fluid and electrolytes (test 7)

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Na+

the acceptable level of ________ is 135-145 mEq/liter

K+

the acceptable level of ________ is 3.5-5.0 mEq/liter

Mg++

the acceptable level of ________ is 1.5-2.5 mEq/liter

CL-

the acceptable level of ________ is 97-110 mEq/liter

Na+ and K+

Proper balance of _________ is necessary for muscle coordination, heart function, fluid absorption, excretion, and nerve function Normally ____ and _____ are filtered and excreted in the urine and feces according to bodies needs.
Imbalances occur due to poor diet, dehydration, medications, and diseases. Also helps promote homeostasis.

Na+

Extracellular, Maintain ECF volume, Transmission on impulses in nerve and muscle, Regulation of acid-base balance, Kidneys important and in regulating Na+

Extracellular

NA+ is an _________ fluid

Hypernatremia

an excess of sodium in the blood plasma

Hypernatremia

Signs and symptoms of ________ include thirst, confusion, neuromuscular excitability, seizures, and coma.

Hyponatremia

abnormally low amount of sodium in your blood or when you have an excess of water in your blood

Hyponatremia

Signs and symptoms of ________ Nausea and vomiting, weakness, severe confusion, seizures

Intracellular

K+ is a ________ fluid.

K+

Transmission on impulses in nerve and muscle
Regulation of acid-base balance
Regulated by Na+ and aldosterone levels

Hypokalemia

occurs when the body releases too much potassium, such as through severe vomiting, diarrhea, or sweating during intense exercise.

Hyperkalemia

occurs with increased levels of K+ most common with kidney disease

Hyperkalemia

Signs and symptoms of ________ include EKG changes, V-fib, cardiac arrest

Hypokalemia

Signs and symptoms of ________ include muscle pain
weakness, cardiac arrthymias

Intracellular

Magnesium++ is a _______ fluid.

Mg++

___________ is essential to the functioning of the human body because it transmits nerve impulses, causes the Contraction of muscles and is integral to healthy development of teeth and bones and immune system.

Mg++

Maintain normal muscle and nerve function
Keeps heart rhythm steady
Supports a healthy immune system
Role in carbohydrate and protein metabolism

Deficiencies in Mg++

signs and symptoms of restlessness, confusion, palpitations, muscle and nerve irritably is R/T ________.

Extracellular

CL- is an __________ fluid.

CL-

Primarily NaCl or HCL, Acid-base balance, Vascular volume
Re-absorption via the kidneys

Osmosis

Movement from an area of low dissolved solutes to one that is higher in dissolved solutes. Low concentration to high.

Osmosis

during ______ water is attempting to equalize the dilution of the solutes

Isotonic Solution

Same concentrate as the cell cytoplasm. Used to expand the ECF. No effect on the ICF

Hypertonic Solution

Contain a higher concentration of solute relative to the cells cytoplasm. When a cell is placed in a hypertonic solution the water moves out of the cell to the higher concentration of solute causing the cell to shrink. Replace electrolytes and shift fluid from interstitial space to plasma. Irritating to vein walls and may cause circulatory overload

Hypotonic Solution

Contain a lower concentration of solute relative to the cells cytoplasm. Too much and cells can burst
Pulls fluid from blood vessels to interstitial tissue and cells.
Can deplete the circulatory system.
Do not give to patients with low blood pressure

Isotonic Solution

examples of ________ include N/S, LR, D5. (used to hydrate)

Hypertonic Solution

examples of ________ include D5, LR, D10 (Short term use)

Hypotonic Solution

examples of ________ include 0.45 NS (short term use)

Electrolyte Solutions 0.9% Normal Saline (NS)

154 mEq of Na+ and Cl-, Isotonic
Advantages: fluid of choice, ECF replacement, To initiate blood transfusions. Disadvantages: Too much: fluid overload

Normal Saline (NS)

blood is always hung with _______,

Lactated Ringers (LR)

Isotonic, Replaces Na+, K+, Cl-, Ca++
Advantages: Most similar to body's electrolyte content
Disadvantages: Do not use: Liver disease, profound shock, cardiac failure, or hypovolemia

KCL in IV

No more than 40mEq/1L
Very irritating to the vein monitor for burning
Monitor K+ levels

Fluid Volume Excess

Defining Characteristics of ______ is VS, Weight gain, Peripheral Edema, Neck vein distention, Moist crackles in the lungs, Hand vein emptying > 3 sec. Bounding pulse, tachycardia, increased respiratory rate, SOB, increased blood pressure
pitting edema overhead

Fluid Volume Deficit

Defining Characteristics of ______ is VS, dry mucus membranes, Skin turgor > 3 secs, Decreased urinary output, Recent weight loss, Hand vein filling > 3 secs. Decreased pulse and thready Decreased B/P, best to check skin turgor over sternum and forehead. sunken eyeballs
syncope, postural hypotension, increased thirst
Lab most elevated due to decreased volume of plasma

Total Parental Nutrition-TPN

50% glucose
must go into a central vein
higher potential of infection

Partial Parental Nutrition-PPN

10% glucose
can be given in a peripheral IV
TPN and PPN are Hypertonic solutions

Total Parental Nutrition-TPN

this type of nutrition can only be given through a central vein such as med port, pic line, central line.

Partial Parental Nutrition-PPN

this type of nutrition can be given through a peripheral line

Parental Nutrition

Nursing assessments for using ___ includes Monitor hyperglycemia, electrolyte imbalance, Infection, Rebound hypoglycemia when discontinued

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