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TERM 3 N2109 HLTH 3 > WEEK 2 FLUIDS AND ELECTROLYTES > Flashcards

WEEK 2 FLUIDS AND ELECTROLYTES Flashcards

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1
Q

What is the difference between facilitated diffusion and active transport?

A

Facilitated diffusion: movement of solutes from higher concentration to lower concentration through a carrier protein

Active transport: movement of solutes against concentration gradient through a carrier protein using ATP

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2
Q

What is the difference between hydrostatic pressure and oncotic pressure?

A

Hydrostatic pressure: Push of fluids

Oncotic pressure: Pull of fluids from proteins such as albumin

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3
Q

Of the total body water volume of about 40 L (60% of body weight), where is the majority of this water found?

A

Intracellular fluid (25 L, 40% of body weight)

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4
Q

Of the extracellular fluid volume of about 15 L (20% of body weight), where is the majority of this fluid found?

A

Interstitial fluid (12 L, 80% of ECF)

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5
Q

Of the ECF volume, where is the smallest portion of this fluid found?

A

Plasma volume (3 L, 20% of ECF)

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6
Q

Of the age groups, which population has the highest percent of body water?

A

Baby

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7
Q

Of the age groups, which population has the lowest percent of body water?

A

Older adult

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8
Q

What is the term for the balance of fluid and electrolytes within normal limits?

A

Homeostasis

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9
Q

What mechanism is for regulation of fluid input?

A

Thirst

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10
Q

What is the main mechanism for regulation of fluid output?

A

Urine

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11
Q

About how much urine is produced per day?

A

1500 ml

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12
Q

What are 4 other ways fluid output is regulated?

A

Sweat, feces, respiration, menstruation

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13
Q

In fluid spacing, what is the term for normal distribution of fluids?

A

1st spacing

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14
Q

What is the term for an abnormal accumulation of interstitial fluid?

A

2nd spacing

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15
Q

What is the term for accumulation of fluid which is not easily exchanged and not where it is supposed to be?

A

3rd spacing

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16
Q

What is the most common example of 3rd spacing?

A

Ascites

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17
Q

What are 3 causes of edema and 3rd spacing? Give examples.

A
  1. Hydrostatic pressure increases (HF)
  2. Oncotic pressure decreases (renal failure, liver dysfunction)
  3. Interstitial oncotic pressure increases (burns)
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18
Q

What are 2 neurological clinical manifestations of fluid volume excess?

A

Confusion, weakness

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19
Q

What are 2 respiratory manifestations of fluid volume excess?

A

Crackles, SOB

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20
Q

What are 2 gastrointestinal manifestations of fluid volume excess?

A

Abdo distension, nausea/vomiting

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21
Q

What is a genitourinary manifestation of fluid volume excess?

A

Increased urine output

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22
Q

What are 3 neurological manifestations of fluid volume deficit?

A
  1. Confusion
  2. Weakness
  3. Increased thirst
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23
Q

What is a safety concern for fluid volume deficit?

A

Postural hypotension

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24
Q

Other than hypotension and tachycardia, what are 3 clinical manifestations of fluid volume deficit?

A
  1. Weight loss
  2. Dry skin and mucous membranes
  3. Elevated hematocrit
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25
What is a respiratory manifestation of fluid volume deficit?
Increased RR
26
What are 2 gastrointestinal manifestations of fluid volume deficit?
Hard stool, decreased motility
27
What are 2 GU manifestations of fluid volume deficit?
Decreased urine output, concentrated urine
28
Name 4 treatments for FVE
1. Diuretics 2. Fluid and sodium restrictions 3. Elevate swollen areas to promote venous return 4. Daily weights, 24-hr intake/output
29
Name 5 kinds of diuretics
1. Carbonic anhydrase inhibitors (CAIs) 2. Loop diuretics 3. Osmotic diuretics 4. Potassium-sparing diuretics 5. Thiazide and thiazide-like diuretics
30
What is the purpose of carbonic anhydrase?
Makes hydrogen ions that body exchanges for sodium and water that are resorbed back into blood.
31
What is another therapeutic effect of CAIs?
Increase oxygenation during hypoxia.
32
What is a negative effect of CAIs?
Elevation of blood glucose.
33
What is an example of a CAI?
Acetazolamide
34
What is the action of loop diuretics?
Block chloride resorption and secondarily sodium resorption
35
What is an example of a loop diuretic?
Furosemide (Lasix)
36
What is the action of osmotic diuretics?
Increases osmotic pressure in filtrate to pull fluid into renal tubules from tissues and inhibit tubular resorption.
37
What is an example of an osmotic diuretic?
Mannitol
38
What is the action of potassium sparing diuretics?
Block aldosterone receptors to block resorption of sodium and water.
39
What are 2 examples of a potassium sparing diuretics?
1. Spironolactone 2. Triamterene
40
What are 2 actions of thiazide and thiazide-like diuretics?
1. Inhibits resorption of sodium, potassium, and chloride to result in osmotic water loss. 2. Direct relaxation of arterioles to reduce peripheral vascular resistance (afterload)
41
What are 2 examples of thiazide and thiazide-like diuretics?
Hydrochlorothiazide, metolazone
42
Which group of drugs may interact with loop diuretics?
NSAIDs
43
What is an adverse event associated with loop and thiazide diuretics?
Decreased serum potassium
44
What lab result would be concerning in a patient taking spironolactone?
Hyperkalemia (higher than ~5.2)
45
What is a negative effect of thiazide diuretics?
Elevated blood glucose
46
When should loop diuretics be taken?
At the same time every morning
47
What adverse events associated with loop diuretics are directly linked to patient safety?
Orthostatic hypotension, muscle weakness, dizziness
48
What drug group may cause ototoxicity if taken with furosemide?
Aminoglycosides
49
Why would a physician prescribe spironolactone and furosemide together?
Promotes diuresis but prevents hypokalemia
50
Name 3 foods that are a source of potassium
Potatoes, meats, bananas
51
What are 3 common adverse events related to potassium sparing diuretics?
Hyperkalemia, dizziness, headache
52
Which laboratory test result is a common adverse effect of furosemide?
Hypokalemia
53
Why would a health care provider prescribe furosemide for a patient with a history of renal insufficiency?
Furosemide continues to be effective even in impaired renal function
54
Why is mannitol contraindicated in patients with anuria?
Mannitol does not influence urine production, it only increases existing urine output.
55
If the patient asks about taking potassium supplements with spironolactone, what should the nurse say?
Spironolactone is potassium sparing, so no need to take supplements.
56
What is the diuretic used for pulmonary edema?
Furosemide
57
What is a possible adverse effect from taking triamterene?
Hyperkalemia
58
What is a common symptom of hypokalemia?
Muscle weakness
59
What are three indications for acetazolamide?
1. Open angle glaucoma 2. High altitude sickness 3. Edema associated with heart failure
60
Name 3 treatments for fluid volume deficit
1. IV fluids 2. Encourage oral intake 3. Review medications with pharmacist and/or doctor
61
Explain the difference between dehydration, FVD, and hypovolemia
Dehydration: Loss of total body water (ICF and ECF) that results from increase in solutes FVD: Loss of ECF only Hypovolemia: Loss of blood volume only
62
What are 3 functions of sodium?
1. Maintains blood pressure and volume 3. Maintains pH balance 4. Maintains nerve function
63
What is the normal lab value for sodium?
135-145 mEq/L
64
What are 4 causes of hyponatremia?
Sodium loss or water gain due to: 1. SIADH 2. Diuretics 3. Excess water intake 4. Diarrhea
65
What are 3 areas of clinical manifestations of hyponatremia?
Depressed & deflated: 1. Neuro: lethargy/weakness, coma, seizures 2. Heart: tachy, weak/thready pulse 3. Resp arrest
66
How is hyponatremia treated?
1. IV fluids 2. Fluid restriction 3. Medication review
67
What are 4 causes of hypernatremia?
Water loss or sodium gain: 1. Diabetes insipidus 2. Excess salt intake 3. Renal failure 4. Dehydration
68
What are 3 areas of clinical manifestations of hypernatremia?
Big & bloated: 1. Skin: flush, edema, low grade fever 2. Polydipsia 3. Late serious signs: swollen dry tongue, nausea/vomiting, increased muscle tone
69
What are 3 functions of potassium?
1. Heart and muscle contraction 2. Nerve function 3. Fluid balance
70
What is the normal lab value for potassium?
3.5 to 5.0 mEq/L
71
What are 3 causes for hypokalemia?
1. GI losses 2. Renal losses 3. Skin losses
72
What are clinical manifestations of hypokalemia?
Low and slow: 1. Heart: dysrhythmias 2. Muscular: decreased reflexes, muscle cramps, flaccid paralysis 3. GI: Constipation, abdo distention, paralytic ileus
73
What are 3 treatments for hypokalemia?
1. K-dur 2. IV fluids with K+ 3. Switch to potassium sparing diuretics
74
What are 2 causes for hyperkalemia?
1. Excess potassium intake 2. Renal insufficiency
75
What are 3 areas of clinical manifestations for hyperkalemia?
Tight and contracted: 1. Heart: Dysrhythmias, hypotension, bradycardia (heart can't pump) 2. GI: Diarrhea, hyperactive bowel sounds 3. Neuromuscular: paresthesia/paralysis of extremities, increased reflexes, muscle weakness/heaviness
76
What are 4 reasons older adults are more at risk for fluid imbalance?
1. Decreased lean muscle (stores water) 2. Thinning skin 3. Decreased hormone production 4. Decreased thirst
77
What are the 3 B's that calcium is responsible for?
1. Bones 2. Blood (clotting) 3. Beats (heart contraction)
78
What are 4 signs and symptoms of hypercalcemia?
Swollen & Slow: 1. Constipation 2. Bone pain (bone demineralization) 3. Stones (renal calculi) 4. Deep tendon reflexes
79
What are 4 signs of hypocalcemia?
1. Bone pain 2. Decreased clotting time (bleeding) 3. Dysrhythmias 4. Excitability of all systems
80
What are the 2 functions of phosphate?
1. Bone and teeth formation 2. Regulates calcium
81
How are calcium and phosphate levels related?
Inversely: when one is high, the other is low
82
What is the main function of magnesium?
Muscle regulation, especially in heart and uterus
83
What are 4 main causes of hypermagnesemia?
1. Diabetic ketoacidosis 2. Antacids 3. Renal failure 4. Hyperkalemia
84
What are 5 clinical manifestations of hypermagnesemia?
Calm and quiet: 1. Bradycardia, hypotension, dysrhythmias 2. Respiratory depression 3. Hypoactive bowel sounds 4. Drowsiness, lethargy, coma 5. Muscle weakness, reduced DTR
85
How is hypermagnesemia treated?
1. Hemodialysis 2. IV Calcium gluconate
86
What are 5 signs and symptoms of hypomagnesemia?
1. Tachycardia, dysrhythmia 2. Dyspnea, tachypnea 3. Diarrhea 4. Confusion, irritability, insomnia, seizures 5. Hyperflexion, twitching, paresthesias
87
How is hypomagnesemia treated?
IV Magnesium Sulfate

TERM 3 N2109 HLTH 3 (3 decks)

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