new fluid and electrolyte Flashcards

interstitial fluid
Terms Definitions
DKA
MAcid
Hypomagnesemia (symptoms)
-dysrhythmia's
-htn
-hyperreflexia
-confusion
-trousseau's and chvostek's sign
HYPERNATREMIA s/s
hyperthermia,tachy,orto bp,irretability,INC MUSCLE REFLEX,hyper bs.
P
2.5-4.5 (anion -/Intracellular)
Sodium
Extracellular fluid's cation
Abnormal fluid loss
-Vomiting
-Diarrhea
-Gastric suction
-Bleeding
Ca
8.5-10.5 (cation +/ extracellular)
Hypophosphatemia
Sx: hyponeuromuscular activity, Treatment: phosphorus replacement
Hypervolemia
Interventions
RESTRICT
*reduce Iv flow rate
*evaluate breath sounds
*semi-fowlers
*treat with diuretics and 02
*I &O and daily weight
*circulation, color, edema
*turn cough, reposition q 2hrs.
0.45% Sodium Chloride (½ NS)
Hypotonic
Active transport
requires ATP for energy
Mg++
1. Plasma- 2mcq/L
2. Interstitial- 1mcq/L
3. Intracellular- 27mcq/L
Lungs
300-400 mL of fluid output/day
intravascular
blood stream plasma
12% body fluid
Hypermagnesemia- clinical manifestations
LethargySlow/Weak pulseLow BPDecreased tonicityBrachypnea
hypotonic
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Fluid volume excess causes
cardiovascular-heart failure, urinary-renal failure, hepatic-liver failure,cirrhosis,normal imbalances
Manifestations of hypocalcemia
tetany, circumoral numbness, parethesias, hyperactive DTRs, Trousseau's sign, Chvotek's sign, seizures, respiratory symptoms of dyspnea and laryngospasm, abnormal clotting, anxiety
In crystalloids, plama volume expanding capacity is related to...
sodium concentration
metabolic acidosis
Low HCO3 and Low pH
Aldosterone
hormone secreted by the adrenal cortex, functions in regulation of Na, K, and Cl
Hydrostatic pressure
force within a fluid compartment
third space
the fluid between the cells
Hypomagnesemia
Occurs as a result of malnutrition(particularly in chronic alcoholism), prolonged diarrhea
Normal serum magnesium level
1.3- 2.1 mEq/L
Water deficit- causes
Decreased water intakeLosses (vomitting, diarrhea, NGT)FeverExcessive use of diureticsHyperglycemia (causes osmotic diuresis)
Is the blood dilute or concentrated?
dilute
Hypokalemia
Signs and symptoms of ________ include muscle pain
weakness, cardiac arrthymias
magnesium
second most abundant cation in the intracellular fluid; normal level is 1.5-2.4 mEq/L; although only small amounts are in the blood, it is imiportant in maintaining normal body function; the majority is found in bone, muscle, and soft tissue; dietary intake is usually 200-400 mg per day; commonly distributed in foods: whole grains, fruits, veges, meat, fish, legumes and dairy products; the major route of excretion is the kidneys
Which electrolytes are found in the intracellular fluids?
Potassium
_____ fluid prevents friction in the joints
synovial
Hypertonic
hypervolemia - HTN (cells shrink as fluid enters vascular)
Functions of potassium
fluid and electrolyte balance
very important in muscle contractions and transmission of nerve impulses
What is (CO2)normal levels?
acid<35-45>alka
CO2 is an acid
What is Na+ a good indicator of?
hydration
S/S of hypervolemia
Cardio- tachycardia; distended neck veins; increased BP, pulse pressure and CVP
Renal- increased urine output
Respiratory- crackles in lungs; shortness of breath; wheezing
General Findings- increased weight; edema
Phosphorus-Phosphate
found primarily in ICF, small amount in ECF
Calcium and phosphate are inversely proportinal; if one rises, the other falls
2.8-4.5 mg/dL
Potassium K+
creates osmotic pressure in ICF, needed for electrical activity in neurons & muscles
SIADH (Syndrome Of Inappropriate Diuretic Hormone)
Excessive ADH production
Abnormally low values of pH (arterial)
Acidosis< 7.35
Hypermagnesemia causes
(serum level more than 2.7 mg/dL)
renal failure, diabetic ketoacidosis, and excessive administration of magnesium
Name the Etiologies of hypocalcemia
inadequate intestinal absorption, nutritional deficiencies, increased deposition of Ca into bone, blood transfusions, parathyroid deficiency due to surgical removal
FVE risk factors
heart failure, renal failure, and cirrhosis of the liver
diffusion
passive mvmt of a solute through a semi permeable membrane from a higher concentration to a lower concentration. (mvmt of the molecules)
Isotonic solution
same osmolality as solution and other bodily fluids
Magnesium (Mg)
Normal range: 1.6 - 2.6 mg/dl
-Excess: hypermagnesemia, loss of deep tendon reflexes (DTR's), CNS depression, neuromuscular depression
-Deficit: hypomagnesemia, hyperactive DTR's, CNS changes
treatment of bicarb deficit
careful administration to replace, monitor of K, shifts out of cells creating high K, patient my be hypokalemic as K shifts back into cell, monitor cardiac status and ABG
causes of hypernatremia
-more water loss than sodium loss
-fever
-heat stroke
-infections
-burns
-diarrhea
-DM
-excessive sodium (NA+) intake
72 hours
When should the tubing usually be changed?
Cystalloid Solutions
Sterile water and electrolytes. Can be hypertonic (more electrolytes then cell), Isotonic (same) or Hypotonic (less then cell)
Interpreting ABG Results1-2-3-4-5-
1- pH2- CO23- HC034- Compensation5- PaCO2 & SaO2
Abnormally low values of Ca++
Hypocalcemia < 8.5 mg/dL
What is Isotonic, Osmotic Pressure,Colloid Oncotic Pressure, and Hydrostatic Pressure?
Isotonic: equal concentration of solutes
Osmotic Pressure: protein in the blood vessels exert a constant osmotic pressure that prevents too much leakage of plasma through the capillaries into the tissue.
Colloid Oncotic Pressure: pressure exerted by protein (24mm/hg)
Hydrostatic Pressure: opposing pressure exerted by the interstitial fluid (ISF) 17mm/hg
Fluid volume excess definition
due to overload or diminished homeostatic mechanisms
water moves from one compartment to another by _____ and ______ which is called water compartments
osmosis and filtration
350 mLs
How much water is lost through the lungs?
What is a mnemonic to help remember S/S of hypernatremia?
FRIED SALT
Extracellular fluid (ECF)
Fluid outside a cell
Divided into 3 smaller compartments: interstitial fluid, intravascular fluid, and transcellular fluid.
17% of total body weight
1/3 of total body water
hypotonic fluids actions/use
pulls fluid from vascular space into cellular spaceuse: dilute ECF, hydrate cells(0.45% Saline, D5W)
Distinguishing Characteristics of Cl-
Major extracelluar anion; Direct relationship with Na+ and Inverse with HCO3-
Name the etiologies of hyponatremia
sodium loss, deficient sodium intake, dilution of body's sodium (SIADH)
What are the side effects of sodium?
gastric upset, nasuea/vomiting, cramps, and venous phlebitis.
filtration affects kidney excretion of
fluid & wastes, then selectively reabsorbs water & substances that need to be conserved
increased capillary permeability
cause of edema; like poking a hole where pressure goes out the window; caused by inflammation, sepsis, burns
loss that can be measured such as urine, bowel
insensible fluid loss
First line of defense for acid base balance (pH)
bicarbonate-carbonic acid buffer system (extracellular fluid buffer system)
What is the treatment fo hypernatremia?
increase fluid intake and dietary restrictions
causes of high phosphorus
infants fed cows milk, using enemas or laxatives that contain this
metabolic acidosis CNS signs (6)
think of septic patient: drowsy, HA (from cerebral edema), lethargy, coma, confusion/restless, weakness
List problems that can occur DT edema
can impede movement between vascular and interstitial space, decreased capillary flow due to increased tissue pressure, interference with organ function, can impede cellular function
What tx. do you provide to the patient?
Oral/IV mg supplements
Asses Renal fx
Assess VS, IO, LOC, heart, and RR
What should the nurse assess for concerning fluid and electrolytes?
Assessment: focus on client's past & present medical hx, including diseases & GI, renal, cardiac, or hepatic dysfuction or disorders.
Pediatric & geriatric clients may be more sensitive to the effects of potassium.
at least once per shift
How often do you inspect the site of an IV for infection or infiltration?
why does water in women and obese are less?
because adipose tissue carries less water
Causes of Abnormally high values of K+
↑intake; ↓ losses; K shift from ICF to ECF (hemolysis, tissue injury, acidosis)
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