Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NURS 470 > High acuity fluids and electrolytes > Flashcards

High acuity fluids and electrolytes Flashcards

1
Q

osmosis

A

movement of H20 between compartments across permeability membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

osmolality

A

concentration of solute in body of water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

starling forces

A

governs the passage exchange of water between the capillary microcirculation and the interstitial fluid
an equation that illustrates the role of hydrostatic and oncotic forces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

hydrostatic pressure

A

pressure exerted by fluid in the interstitial or capillary space against the cell wall
arterial=high
venous=low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

oncotic pressure

A

pressure exerted by plasma proteins in the capillary or within the interstitial space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

second space edema

A

pitting and non-pitting edema
in the interstitial space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

third space fluid

A

ascites
body cavities that normally don’t have fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

isotonic solutions

A

closely approximates normal serum plasma osmolality
NS and LR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

hypotonic solutions

A

shifts fluids from the intravascular compartment into intracellular compartments
FLUID INTO CELL
1/2NS, D5W

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

hypertonic solutions

A

shifting fluids from ICF and ECF into intravascular compartment (expands blood volume)
D10W, D51/2NS, 3%NS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

hypernatremia causes

A

renal losses
hypertonic feedings (tube feeds)
increased Na intake
hyperaldosteronism
high stress & increased cortisol
diabetes insipidus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

hypernatremia symptoms

A

FRIED SALT
flushed skin and fever
restless, irritable, anxious, confused
increased blood pressure and fluid retention
edema: peripheral and pitting
decreased urine output
skin flushed
agitation
low-grade fever
thirst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

hypernatremia treatment

A

depends on cause (treat cause)
fluids
DI -> give ADH
reduce Na intake
tx aldosteronism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

hyponatremia causes

A

use of diuretics
vomiting
diarrhea
diaphoresis
urination
hypovolemia
SIADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

hyponatremia symptoms

A

SALTLOSS
stupor/coma
anorexia, nausea, vomiting
lethargy
tendon reflexes (decreased)
limp muscles (weakness)
orthostatic hypotension
seizures/headache
stomach cramping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

hyponatremia treatment

A

increase Na to H2O ratio
give Na
tx underlying cause
restrict fluid
normalize serum osmolality
assess volume status of patient
assess urine sodium concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

diabetes insipidus

A

“water diabetes”
abnormal secretion or action of ADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

diabetes insipidus s/s

A

up to 20L urine/day
low specific gravity
low osmolarity
hypovolemia
increased thirst
tachycardia
hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

4 types of DI

A

central
nephrogenic
gestational
primary polydipsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

central diabetes insipidus

A

decreased secretion of ADH
causes: idiopathic, head trauma, pituitary tumor, neurosurgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

nephrogenic diabetes insipidus

A

kidney resistance to ADH
causes: lithium toxicity, renal disease, hypokalemia, pregnancy, meds

22
Q

diagnostic criteria for DI

A

low urine osmolality
high serum osmolality
low urine specific gravity
hypernatremia

23
Q

DI treatment

A

hormonal replacement therapy with Desmopressin or Vasopressin

24
Q

DI collaborative management

A

frequent neuro assessments
monitor I&O hourly
monitor electrolytes
replace fluids
hormonal replacement

25
SIADH
increased production of ADH increased water reabsorption in renal tubules increased water retention and dilutional hyponatremia with a low serum osmolality
26
causes of SIADH
brain damage: meningitis, SAH infective: pneumonia, lung or brain abscess hypothyroidism malignancy: SCLC drugs: carbamazepine, SSRIs, amitriptyline, morphine
27
SIADH pathophysiology
increased production/release of ADH increased water reabsorption/retention water intoxication
28
SIADH s/s
oliguria (<400mL/24hr) in absence of hypovolemia hyponatremia high urine specific gravity (>1.02)
29
SIADH lab manifestations
low serum Na (<130) low serum osmolality (<280) high urine osmolality (>500) high urine Na (>20)
30
SIADH collaborative interventions
frequent neuro assessment water restriction seizure precautions high sodium diet NS IV or hypertonic saline demeclocycline (derivative of tetracycline)
31
rhabdomyolysis definition
rapid release of cellular contents from damaged skeletal muscle cells
32
rhabdomyolysis causes
muscle injury: trauma, burns, electrocution, immobilization, metabolic disorders, DKA, hyponatremia, hypokalemia, hypophosphatemia, ischemia, compression, vascular injury, SCD meds/illicit drugs increased muscular activity: sport, seizures, status asthmaticus, infections, inflammatory myopathies, hypo/hyperthermia, idiopathic
33
s/s of rhabdomyolysis
myoglobinuria (brown urine) hyperuricemia hyperkalemia hyperphosphatemia hypocalcemia -> cardiac arrythmias elevated Creatinine kinase
34
rhabdomyolysis complications
AKI compartment syndrome DIC MODS
35
rhabdo collaborative management
alkalinization of urine correct electrolyte imbalances (reverse acidosis) IV hydration and diuresis (NPO status) fasciotomy dialysis
36
tumor lysis syndrome definition
rapid tumor cell death resulting from cancer therapy causing rapid release of intracellular contents
37
highest risk tumor types for tumor lysis syndrome
non-hodgkins lymphoma acute leukemias chronic lymphoblastic leukemia solid tumors
38
pathophysiology of tumor lysis syndrome
complex series of events causing spilling of intracellular contents from tumor cells, an inability of the kidneys to excrete and maintain normal serum levels
39
s/s of tumor lysis syndrome
hyperuricemia hyperphosphatemia hypotension hyperkalemia hypocalcemia -> cardiac arrythmia and arrest fluid overload, weight gain, edema -> respiratory failure anuria oliguria weakness lethargy cramping tetany renal insufficiency flank pain N/V/D
40
s/s of hyperuricemia
N/V azotemia oliguria/anuria decreased urine pH uric acid crystals found in urinalysis
41
hyperkalemia s/s
EKG changes: flat P, wide QRS, high T weakness twitching hyperactive bowel sounds nausea diarrhea
42
hyperphosphatemia s/s
hypocalcemia joint/muscle pain renal failure hypertension edema
43
hypocalcemia s/s
cramping tetany Chvostek's sign: muscle twitch on cheek Trousseau's sign: arterial blood flow occlusion with fingers extending EKG changes: prolonged QT
44
tumor lysis syndrome collaborative management
administer allopurinol alkalinization or urine correct electrolyte imbalance aggressive hydration starting prior to chemo dialysis
45
hepatorenal syndrome
occurrence of renal failure in a patient with advanced liver disease in the absence of an identifiable cause of renal failure
46
HRS etiology
serious complication of liver cirrhosis with poor prognosis portal vein HTN fluids back up into abdomen
47
2 types of HRS
type 1: decreased systemic circulation (BP) type 2: severe ascites, refractory to diuresis
48
HRS pathophysiology
portal hypertension -> splanchnic vasodilation -> decreased effect circulatory volume -> RAAS activation -> renal vasoconstriction -> HRS
49
hepatic-related ascites
liver cirrhosis is most common cause ascites is caused by a combo of increased hydrostatic pressure in liver veins (Portal HTN) and decrease in colloid osmotic pressure
50
HRS s/s
type 1: rapid, progressive type 2: chronic, slowly progressive general: liver failure w/ increased LFTs oliguria decreased serum and urine Na increased BUN and Cr decreased GFR
51
HRS collaborative management
fluid restriction CRRT pharm: midodrine, octreotide, albumin surgical: liver transplant, transjugular intrahepatic portosystemic (TIPS) shunt
52
NANDAs
excess fluid volume deficient fluid volume electrolyte imbalance impaired liver function

NURS 470 (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions