Wk 5 Fluids and Electrolytes

Question 1

Concentrations of electrolytes dependent on

Answer 1

intake, absorption, distribution, excretion

Question 2

Intracellular electrolytes

Answer 2

Potassium, magnesium, phosphorus

Question 3

Extracellular electrolytes

Answer 3

sodium, chloride, bicarbonate

Question 4

Negative charged electrolytes

Answer 4

phosphorus, chlorides, bicarbonates (anions)

Question 5

Positive charged electrolytes

Answer 5

sodium, potassium, calcium, magnesium (cations)

Question 6

Normal lab values: sodium

Answer 6

136-145 meq/L

Question 7

Normal lab values: potassium

Answer 7

3.5-5.0 meq/L

Question 8

Normal lab values: magnesium

Answer 8

1.7-2.2 meq/dL

Question 9

Normal lab values: calcium

Answer 9

9-11 mg/dL

Question 10

Normal lab values: phosphate

Answer 10

3.2-4.3 mg/dL

Question 11

Sodium <136

Answer 11

Hyponatremia

Question 12

Sodium >145

Answer 12

Hypernatremia

Question 13

Main extracellular fluid cation

Answer 13

Sodium, governs osmolality

Question 14

Sodium highly influences water

Answer 14

distribution

Question 15

Two other functions of sodium

Answer 15

Aids in acid-base balance

Activates muscle and nerve cells

Question 16

Hyponatremia causes

Answer 16

diarrhea, vomiting, NG suction, fistula, polyuria, adrenal insufficiency, burns, wounds, fasting diets, drinking too much water, excess hypotonic fluid

Question 17

Sodium is highly influential in

Answer 17

LOC because brain cells are sensitive to water and fluid shifts

Question 18

If you don’t have enough fluid in the vascular space you will have

Answer 18

Cellular swelling, which in the brain causes LOC changes

Question 19

Hyponatremia signs/symptoms

Answer 19

Confusion/altered LOC, anorexia and muscle weakness, seizures and coma

Question 20

Electrolytes influence

Answer 20

fluid balance, acid-base balance, nerve impulses, muscle contractions, heart rhythms, etc.

Question 21

Hyponatremia dilution

Answer 21

Too much water, hypervolemia

Question 22

Hypervolemia causes

Answer 22

increase BP, weight gain, bounding rapid pulse, increase in urine specific gravity

Question 23

Hyponatermia depletion

Answer 23

hypovolemia, absolute loss of sodium in some way, we’ve lost both sodium and fluid

Question 24

Hypovalemia causes

Answer 24

decrease BP, tachycardia, dry skin, weight loss, decrease in urine specific gravity

Question 25

With depletion hyponatremia you see

Answer 25

muscle weakness, altered LOC

Question 26

Hyponatremia treatment

Answer 26

Sodium replacement, IV or PO, IV NS in a continuous replacement IV

Question 27

Must replace sodium

Answer 27

slowly because you can have rapid shift of brain cell concentration

Question 28

Dilution hyponatremia treatment

Answer 28

restrict fluids

Question 29

Also

Answer 29

treat the cause!

Question 30

Sometimes we replace using

Answer 30

sodium bicarbonate PO

Question 31

ABG

Answer 31

arterial blood gas

Question 32

If giving sodium bicarbonate PO then

Answer 32

1-3 hours after or before meals, it will be better absorbed that way

Question 33

Hypernatremia

Answer 33

>145

Question 34

You cannot get hypernatremia by

Answer 34

eating really salty foods

Question 35

Causes of hypernatremia

Answer 35

IV fluids, tube feedings, near drowning in salt water, not enough water intake or too much water loss, around diuresis

Question 36

Low fluid intake or excess loss symptoms

Answer 36

cognitively impaired, diarrhea, high fever, heat stroke

Question 37

Hypernatremia symptoms

Answer 37

altered LOC, confusion, seizure, coma, dry sticky mucous membranes, muscle cramps, extreme thirst

Question 38

Hypernatremia treatment if low fluid balance

Answer 38

add water

Question 39

if high sodium is cause

Answer 39

remove the sodium

Question 40

too quick of a correction can be

Answer 40

deadly

Question 41

Gradually correct sodium imbalances over

Answer 41

48 hours to avoid edema of cerebral cells

Question 42

Hypokalemia

Answer 42

<3.5meq/L

Question 43

Hyperkalemia

Answer 43

>5.0meq/L

Question 44

98% of potassium is

Answer 44

inside the cells

Question 45

Potassium responsible for

Answer 45

cardiac and muscle cell contraction, cell excitability and electrical status

Question 46

Main intracellular cation

Answer 46

potassium

Question 47

Main source of potassium

Answer 47

diet

Question 48

Main source of potassium loss

Answer 48

kidneys, polyuria

Question 49

Renal or GI loss causes of potassium loss

Answer 49

DIURESIS! Diarrhea, vomitting, ileostomy

Question 50

Acid base cause of hypernatremia

Answer 50

potassium shifts into extracellular space

Question 51

Biggest sign or symptom of low potassium

Answer 51

cardiac rhythm disturbances, can be lethal

Question 52

Other symptoms of hypokalemia

Answer 52

muscle weakness, leg cramps, low bowel motility

Question 53

What causes hyperkalemia?

Answer 53

Urinary output is not enough, kidney failure, OR massive cell injury like burns, trauma, sepsis

Question 54

Certain drugs can cause hyperkalemia

Answer 54

diuretics, ACEi, ARBs, NSAIDS

Question 55

Signs/symptoms of hyperkalemia

Answer 55

Cardiac rhythm disturbances (peaked T waves), muscle weakness, cramps, GI upset

Question 56

Magnesiums helps to stabilize cardiac muscles by

Answer 56

block and control movement of potassium out of cardiac cells

Question 57

Magnesium also helps to stabilize

Answer 57

smooth muscle

Question 58

hypomagnesemia causes

Answer 58

diuresis, GI or renal loss, low intake, alcohol abuse, pancreatitis, hyperglycemia

Question 59

Signs and symptoms of low magnesium

Answer 59

hyperactive reflexes, confusion, cramps, tremors, seizures,