypertonic solution should be used cautiously and patience with
Reno in cardiac disease. It draws fluid from the intracellular space into the bloodstream.
118
Dextrose 5% in NS is an example of
Hypertonic solution
119
Dehydration is a what kind of state
Hypertonic state
120
Hypokalemia ECG changes
Flattened or inverted T-wave, a depressed ST segment, and a characteristic U wave
121
Hypermagnesimia cause
Muscle weakness
122
True or false
| Hypocalcemia may be treated with IV calcium gluconate
True
123
Serum phosphate levels will fall below normal range in patients who
Abuse alcohol
124
FVD at risk for
Hypovolemia
Loss of both water and electrolytes
125
Dehydration
Just the loss of water
No electrolytes lost
126
Cause of FVD
```
GI losses, vomiting, diarrhea
Diuretics
Hemorrhaging
Diaphoresis
Diabetes insipidus ( peeing a lot)
Kidney disease
DKA
Hyperventilation
```
127
Symptoms for FVD
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
Labs for FVD
```
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
Nursing Care
```
Fluid replacement
Monitor patient weight daily
I & O
Notify if output falls below 30mL/hours
Fall risk
```
130
Complications for FVD
Hypovolemic shock (legs elevated, pt flat, oxygen, replace volume, vasoconstrictors, colloids)
131
FVE causes:
```
HF (due to heart not pumping correctively)
Steroids
Kidney difunction
Cirrhosis
Burns
Excess sodium intake
```
132
Symptoms of FVE
```
Hypertension due to too much fluid, makes heart work hard
Tachycardia
Tachpnea
Weight gain
Edema
Ascites
Bounding pulses
Dyspnea
Crackles
Distended neck veins
```
133
Labs for be FVE
```
All decreased: due to dilution
Hct
Hgb
Serum osmolarity
BUN
Diluted urine
Urine osmolarity
Urine specific gravity
```
134
Monitor what for FVE
```
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
Complications of FVE
Pulmonary edema dyspnea pink frothy sputum
High risk for skin breakdown
Skin care, caution with repositions
136
Calcium has an inverse relationship with
Phosphorus
If one is high other will be low
137
Calcium
Normal level
9-11
138
Calcium
Function
Bone and teeth formation
Clotting
Nerve and muscle functioning
139
Hypocalcemia
Causes
Vit. D deficiency (allows for absorption of Ca in the body)
Hypoparathyroidism
Too much phosphorus
Pancreatitis
140
Signs and symptoms of hypocalcemia
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
Nursing Care for hypocalcemia
Increase intake of calcium
| Supplements
142
Hypercalcemia cause
Long term steriod use
Bone cancer
Hyperparathyroidism
143
Symptoms of Hypercalcemia
```
Constipation
Decreased deep tendon reflexes
Weakness
Lethargy
Kidney stones
```
144
Magnesium function
Nerve and muscle
Bone formation
Heart function
145
Normal range for magnesium
1.3-2.1
146
Hypomagnesimia
Causes
GI losses
Alcohol abuse
Diuretics
Malnourtrition
147
Symptoms of hypomagnesmia
Hyperactive DTR
Tetany
Seizures
Constipation
148
Hypomagnesmia
Management
Increased intake of foods
| Supplements (can cause diarrhea)
149
Hypermagnesmia
Causes
Kidney disease
| Excessive intake of laxatives or antacids
150
Hypermagnesimia
Signs and symptoms
Muscle weakness
Lethargy
Hypotension
Respiratory or cardiac arrest
151
Diminished deep tendon reflex’s
Hyper or hyponatremia
Hyponatremia
152
Signs and symptoms of hyponatremia are often what in ____ in nature
Neurological
153
A patient with hyponatremia will typically have a increased or decreased level of consciousness
Decreased
154
Renal failure
| Considered that sodium levels will be too high or too low
Too high with renal failure
155
What are the three classifications of hyponatremia
Hypovolemic
Hyper
Uvolemic
156
Cardiac output will be increased or decreased with hyperchloremia
Decreased
157
Hyperchloriemia
Peripheral vasodilation
158
Chloride level below what is considered hypo
95
159
High aerial chloride level
Brady or tachycardia
Hypo or hypertension
Brady
Hypo
160
What causes the muscle weakness in hypokalemia
Due to decreased impulse conduction
161
What GI symptoms will be seen in hyperkalmia
Diarrhea
Hyperactive bowel sounds
Nausea
162
GI symptoms with hypokalemia
Constipation
Ilieus
Nausea
Vomiting
163
Ekg with hypokalemia
St depression
Q wave enlarged
T wave fat or inverted
164
True or false
Confusion, restlessness and irritability are associated with hyperkalmia
True
165
Serum osmolarity
280-300
166
Calcium and what have an inverse relationship
Phosphorus
