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RNC NIC > Fluids And Electrolytes > Flashcards

Fluids And Electrolytes Flashcards

1
Q

Total body water (TBW)

A

Water main component
TBW divided into intracellular water (ICW) and Extracellular water (ECW)

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2
Q

TBW decreases with advancing GA

A

First trimester - 90% of body weight
32 weeks - 80%
Term - 78%
5th month - term mostly extracellular
Age 1 - 60-65% (mostly intracellular)

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3
Q

Osmolality

A

Water’s relative content of solutes (electrolytes and proteins)

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4
Q

Main extracellular ion

A

Sodium
Regulated by kidney

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5
Q

Main intracellular ion

A

Potassium, regulated by sodium potassium cellular pump

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6
Q

Sodium

A

Major extracellular ion
Makes up 90% of total solutes in extracellular compartment
Premies dump sodium so need higher levels in bag

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7
Q

Potassium

A

Major intracellular cation
Initiates and maintains muscular contraction in cardiac and skeletal muscle

3.5-5.5

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8
Q

Chloride

A

Extracellular, works with sodium to maintain plasma volume (holds onto water)
Normal - 96-111
Low chloride and high bicarbonate - alkalosis
High chloride and low bicarbonate - acidosis

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9
Q

Calcium

A

Most abundant mineral in human body
Important for muscle contraction, neural transmission, and blood coagulation

8.8-10.3

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10
Q

Phosphorus

A

85% is in skeleton
Remaining is in soft tissues and extracellular fluid
Good for bone strength, erythrocyte function, cell metabolism, and generation and storage of energy

Milk fortification

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11
Q

Magnesium

A

Energy production, cell membrane function, and protein synthesis

1.6-2.4

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12
Q

Trace minerals

A

Zinc and copper

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13
Q

Zinc

A

Accumulated mostly in 3rd trimester
Metabolism

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14
Q

Copper

A

Adequate stores in liver for both preterm and term

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15
Q

Weight loss week 1 of life

A

5-10% in term
10-20% in preterms

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16
Q

Potassium in 1st DOL

A

Shifts from intracellular to extracellular, can rise
As renal excretion occurs will decrease

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17
Q

Glucose in first DOL

A

Decreases 60-90 minutes after birth
Once they hit low, this trigger glucogenesis ( but premies don’t have glycogen stores)

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18
Q

Calcium in first DOL

A

Abrupt stop in maternal supply, plasma will drop and reach nadir 24-48 hours after birth
PTH increases which mobilizes calcium from bone (if hypocalcemic, result of sluggish PTH response)

If lower albumin and acidosis occurs, can result in lower calcium in plasma

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19
Q

Highest loss of fluid

A

Urine

20
Q

Body weight

A

1 gram of weight = 1 ml of fluid

21
Q

Normal UOP

A

2-4 ml/kg/hr

22
Q

Urine specific gravity

A

Normal is 1.008-1.012
Early indication of hydration status
If high - dehydrated and need fluid
If low - too much fluid and diluted

Used in premies because kidneys are immature and can’t concentrate tribe well

23
Q

Proteinuria

A

Sign of dehydration

24
Q

Hematuria

A

Renal vein thrombosis

25
Q

BUN

A

Blood urea nitrogen
7-20
High or rapid rise indicates some degree of renal failure

26
Q

Creatinine

A

0.8-1.4
More reliable than BUN
Levels mimic mom at birth
0.2-0.5 per day increase indicates renal failure

27
Q

Fractional excretion of sodium (FENa)

A

Determines kidney damage vs volume issue

28
Q

Premie body fluid composition

A

85-90% water
1/3 intracellular
2/3 extracellular

29
Q

Insensible water loss

A

Due to increased permeability of skin
70% from skin
30% from respiratory tract

Average loss 10-60 ml/kg/day

30
Q

Insensible water loss results in

A

Hypernatremia, dehydration, loss of heat

31
Q

Phototherapy and water loss

A

Can increase, should increase fluids if on photo

32
Q

Dehydration can result from

A

GI losses
Acute blood loss
Medications (caffeine)

33
Q

Low protein (albumin) can cause

A

Overhydration/edema/third spacing

34
Q

Over hydration puts baby at risk for

A

PDA
IVH
BPD

35
Q

If metabolic acidosis occurs…(K)

A

Potassium shifts from intracellular to extracellular
Increases potassium

36
Q

If metabolic alkalosis occurs (K)…

A

K shifts from extracellular to intracellular, lower K

37
Q

DiGeorge (chromosomal deletion at 22)…electrolytes

A

Hypocalcemia due to atresia or hypoplasia of parathyroid gland
Murmur due to cardiac issues
Facial anomalies

38
Q

Phenytoin (seizures) and Lasix…

A

Reduces diuretic response to Lasix

39
Q

Too much fluid can cause…Na

A

Hyponatremia, high UOP

40
Q

EKG with hypoK

A

Flattened T waves

41
Q

EKG with hyperK

A

Peaked T waves

42
Q

NEC sign (Blood gas)

A

Persistent metabolic acidosis (lower ph and bicarbonate)
NEC causes lactic acidosis secondary to necrotic bowel

43
Q

Diabetes insipid is

A

High Na and high UOP

44
Q

High Na and low UOP

A

Insufficient intake

45
Q

Calcitonin

A

Decreases calcium
Perinatal asphyxia and stress can cause increase in this

46
Q

High K in preterms, first line treatment

A

Insulin glucose infusion
Insulin causes K to enter cells
Glucose is to avoid hypoglycemia associated with giving insulin

47
Q

Intestinal ileus associated with low…

A

K

RNC NIC (6 decks)

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