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NURS 2055 > Fluids and Electrolytes Part 2 > Flashcards

Fluids and Electrolytes Part 2 Flashcards

1
Q

What is the sodium fluid volume?

A

136 - 145 mmol/L

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2
Q

Define hypernatremia with its causes and the fluid volume?

A
  • Water deficiency caused by plasma osmolality
  • > 145 mmol/L
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3
Q

Define hyponatremia with its causes and the fluid volume?

A
  • Excess water or loss of sodium containing fluids
  • <136 mmol/L
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4
Q

For treating a patient with hyponatremia why do we not rapidly correct sodium levels?

A

Leads to osmotic demyelination syndrome with permanent damage to nerve cells in brain

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5
Q

How we do being to check each patient for any extracellular fluid volume balances?

A

By checking hematocrit: ratio of red blood cells to the volume of whole blood. Expressed as a percentage. The higher the percentage the more dehydrated an the lower the percentage means over hydration

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6
Q

What are some signs of dehydration?

A
  • Decreased skin turgor and dry mucous membrane
    • Low blood pressure
    • Increased hematocrit
      • Low urine
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7
Q

What are some signs of fluid excess?

A
  • Swelling, pitting edema
    • Crackles
    • Increased jugular vein distention
      • Increased body weight
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8
Q

What are primary forms of therapy?

A

For fluid volume excess, it’s diuretics and fluid restriction

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9
Q

Which systems are you evaluating for intake and output for nursing implementation?

A
  • Cardiovascular changes
    • Respiratory changes
      • Neurological changes
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10
Q

What is the volume of potassium for normal balance?

A

3.5 - 5.1 mmol/L

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11
Q

What controls the potassium in the body?

A

Na/K pump

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12
Q

What is the primary route of potassium loss?

A

90% of potassium is excreted by the kidneys

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13
Q

What would cause high potassium levels?

A

Kidney failure since the kidneys are responsible to excreting potassium

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14
Q

What relationship do sodium and potassium have?

A

Inverse relationship. Factors that cause sodium retention will result in potassium loss in urine

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15
Q

Define hyperkalemia w/clinical manifestations and its value. basically everything you know

A
  • Potassium level of >5.1mmol/L
  • MOST signs and symptoms are ELEVATED. Basically heart is tight and contracted (everything ELEVATED such as bowel sounds, diarrhea, abdominal cramping))
  • usually impaired by renal excretion or massive cell destruction causing potassium to leak from cells such as a massive burn, tissue damage or crash injury.
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16
Q

What system does hyperkalemia affect and how?

A

Cardiac system. High potassium = Tall, peaked T waves. Because as Potassium increases, membranes depolarize, altering cell excitability.

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17
Q

How do we increase excretion of potassium?

A
  • Eliminate oral and parenteral potassium intake
  • diuretics, dialysis, ion-exchange
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18
Q

Define hypokalemia w/clinical manifestations and its value

A
  • Abnormal losses of potassium level < 3.5mmol/L. shift of potassium from ECF to ICF. Caused by low magnesium, alkalosis and diabetic ketoacidosis
  • Associated with impaired repolarization such as:
    • flattening of T wave
    • emergence of U wave
      • peaked P wave
  • MOST signs and symptoms are Fatigue, muscle weakness, decreaed reflexes, LOW and SLOW and DEPRESSED
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19
Q

How do we fix hypokalemia?

A

Administer potassium chloride supplements (KCl)

20
Q

What must be done to KCl before administering?

A

Must be diluted before administering

21
Q

What are the 2 levels of calcium levels?

A

Total: 2.10 - 2.50 mmol/L
Ionized: 1.15 - 1.35 mmol/L

22
Q

What is the relationship between calcium and phosphorous?

A

They have an inverse relationship. As one increases the other decreases.

23
Q

Define hypercalcemia w/symptoms and its value, basically everything you know

A
  • hyper = LOW and SLOW. Reduced excitability of both muscles and nerves
  • Excess calcium mostly caused by hyperparathyroidism and malignancy.
  • Value of > 2.50 mmol/L
24
Q

Define hypocalcaemia w/symptoms and its value, basically everything you know

A

FAST and EXCITABLE

  • Caused by decrease in the production of PTH resulting in low calcium.
  • tetany (muscle contraction)
  • It’s value is < 2.10 mmol/L
    Increase excitability
25
Q

What are the 2 important signs from hypocalcaemia?

A

1) Trousseau’s sign: carpal spams induced by inflation BP cuff above the SP

2) Chvostek’s sign: contraction of facial muscles in response to a tap over the facial nerve in front of the ear

26
Q

What is the normal range for phosphate?

A

1.0 - 1.50 mmol/L

27
Q

Define hyperphosphatemia and its value. what does it cause?

A
  • > 1.5 mmol/L usually caused by renal failure or chemotherapy or large intake of vitamin D
  • Doesn’t cause too many problems with body functions but hyperphosphatemia causes hypocalcaemia so we must treat.
28
Q

Define hypophosphatemia, it value and clinical manifestations

A
  • Usually found in malnourishment and alcohol withdrawal.
  • Related to deficient of ATP or an enzyme in RBC’s
  • Value is < 1.0mmol/L
29
Q

what do we want to avoid when administering phosphate?

A

Sudden hypocalcaemia is a potential complication of administering phosphorous too quickly

30
Q

What is the normal range for magnesium?

A

0.65 - 1.05 mmol/L

31
Q

How is magnesium regulated?

A

By GI absorption and renal excretion

32
Q

Define hypermagnesemia and its value

A
  • Increased magnesium intake accompanied by renal insufficiency or failure. > 1.05mmol/L
    • Impairs nerves and muscles as well as deep tendon reflexes
    • Note that treatment of eclampsia in pregnancy is administration of magnesium sulphate
33
Q

What systems do magnesium affect?

A

Cardiac system. High magnesium comes close send after potassium for putting someone in cardiac arrest.

34
Q

Define hypomagnesemia w/clinical manifestations and its value

A
  • Limited magnesium intake (prolonged fasting, starvation, chronic alcoholism).
  • same signs as hypocalcaemia1) Trousseau’s sign: carpal spams induced by inflation BP cuff above the SP2) Chvostek’s sign: contraction of facial muscles in response to a tap over the facial nerve in front of the ear
    Hyperactive deep tendon reflexes
  • < 0.65 mmol/L
35
Q

How does protein imbalances impair plasma?

A

Larger molecular size makes it remain in vascular spaces

36
Q

Define hypoproteinemia

A

Low protein. Decreased food intake and starvation

37
Q

Define hyperproteinemia

A

Excess protein which is rare. Caused by dehydration and hemoconcentration

38
Q

What symptoms of protein imbalances?

A
  • Edema (decreased oncotic pressure)
    • Slow healing
      • Anorexia
39
Q

How do we correct mild fluid and electrolyte imbalances?

A

Oral rehydration
Water, electrolytes, glucose which helps Na absorption in small intestine

40
Q

Describe hypotonic solutions

A

Provides more water then electrolytes thus diluting ECF

41
Q

What are some hypotonic solutions?

A

0.45% saline

42
Q

Describe isotonic solutions

A

Expands only the ECF
- Ideal for fluid replacement for patients with ECF volume deficit

43
Q

What is an isotonic solution?

A

ringer’s lactate

44
Q

Describe hypertonic solutions

A

Initially raises the osmolality of ECF and expands it
- Required frequent monitoring

45
Q

Describe plasma expanders solutions

A
  • Stays in vascular space
    • Increases the osmotic pressure

NURS 2055 (18 decks)

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