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Med-Surg Nursing > objective 4 (1) > Flashcards

objective 4 (1) Flashcards

1
Q

what are the principles of fluid and electrolyte balance?

A
  • Necessary for life and homeostasis
  • Nursing role is to help prevent and treat fluid and electrolyte
    disturbances
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2
Q
  • State of equilibrium in body
  • Naturally maintained by adaptive responses
  • Body fluids and electrolytes are maintained within narrow limits
A

homeostasis

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3
Q

what is the % of water content of the body?

A
  • 50% to 60% of body weight in adult
  • 45% to 55% in older adults
  • 70% to 80% in infants
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4
Q

inside the cell

A

intracellular fluid

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5
Q

outside a cell

A

extracellular fluid

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6
Q

Normal distribution of fluid in ICF and ECF

A

first spacing

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7
Q

Abnormal accumulation of interstitial fluid

A

second spacing

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8
Q

loss of ECF into a space that does not contribute to
equilibrium

A

third spacing

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9
Q

cations that carry a positive charge and anions
that carry a negative charge

A

active chemicals

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10
Q

what are the major cations?

A

sodium, potassium, calcium, magnesium and
hydrogen ions

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11
Q

what are the major anions>

A

chloride, bicarbonate, phosphate, sulfate and
proteinate ions

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12
Q

what is the major cation in ECF?

A

sodium (Na+)

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13
Q

what is the normal for sodium?

A

134-145 mmol/L

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14
Q

what is the major cation in ICF?

A

potassium K+

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15
Q

what does the movement of fluid through capillary walls depend on?

A
  • Hydrostatic pressure
     Pressure exerted on the walls of blood vessels
  • Osmotic pressure
     Pressure exerted by the protein in the plasma
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16
Q

movement of water between 2 compartments

A

osmosis

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17
Q

movement of a substance from an area of higher concentration to
one lower concentration (ions and molecules - eg O2 and CO2)

A

diffusion

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18
Q

movement of water and solutes from high hydrostatic pressure to
low hydrostatic pressure (eg kidney filtering lymph)

A

filtration

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19
Q

energy is expended for the movement to occur against a
concentration gradient
12

A

active transport

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20
Q

what is the average fluid intake?

A

2500mL/day

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21
Q

what is the average fluid output?

A

1500mL/day Urine
100mL/day bowels

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22
Q
  • Dietary intake of fluid and food or enteral feeding
  • Parenteral fluids (IV)
A

fluid gain

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23
Q
  • Kidney: urine output
  • Lungs / skin loss - insensible losses
  • GI tract
A

fluid loss

24
Q

what are the homeostatic mechanisms?

A
  • Kidney – regulates F & E balance
  • Heart and Blood Vessel – renal perfusion and water and electrolyte
    regulation
  • Lung – exhalation
  • Pituitary – ADH conserves water as needed
  • Adrenal – fluid retention or water loss
  • Parathyroid –regulates calcium and phosphate balance
25
Q

pinched skin with slow rebound

A

tenting

26
Q
  • loss of water alone with increased serum sodium
    (Na+) level
  • Most common in older adults
A

dehydration

27
Q
  • low volume of extracellular fluid (blood )
  • accompanied by low e- level
A

hypovolemia

28
Q

what are the causes of hypovolemia?

A
  • Prolonged vomiting, Diarrhea
  • GI suctioning
  • profuse urination or sweating
  • decreased intake
  • wound loss (burn injury)
  • inability to gain access to fluid
29
Q

what are the risk factors of hypovolemia?

A

diabetes insipidus, hemorrhage, coma, and
third space shifts

30
Q

Greater due to decreased plasma
volume

A

hematocrit

31
Q

hyponatremia and hypernatremia

A

sodium imbalances

32
Q

hypokalemia and hyperkalemia

A

potassium imbalances

33
Q

hypocalcemia and hypercalcemia

A

calcium imbalances

34
Q

hypomagnesemia and hypermagnesemia

A

magnesium imbalance

35
Q

hypophosphatemia and hyperphosphatemia

A

phosphorus imbalance

36
Q

hypochloremia and hyperchloremia

A

chloride imbalances

37
Q

what are the causes of hyponatremia?

A

adrenal insufficiency, water intoxication, SIADH, &
losses by vomiting, diarrhea, sweating, & diuretics

38
Q

what are causes of hypernatremia?

A

excess water loss, excess Na+ administration, diabetes
insipidus, heat stroke, & hypertonic (3% NACL) IV
solutions

39
Q

what is potassium for?

A
  • Transmission and conduction of nerve and muscle
    impulses
  • Cellular growth
  • Maintenance of cardiac rhythms
  • Acid–base balance* Transmission and conduction of nerve and muscle
    impulses
  • Cellular growth
  • Maintenance of cardiac rhythms
  • Acid–base balance
40
Q

what is the causes of hypokalemia?

A
  • Abnormal losses of K+ via the kidneys or
    gastrointestinal tract
  • Magnesium deficiency
  • Metabolic alkalosis
41
Q

what are the causes of hyperkalemia?

A
  • Massive intake
  • Impaired renal excretion
  • Shift from ICF to ECF
  • Most common in renal failure
  • tissue trauma (severe burns)
42
Q

what are the normal calcium values?

A

2.25-2.75 mmol/L

43
Q

what are the causes of hypocalcemia?

A
  • Decreased production of PTH (hypoparathyroidism)
  • Acute pancreatitis
  • Multiple blood transfusions
  • Alkalosis
  • Vitamin D deficiency
44
Q
  • Inflate a B/P cuff 20 mmHg above systolic
  • Adducted thumb, flexed wrist and metacarpophalangeal joints, extended
    interphalangeal joints
A

trousseau’s sign

45
Q

Twitching of the facial muscles in response to tapping over the area of
the facial nerve.

A

chovstek’s sign

46
Q

what are the causes of hypercalcemia?

A
  • Hyperparathyroidism (two-thirds of cases)
  • Malignancy
  • Vitamin D overdose
  • Prolonged immobilization
47
Q

what the normal magnesium values?

A

0.74-1.07 mmol/L

48
Q

what are the causes of hypomagnesemia?

A
  • Prolonged fasting or starvation
  • Chronic alcoholism
  • Fluid loss from gastrointestinal tract
  • Prolonged parenteral nutrition without supplementation
  • Diuretics
49
Q

what are the causes of hypermagnesemia?

A

Increased intake or ingestion of products containing
magnesium when renal insufficiency or failure is
present

50
Q

what are the normal phosphorus values?

A

0.97-1.45 mmol/L

51
Q

what are the causes of hypophosphatemia?

A

*Malnourishment/malabsorption
* Alcohol withdrawal
* Use of phosphate-binding antacids
* During parenteral nutrition with inadequate
replacement

52
Q

what are the causes of hyperphosphatemia?

A
  • Acute or chronic renal failure
  • Chemotherapy
  • Excessive ingestion of phosphate or vitamin D
53
Q

what are the normal protein values?

A

64 – 83 g/l

54
Q

what are the causes of hypoproteinemia?

A

Anorexia
- Malnutrition
- Starvation
- Fad dieting
- Poorly balanced vegetarian diets

55
Q

Rare, but can occur with dehydration induced hemoconcentration

A

hyperproteinemia

Med-Surg Nursing (13 decks)

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