Fluids, Electrolytes, Acid-Base Balance, & IV Therapy

Created by mmdebn 

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acidosis

excess of acid or depletion

active transport

move substances from an area of lower concentration to an area of higher concentration

aldosterone

a mineralocorticoid steroid hormone produced by the adrenal cortex. Works in ther renal tubules to retain sodium and conserve water by reabsorption; increases urinary potassium excretion

alkalosis

a condition in which the pH of body fluids is above normal because of either a loss of acid or an accumulation of base bicrbonate

anions

negatively charged ions

antidiuretic hormone ADH

controls how much fluid leaves the body in the urine

ascites

abnormal accumulation of fluid within the peritoneal cavity

atrial natriuretic peptide

a hormone involved in the regulation of renal and cardiovascular homeostasis. It is produced in the atrium and helps to normalize blood pressure and volume

carpopedal spasm

a characteristic contraction of the fingers, also called Trousseau's sign

cations

positively charged ions

dehydration

when there is too little water in the plasma, water is drawn out of the cells by osmosis to equalize the concentration and the cells shrivel

diffusion

the process by which substances move back and forth across the membrane until they are evenly distributed throughtout the available space

edema

an accumulation of freely moving interstitial fluid (fluid in the spaces surrounding the cells)

electrolytes

molecules that atomic particles are capable of conduction an electric current

extracellular

fluid outside the cell

filtration

the movement of water and suspened substances outward thru a semipermeable membrane

hydrostatic pressure

pressure exerted by fluids

hypercalcemia

occurs when the serum calcium level is above 10.6 mg/dL

hyperchloremia

...

hyperkalemia

Occurs when the serum potassium level rises above 5.0 mEq/L.

hypermagnesemia

is present when there is a serum level above 2.1 mEq/L

hypernatremia

occurs when sodium level rises above 145 mEq/L

hyperphosphatemia

...

hypertonic

of greater concentration

hyperventilation

a rapid respiratory rate

hypervolemia

excessive blood volume

hypocalcemia

occurs when the calcium level drops below 8.4 mg/dL

hypochloremia

...

hypodermoclysis

slow infusion of isotonic fluid into subcutaneous tissue, may be used for small volumes of fluid

hyponatremia

...

hypophosphatemia

occurs when the level falls b

hypotonic

of less concentration

hypovolemia

too little blood volume (third spacing)

hypoxemia

insufficiency of oxygen, which triggers an automatic increase in respiration

insensible

not aware of

interstitial

fluid in the spaces surrounding the cells

intracellular

fluid within the cell

intravascular

fluid within the blood vessels.

ions

electrically charged particles

isotonic

of equal solute concentration

ketoacidosis

breath of a patient may have a fruity odor owing to the presence of ketone bodies

osmolality

concentration of the solution determined by the number solutes in it

osmosis

refers to the movement of pure solvent (liquid) across a membrane

stridor

shrill, harsh sound upon inspiration

tetany

skeletal muscle spasm where the muscles are in sustained contraction and causing spasm

transcellular

includes aqueous humor, saliva, cerebrospinal, pleural, peritoneal, synovial, and pericardial fluids, gastrointestinal secretions, and fluid in urinary system ad lymphatics

turgor

degree of elasticity

hypokalemia

occurs when the potassium level falls below 3.5 mEq/L

hypomagnesemia

occurs when the serum level drops below 1.3 mEq/L

The nurse assesses that the patient's urine has become much more concentrated, which results from the effect of:

aldosterone

When the water absorption in the renal tubules becomes greater than normal, the nurse anticipates that the urine will become:

more concentrated

The nurse explains that when oxygen is directed out of the arteries and into the capillaries, this process is:

diffusion

The patient's IV has been infusing at a very high rate and now the patient appears to be in fluid volume overload, as indicated by:

pulmonary edema

A small child is hospitalized with severe metabolic acidosis after ingesting a whole bottle of baby aspirin about 8 hours ago. The nursing care for this patient is geared toward reassuring the patient and:

frequent assessment of mental and neurological status

The nurse explains that fluids carrying nutrients and wastes on a random basis throughout the body are carried primarily by:

extracellular fluid.

The nurse clarifies that electrolytes, such as sodium and potassium, when dissolved, break down into smaller particles, which are called:

ions

The nurse assists a dyspneic patient to sit in a high Fowler's position. This aids gravity in helping the movement of oxygen from the pulmonary capillaries into the blood by the process of:

diffusion

The nurse evaluates the laboratory reports on electrolyte values carefully to assess the balance between positive and negative ions, which is regulated by the process of:

diffusion

When the nurse hangs an IV bag with Na+, K+, and Cl-, he is aware that ____ are being administered

electrolyes

Each compartment of the body has a water-fluid distribution movement of its own. These fluids move and distribute themselves between these compartments via a process known as:

osmosis

The LPN is preparing to add a new IV of D5W with potassium to an existing line. The LPN notices that there is only 25 mL of urine collected over the last hour. The LPN's best intervention is to:

not hang the IV with potassium; inform the RN of urine output.

Both the intracellular and extracellular fluids are made up of many different electrolytes, but the most abundant intracellular positively charged electrolyte is:

potassium

The patient with metabolic acidosis should be closely monitored for the compensatory condition of

respiratory alkalosis

The K+ laboratory report shows a level of 5.2 mEq/L. The nurse will assess the patient closely for:

irregular heartbeat

A patient has renal damage because of diabetes, which puts the patient at risk for

hyperkalemia

Hyperchloremia, as noted on a laboratory report, is usually associated with

metabolic acidosis

Older adults are at risk for dehydration because of reduced thirst and aging kidneys. The nurse monitors for the early indicator of dehydration, which is:

constipation

The nurse has two newly admitted patients with dehydration. One patient is dehydrated from heat exhaustion and the other from an overdose of Lasix. The finding that will present in both patients is:

increased laboratory values of hemoglobin and hematocrit

The nurse clarifies that fluid balance is mainly monitored in the body by two systems, which are the

circulatory and renal

The nurse is aware that extracellular fluid osmolarity is primarily maintained by

sodium

The nurse instructs that the healthy kidney adjusts the volume and composition of the filtrate that prevents excessive fluid loss by:

tubular reabsorption

The nurse instructs a family that the blood being brought by the incoming capillaries into the kidney, which contains nitrogenous substances to be excreted as waste, involves a process of:

filtration

Because the patient is hypovolemic, the nurse anticipates that treatment will be focused on

extracellular fluid deficit, encourage fluid intake

The patient is frequently thirsty. The nurse assesses this symptom as

too much sodium and too little water in the body

The nurse assesses that the patient with congestive heart failure who is being treated with a diuretic has lost 5 pounds in 1 day. This weight loss is equivalent to the loss of ____________________ liters of fluid.

2.2 Liters

The nurse assesses deep rapid respirations in a patient with metabolic acidosis to be an indicator of the homeostatic system at work to reduce the ____________________ level.

CO2

The nurse would anticipate in a patient with respiratory acidosis that the blood pH reading would be lower than ____________________.

7.35

The nurse cautions a group of high school athletes about fluid loss in hot, dry weather, because the normal loss from respiration, which is ____________________ to ____________________ mL/day, is doubled.

300, 400

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