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Funds II Theory > Module 2: Fluid & Electrolytes and Acid-Base Balance > Flashcards

Module 2: Fluid & Electrolytes and Acid-Base Balance Flashcards

1
Q

Potassium Normal Range

A

3.5-5.0 mEq/L

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2
Q

Sodium Normal Range

A

135-145 mEq/L

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3
Q

Calcium Normal Range

A

8.5-10.2 mg/dL

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4
Q

Function of Sodium in the body

A

regulates fluid balance (water retention)
nerve impulses
muscle contractions

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5
Q

Main factors that increase sodium

A

DEHYDRATION
kidney dysfunction
TUBE FEEDINGS (bc it’s hypertonic)
vomiting/diarrhea
diaphoresis

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6
Q

Main factors that decrease sodium

A

fluid overload
excess fluid loss
GI suctioning
vomiting/diarrhea
potassium-sparing diuretics
inadequate sodium intake
hypertonic solutions

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7
Q

Main S/S of decreased sodium

A

CONFUSION
seizures
MUSCLE WEAKNESS
restlessness
(seizure -> coma -> death)

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8
Q

Main S/s of increased sodium

A

edema
HYPERTENSION
CNS effects
excessive thirst
DRY
nausea/vomiting
LOW GRADE FEVER
DECREASED URINE OUTPUT

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9
Q

Nursing considerations for sodium

A

hyponatremia is helped by hypertonic IV fluids
I&O
daily weights
monitor fluid balance
NEURO ASSESSMENT

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10
Q

Function of Potassium in the body

A

cardiac (rhythm)
CNS

if Na goes up, K goes down (vice versa)

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11
Q

Main factors that cause increased potassium

A

RENAL FAILURE
diabetes
DEHYDRATION
ACIDOSIS (metabolic or respiratory)
burns/traumatic injury
excessive potassium intake

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12
Q

Main factors that cause decreased potassium

A

diuretics (non-potassium sparing)
DIARRHEA
VOMITING

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13
Q

Main S/S of decreased potassium

A

muscle twitches/cramps
NUMBNESS/TINGLING
NAUSEA
VOMITING
ILEUS (no peristalsis)

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14
Q

Main S/S of increased potassium

A

heart palpitations
SOB
angina
cramping
arrhythmias
diarrhea
tachypnea
bradycardia
abdominal cramping
decreased BP

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15
Q

Nursing considerations for potassium

A

non-K sparing diuretics (furosemide) = hypokalemia, closely monitor, may require K+ supplements

NEVER give K+ as IV push or injection - only oral route or via infusion pump (on slow)

I&O

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16
Q

Function of Calcium in the body

A

blood coagulation
bone/teeth formation

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17
Q

Main Factors causing decreased calcium

A

renal disease
decreased Ca and vitamin D intake
increased Mg levels

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18
Q

Main S/S of decreased calcium

A

positive trousseau’s sign:
-wrist flexion when inflating BP cuff

positive chvostek’s sign:
tap on cheek and will cause muscles to contract
-facial twitching
-arrhythmias
-numbness and tingling
-diarrhea

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19
Q

Main S/s of increased calcium

A

muscle weakness
fatigue and weakness
constipation
hypo-active reflexes
bone pain
renal calculi
bradycardia/bradypnea

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20
Q

Nursing considerations for calcium

A

hypocalcemia = increased risk for fractures and bleeding

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21
Q

Function of hypotonic fluids

A

ECF moves inside cell

CELL SWELLS

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22
Q

Uses for hypotonic fluids

A

dehydrated cells
diabetic ketoacidosis
hyperglycemia (increased bl sugar)

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23
Q

Side effects of hypotonic fluids

A

can cause cell lysis
decreased bp

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24
Q

Examples of hypotonic fluids

A

5% dextrose in water (D5W)
0.25% NaCl (1/4 NS)
0.45% NaCl (1/2 NS)

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25
Function of isotonic fluids
increase ECF volume (blood volume)
26
Uses for isotonic fluids
blood loss surgery vomit diarrhea dehydration
27
Examples of isotonic fluids
lactated ringers (LR) 0.9% NaCl (NS) 5% dextrose in water (D5W) (in bag)
28
Function of hypertonic fluids
ICF moves outside of cell CELL SHRINKS
29
Uses of hypertonic fluids
swollen cells CEREBRAL EDEMA HYPONATREMIA
30
Side effects of hypertonic fluids
can cause fluid overload (PE) can cause phlebitis
31
Examples of hypertonic fluids
5% dextrose in 0.45% NaCl 5% dextrose in 0.9% NaCl (NS) 3% NaCl
32
Phlebitis: definition, S/S, intervention
inflammation of a vein pain, increased skin temp, redness D/C IV line, apply moist warm compress, monitor IV site for redness/tenderness to prevent infection
33
Infiltration: definition, S/S, intervention
leakage of IV solution or med into extravascular tissue (non-vesicant - doesn't irritate tissue) edema, pallor, decreased skin temp around site, pain D/C IV line, elevate extremity, warm compress to absorb fluid
34
Extravasation: definition, S/S, intervention
IV catheter becomes dislodged and med infuses into tissues (vesicant - irritates tissue) pain, stinging, burning, swelling, redness at site D/C IV line, apply cool compress, admin antidote if exists for med
35
Hypervolemia cause
overhydration
36
Hypervolemia VS
hypertension increased temp bounding pulses increased RR, HR
37
Hypervolemia S/S skin
moist/wet/oozy skin/wounds warm to touch skin redness edema (may be pitting) moist mucous membranes
38
Hypervolemia S/S neuro/musculoskeletal
decreased mobility decreased ROM confusion weakness
39
Hypervolemia S/S CV/pulmonary
tachycardia tachypnea crackles regurgitation in heart productive cough dyspnea JVD S3 sounds
40
Hypervolemia S/S GU
increased urination/output clear urine
41
Hypervolemia labs
decreased Hct, K, Na, osmolality (bl thickness)
42
Nursing assessments for hypervolemia
cardiac assess (for heart failure) pulmonary assess
43
Nursing interventions for hypervolemia
diuretics daily weights fluid restriction hypertonic fluids
44
Hypovolemia cause
dehydration rapid loss of 3% body wt associated with fluid and electrolyte imbalances
45
Hypovolemia VS
hypotension weak pulses increased RR, HR decreased SpO2
46
Hypovolemia S/S skin
dry cool to touch pallor decreased skin turgor dry mucous membranes
47
Hypovolemia S/S neuro/musculoskeletal
confusion weakness lethargy cramping no perspiration
48
Hypovolemia S/S CV/pulmonary
tachycardia tachypnea orthostatic hypotension weak pulses slow cap refill
49
Hypovolemia S/S GU
decreased urination/output dark urine/concentrated no output
50
Hypovolemia labs
hyperkalemia hypernatremia INCREASED HCT increased Hgb increased osmolality (dense/thick)
51
Nursing assessments for hypovolemia
cardiac/pulmonary
52
Nursing interventions for hypovolemia
CIRCULATION IV fluids increased oral intake assist w/ ambulation bed alarm
53
pH normal range
7.35 - 7.45
54
PaCO2 normal range
35 - 45 mmHg
55
HCO3 normal range
22 - 26
56
PaO2 normal range
80-100
57
SpO2 normal range
97-100%
58
Osmolality (serum) normal range
275-295 if HIGH pt is dehydrated, if LOW pt is overhydrated
59
What causes metabolic acidosis?
kidney failure liver failure severe diarrhea (ASSidosis)
60
Anticipating ABG Values for metabolic acidosis
pH < 7.35 HCO3 < 22 PaCO2 = normal (uncompensated)
61
How does the body compensate for metabolic acidosis?
respiratory system increases pH and decreases acidity by increasing RR to remove CO2 (kussmaul breathing)
62
What else is retained with metabolic acidosis?
potassium ions (hyperkalemia)
63
What causes metabolic alkalosis?
loss of gastric contents; vomiting (AHHHlkalosis)
64
Anticipated ABG values for metabolic alkalosis
pH > 7.45 HCO3 > 26 CO2 = normal (uncompensated)
65
How does the body compensate for metabolic alkalosis?
respiratory system by increasing CO2 via HYPOventilation
66
What causes respiratory acidosis?
HYPOventilation: drug overdose, opioids, sleep apnea, COPD, asthma
67
Anticipated ABG values for respiratory acidosis
pH < 7.35 CO2 > 45 HCO3 = normal (uncompensated)
68
How does the body compensate for respiratory acidosis?
kidneys increase HCO3 and absorb HCO3 (use more of it)
69
What causes respiratory alkalosis?
HYPERventilation: pain, anxiety, fear
70
Anticipated ABG values for respiratory alkalosis
pH > 7.45 CO2 < 35 HCO3 = normal (uncompensated)
71
How does the body compensate for respiratory alkalosis?
kidneys excrete (get rid of) HCO3
72
How many abnormalities do uncompensated imbalances have?
2 will be abnormal (including pH) 1 will be normal
73
How many abnormalities do partially compensated imbalances have?
All 3 will be abnormal
74
How many abnormalities do fully compensated imbalances have?
pH will be normal other 2 will be abnormal
75
Diuretics do what to potassium levels?
DROP THEM
76
Do you give diuretics if the potassium level is low?
NO bc it will drop it even more
77
What is the first type of fluids that will most likely be given?
isotonic
78
What is the priority electrolyte?
potassium

Funds II Theory (7 decks)

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