Fluid & electrolytes
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130 terms
Terms | Definitions |
|---|---|
 sodium (Na+) hyper lab value | Above 145 |
| (Na+) hyper causes | water deprivation, large amounts of concentrated salt solution |
| (Na+) hyper symptoms | thirst, dry mucous membranes, sticky tongue, restless , irritability, agitation, convulsions |
| (Na+) hyper intervention/treatment | Safety - CNS changes Administer H2O |
| sodium (Na+) hypo lab value | Below 135 |
| (Na+) hypo causes | kidney disease, prolonged sweating, diuretics, water excess |
| (Na+) hypo symptoms | postural hypotension, abdominal cramping, nausea, vomiting, tachycardia, convulsions |
| (Na+) hypo | Safety - CNS changes Sodium replacement |
| Potassium (K+) hypo lab value | below 3.5 |
| (K+) hypo causes | potassium wasting diuretics, diarrhea, vomiting, polyuria, extreme sweating |
| (K+) hypo symptoms | weakness, fatigue, decreased muscle tone, paresthesias, weak irregular pulse, ventricular dysrhythmias |
| (K+) hypo intervention/treatment | Safety - cardiac Administer K |
| Potassium (K+) hyper lab value | above 5.0, emergency at 6.0 |
| (K+) hyper causes | renal failure, fluid volume deficit, K sparing diuretics, extensive burns, diabetic ketoacidosis |
| (K+) hyper symptoms | anxiety, paresthesias, weakness dysrhythmias, abdominal cramps, diarrhea, EKG changes may lead to cardiac arrest |
| (K+) hyper intevention/treatment | Safety - cardiac K wasting diuretics, Kayexelate, Insulin |
| Calcium (Ca+) hypo lab value | below 8.5 |
| (Ca+) hypo causes | surgery thyroid or parathyroid, vitamin D deficiency, extensive blood transfusions containing citrate, hypoalbuminemia |
| (Ca+) hypo symptoms | numbness and tingling of fingers and circumoral region, + Trousseau's sign, + Chvostek's sign |
| (Ca+) hypo intevention/treatment | Safety - neuromuscular changes Administer Calcium Salts, Calcium Gluconate |
| Calcium (Ca+) hyper lab value | above 10.5 |
| Ca+ hyper causes | hyperparathyroidism, prolonged immobilization, osteoporosis, carcinoma with bone metastasis |
| Ca+ hyper symptoms | anorexia, nausea, vomiting, back pain usually r/t kidney stones, lethargy, fractures |
| Ca+ hyper Intervention/Treatment | Safety - prevent pathological fractures, prevent with wt bearing exercise, hydration, Calcitonin prevents bone resorption |
| Magnesium (Mg+) hypo lab value | Below 1.5 |
| (Mg+) hypo causes | malnutrition, alcoholism, diarrhea, vomiting, fistula |
| (Mg+) hypo symptoms | muscle tremors, hyperactive deep tendon reflexes, confusion and disorientation, ventricular dysrhythmias |
| (Mg+) hypo Intervention/Treatment | Safety - neuromuscular changes and CNS changes Administer Magnesium |
| Magnesium (Mg+) hyper lab value | Above 2.5 |
| (Mg+) hyper causes | renal failure, excessive oral or parenteral intake of magnesium |
| (Mg+) hyper symptoms | hypoactive deep tendon reflexes, decreased rate and depth of respirations, hypotension |
| (Mg+) hyper Intervention/Treatment | Safety- neuromuscular changes and respiratory changes Administer Calcium Chloride, Calcium Gluconate to oppose effects on cardiac muscle, increase fluids |
| Blood gas values: Normal pH | 7.35-7.45 |
| Blood gas values:Normal pCO2 | 35-45 |
| Blood gas values: Normal Bicarbonate | 22-26 |
| Fluid balance: Intracellular vs Extracellular | Intracellular: 42% of total body weight. Extracellular: 17% total body weight. |
| Extracellular compartments of fluid storage | (17% total body weight) Interstital: btwn cells and outside cells. Intravascular: blood plasma, Transcellular: cerebral spinal, GI Fluid, etc. |
| Fluids and electrolytes necessary to ________ | maintain homeostasis in all body systems |
| Men or women have more water? | Men: men have more muscle, therefore more water. Women have more fat. |
| Osmosis | diffusion of molecules through a semipermeable membrane from a place of higher concentration to a place of lower concentration until the concentration on both sides is equal |
| Diffusion | movement of a solute in a solution across a semipermeable membrane from an area of higher concentration to an area of lower concentration |
| Filtration | process by which water and diffusable substances move together in response to fluid pressure |
| Active transportation | requires metabolic activity and the expenditure of energy to move materials across cell membranes (requires ATP) |
| Intake based on _______ which is controlled by ______ | Intake based on thirst mechanism which is controlled by hypothalamus |
| Most diffusion in our bodies is _________ | gas exchange |
| renin-angiotensin | renin-angiotensin-aldosterone system is a hormone system that regulates blood pressure and water (fluid) balance. When blood volume is low, the kidneys secrete renin. Renin stimulates the production of angiotensin. Angiotensin causes blood vessels to constrict, resulting in increased blood pressure. |
| ANP | Atrial natriuertic peptide, responds to excess fluid in atria, increases water and sodium removal by the kidney (to decrease blood pressure). |
| Na+ is mostly found ____ (in relation to cell) | outside of cell |
| K+ is mostly found _____ (in relation to cell) | inside of cell |
| Purpose of potassium pump | helps put ions back where they belong |
| Breathing expires ____ mL H2O per day | 400 |
| GI tract loses ___-___ mL fluid per day | 100-200 |
| Fluid output occurs through four organs of water loss: | the kidneys, the skin, the lungs, and the gastrointestinal tract |
| Insensible water loss | continuous and is not perceived by the person but can increase significantly with fever or burns |
| Sensible water loss | occurs through excess perspiration and can be perceived by the client or by the nurse through inspection |
| Kidneys produce ____ to ____ mL of urine per day | 1200-1500 |
| The basic types of fluid imbalances are ____ & _____ | isotonic and osmolar |
| Isotonic imbalances are: | when water and electrolytes are gained or lost in equal proportions |
| Osmolar imbalances are: | losses or excesses of only water so that the concentration of the serum is affected |
| Fluid volume deficit | loss of water and electrolytes in equal (isotonic) proportions. Due to vomiting, suctioning, hemorrhage, diaphoresis, fever, decreased oral intake, diuretics. Signs/symptoms: dry skin and mucous membranes, poor skin turgor, flat jv. Treatment: oral replacement, electrolyte replacement if necessary |
| Fluid volume excess | fluid and sodium being retained in body-. Due to CHF, renal failure, liver cirrhosis, excessive sodium intake. S/s: edema in sacral or ankle area, JVD. Treatment: fluid restriction, sodium restriction. |
| Hyper-osmolar | dehydration- water loss only. Causes: diabetes insipidus, diabetes ketoacidosis, excessive hypertonic tube feeding |
| Hypo-osmolar | water excess. Due to excess water intake. |
| Cations interchange, true or false | True. Cations interchange when one cation leaves the cell and is replaced by another. This occurs because cells tend to maintain electrical neutrality |
| _____ is the most abundant cation in extracellular fluid | Sodium is the most abundant cation (90%) in ECF. |
| _____ maintains water balance | sodium maintains water balance through their effect on serum osmolality, nerve impulse transmission, regulation of acid-base balance, and participation in cellular chemical reactions |
| sodium is regulated by: | dietary intake and aldosterone secretion. |
| hyponatremia | abnormally low level of sodium in the blood |
| hypernatremia | excessive amounts of sodium in the blood |
| _____ is the major electrolyte and principle cation in the intracellular compartment | Potassium |
| Potassium regulates: | many metabolic activities and is necessary for glycogen deposits in the liver and skeletal muscle, transmission and conduction of nerve impulses, normal cardiac conduction, and skeletal and smooth muscle contraction |
| Potassium regulated by: | dietary intake and renal excretion |
| The body conserves potassium well or poorly? | The body conserves potassium poorly. Therefore, any condition that increases urine output decreases the serum potassium concentration |
| Any condition that alters kidney function will alter _________ | potassium serum concentration |
| Hypokalemia | abnormally low level of potassium in the circulating blood leading to weakness and heart abnormalities |
| Hyperkalemia | higher than normal levels of potassium in the circulating blood |
| where is calcium stored? | Calcium is stored in bone, plasma, and body cells. Ninety-nine percent of calcium is located in bone. |
| Why is calcium necessary? | Calcium is necessary for bone and teeth formation, blood clotting, hormone secretion, cell membrane integrity, cardiac conduction, transmission of nerve impulses, and muscle contraction. |
| Hypocalcemia | abnormally low level of calcium in the blood |
| Hypercalcemia | the presence of abnormally high levels of calcium in the blood |
| Magnesium is essential for: | enzyme activities, neurochemical activities, and cardiac and skeletal muscle excitability. Approximately 50% - 60% of magnesium is maintained within the bone |
| Magnesium regulated by: | dietary intake, renal mechanisms, and actions of the parathyroid hormone |
| The three major anions of body fluids are: | Chloride (Cl-), Bicarbonate (HCO3-), Phosphate (PO4 3-) |
| _____ is most major anion in extracellular fluid. | Chloride is the major anion in ECF. The transport of chloride follows sodium. |
| Chloride regulated by: | dietary intake and the kidneys. |
| ______ is the major chemical base buffer within the body. | Bicarbonate |
| Bicarbonate ion essential for: | acid-base balance. |
| Regulation of bicarbonate system by: | kidneys |
| Bicarbonate part of buffering system with ____ | carbonic acid |
| Buffer anion found primarily in ICF is ___ | phosphate |
| Phosphates assists in: | acid-base regulation. |
| Calcium and ____ are inversely proportional | Calcium and phosphate are inversely proportional; if one rises, the other falls |
| Phosphate regulated by: | by dietary intake, renal excretion, intestinal absorption, and PTH |
| _____ pH is an indirect measurement of hydrogen ion (H+) concentration | Arterial pH |
| Arterial pH reflection of balance between: | Carbon dioxide (CO2) regulated by the lungs and Bicarbonate (HCO3-), a base regulated by kidneys |
| The three general types of acid-base regulators in the body are: | chemical, biological, and physiological buffering systems |
| A buffer is a substance that can absorb or release____ to correct an acid-base imbalance | H+ |
| The largest chemical buffer in the ECF is the: | carbonic acid and bicarbonate buffer system. It's the first buffering system to act. |
| When carbon dioxide increases, there is an increase in ___ ions produced, and vice versa | hydrogen |
| Biological buffering occurs when: | hydrogen ions are absorbed or released by cells. It occurs after chemical buffering. |
| The two physiological buffers in the body are the: | lungs and the kidneys |
| When the concentration of hydrogen ions is altered, the lungs react to correct the imbalance by: | altering the rate and depth of respiration |
| How long do the kidnyes take to regulate acid-base imbalance? | a few hours to several days. They reabsorb bicarbonate in cases of acid excess and excrete it in cases of acid deficit. |
| best way to evaluate acid-base balance | Arterial blood gas (ABG) analysis |
| six components of Arterial Blood Gas analysis | pH, PaCO2, PaO2, oxygen saturation, base excess, and HCO3- |
| pH measures | hydrogen ion (H+) concentration in the body fluids. Even a slight change can be potentially life threatening. |
| An increase in concentration of H+ makes a solution more _____ | acidic |
| A decreasein concentration of H+ makes a solution more | alkaline |
| PaCO2 is | the partial pressure of carbon dioxide in arterial blood and is a reflection of the depth of pulmonary ventilation. The normal range is 35 to 45 mm Hg. >45 causes hypoventilation- rate and depth of ventilation decreases, carbon dioxide is retained. <35, rate and depth of ventilation increases. |
| PaO2 is | the partial pressure of oxygen in arterial blood. It has no primary role in acid-base regulation if it is within normal limits. 80 to 100 mm Hg. Pao2 60 or less- anaerobic metabolism, lactic acid production, leads to metabolic acidosis |
| Oxygen saturation is | the point at which hemoglobin is saturated by oxygen (02). When a client is hypoxic and uses up readily available oxygen, the reserve oxygen (oxygen attached to hemoglobin) is drawn upon to provide oxygen to the tissues. |
| When the PaO2 falls below 60mm Hg, there is a large ____ in saturation | drop. Normal range is 95% to 99% |
| Base excess is | the amount of blood buffer (hemoglobin and bicarbonate) that exists. Normal value: + or - 2 |
| Serum bicarbonate (HCO3-) is | the major renal component of acid-base balance and is excreted and reproduced by the kidneys to maintain a normal acid-base environment. Normal 22-26 meq per liter |
| The four primary types of acid-base imbalance are: | Respiratory acidosis Respiratory alkalosis Metabolic acidosis Metabolic alkalosis |
| Respiratory acidosis marked by | an increased arterial carbon dioxide concentration (PaCO2) and decreased pH. |
| Respiratory acidosis caused by | Hypoventilation due to respiratory problem such as pneumonia, cystic fibrosis, respiratory failure, drug overdose, head injury, obesity. s/s- confusion, dizziness, lethargy, headache. You will see a ph less than 7.35. Paco2 greater than 45. |
| Respiratory alkalosis is marked by | a decreased PaCO2, and increased pH. |
| Respiratory alkalosis caused by | Asthma, inappropriate mechanical ventilator settings. Non resp- anxiety, head injuries, infection, salycilic overdose. |
| Daily weights and I & O measurement | Same time, same clothing. Void before weighing, weigh before breakfast. Daily weights more accurate than daily I and O |
| For bed ridden pt, measure: | abdominal girth |
| Enteral replacement of fluids | A way to provide food/fluids through a tube placed in the nose, the stomach, or the small intestine. |
| Parenteral replacement | feeding a person intravenously, bypassing the usual process of eating and digestion |
| Total parenteral nutrition | administration of a nutritionally adequate solution through a catheter into the vena cava |
| crystalloids | Solutions with small particles that flow easily from blood stream into cells; sugar and salt. Used in replacement of fluids and electrolytes |
| Colloids | Replacement of blood and blood products. |
| a _____ solution moves fluid into the cells, causing them to enlarge | hypotonic |
| an _____ solution expands the body's fluid volume. It has the same osmolarity as blood | isotonic |
| A _____ solution pulls fluid from cells | hypertonic |
| Tests that provide further objective data about fluid, electrolyte and acid-base balances include: | serum and urinary electrolyte levels, hematocrit, blood creatinine level, BUN levels, urine specific gravity, and ABG readings |
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