Medsurge Midterm 1

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Hypokalemia

occurs with GI and renal losses

Hyperkalemia

occurs with adrenal insufficiency

Hyponatremia

occurs with increased thirst and ADH release

Hypernatremia

results from increase insensible losses and diabetes insipidus.

urine specific gravity

is increased in relation to kidneys attempt to conserve water and is decreased with diabetes insipidus.

Aldosterone

is secreted when fluid volume is low causing reabsorption of sodium and chloride.

Isotonic electrolyte solutions (lactated ringers and 0.9% sodium chloride)

frequently used to treat a hypotensive patient with FVD (hypovolemia) because they expand plasma volume.

hypotonic electrolyte solution (0.45% sodium chloride)

When the patient becomes normotensive, this solution is often used to provide both electrolytes and water for normal excretion of metabolic wastes.

acute tubular necrosis

Prolonged FVD may cause a serious problem with renal function. The HCP needs to see if oliguria is produced from FVD or more seriously, produced by _______ ______ _______ from prolonged FVD. The fluid challenge test will verify this problem.

Eight

Fluid Volume deficit should be monitored at least every ___ hours. Shock can occur if 25% or more of the intravascular volume is depleted.

Symptoms associated with FVD

a decrease in body temperature, loss of a pound roughly represents 500mL of fluid loss. weak rapid pulse, orthostatic hypotension, cold extremities, declined mental function, additional longitudinal furrows on the tongue and tongue is smaller, low central venous pressure.

Hypervolemia

always secondary to an increased total body sodium content.

Symptoms of hypervolemia

edema, distended neck veins, crackles, tachycardia, hypertension, increased pulse pressure, increased central venous pressure, increased weight, increased urine, shortness of breath or wheezing.

Hypervolemic lab values

low BUN and hematocrit levels

Hypervolemia

occurs when aldosterone is chronically stimulated and the sodium level in urine does not rise

Thiazide diuretics

block 5% to 10% of total sodium reabsorption by blocking the distal tubule

Loop diuretics

block 20 to 30% of total sodium reabsorption by blocking sodium reabsorption in the loop of henle

Potassium

electrolyte to watch when administering diuretics because hypo or hyperkalemia may occur, depending on where the diuretics work in the kidney. (Hyperkalemia can only occur if diuretics are used in the last distal tubule, ie. spironolectone)

the sodium salt sodium chloride

is the type of salt that contributes to edema.

stimulates renin release

Decreased arterial blood pressure
decreased renal blood flow
increased renal sympathetic nerve activity
low-salt diet can stimulate renin release

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