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fluid and electrolytes

Terms in this set (124)

sensible losses
can be measured and include fluid lost during urination, defecation, and wounds
insensible losses
cant be measured or seen; fluid lost from evaporation through the skin
sodium (Na)
135-145 mEq/L
potassium (K)
3.5-5.0 mEq/L
calcium (Ca)
4.5-5.1 mEq/L
magnesium (Mg)
1.3-2.3 mEq/L
chloride (Cl)
97-107 mEq/L
bicarbonate (HCO3)
25-29 mEq/L
phosphate (PO4)
2.5-4.5 mg/dL
osmosis
method of transporting body fluids
diffusion
the tendency of solutes to move freely throughout a solute
filtration
passage of fluid through a permeable membrane. fluids move from higher pressure to lower pressure
hypotonic
solution has less osmolarity than plasma
hypertonic
solution has a greater osmolarity than plasma
isotonic
solution has same concentration as plasma
adrenal gland hormone that increases retention of sodium & water
aldosterone
pituitary hormone which causes water retention
ADH
Most abundant cation in extracelluar fluid
sodium
most abundant cation in intracellular fluid
potassium
Important for cell membrane integrity, cardiac conduction, blood coagulation, bone growth & maintenance, and muscle relaxation
calcium
important enzyme activities, neurochemical activities, & muscular excitability
magnesium
regulates neuromuscular excitability, acid-base balance, and muscle contraction
potassium
important in fluid balance, nerve transmission and neuromuscular function
sodium
Major nutritional sources for potassium
whole unprocessed foods, fruits, vegetables, meats, instant coffee, molasses, legumes
Major nutritional sources for magnesium
whole grains, legumes, dark green leafy green veggies, laxatives/antacids containing Mg+
Major nutritional sources for calcium
dairy products, green leafy veggies, sardines, oranges
Major nutritional sources for sodium
processed foods, preserved meats, canned veggies
What is the best day to day indicator of fluid balance: bp, pulse, skin turgor, I&O, or weight
daily weights
What are the signs/symptoms of fluid volume dificit?
dry, coated tongue
rapid, thready pulse
orthostatic hypotension
What are the signs/symptoms of fluid volume excess?
warm, moist, shiny, tight skin
inspiratory crackles in bases bilaterally
jvd present with HOB elevated 45 degrees
the two major fluid compartments in the body
intracellular
extracellular
positive ions
cations
sodium, potassium, calcium, hydrogen, and magnesium
negative ions
anions
chloride, bicarbonate, and phosphate
thirst regulation is controlled in the _____
hypothalamus
A client is experiencing difficulty with edema and fluid overload. what nursing intervention would be the most accurate in evaluating the clients fluid balance?
evaluate changes in daily weights
A client has recurrent fevers to 102 degrees. For which problem is this client at increased risk?
fluid loss
The mouth care measure that the nurse uses with caution in the client with nasogastric tube to suction is
allowing the client to suck on ice chips to relieve dry mouth
when patients are prescribed a low-potassium diet, they should be taught to avoid
melons and oranges
The nurse assesses the patient who is severely dehydrated and going into shock. What changes in vital signs is noted?
decreasing BP, increasing pulse
when hypovolemic shock is suspected, which is the highest priority nursing aciton?
start IV fluids
solute
particles
solvent
water
hypervolemia
fluid overload
crystalloid
salt that readily dissolves
hyovolemia
fluid deficit
edema
excess fluid in interstitial space
agglutinin
antibody that causes a clumping of specific antigens
antigen
substance that causes formation of antibodies
cross-matching
the process of determining compatibility between blood specimens
diuretics
-increase renal excretion of water, sodium, and other electrolytes
-increase risk for fluid volume deficit
normal pH
7.35-7.45
buffer
a substance that prevents body fluids from becoming overly acidic or alkaline
what is the rate of administration for packed RBCs
one unit over 2-3 hours; no longer than 4 hours
who has more extracellular fluid
newborns
osmolarity
concentration of particles in a solution
osmosis
major method of transporting body fluids
pituitary gland
stores and releases ADH, which makes the body retain water
intravascular fluid
plasma; liquid component of the blood
extracellular fluid
fluid outside the cells; 30% of total body water
intracellular fluid
fluid inside the cells; 70% of total body water
signs of sepsis
rend/tender insertion site, fever, malaise, and other vital sign changes
infiltration
the escape of fluid into the subQ tissue due to a dislodged needle that has penetrated a vessel wall
what is potassium needed for
neural, muscle, and cardiac function
what will a patient with dehydration have an increase in
aldosterone
total parenteral nutrition
an intravenous hypertonic solution containing dextrose, proteins, vitamins, and minerals
what should you vigilantly monitor for in a patient with hyperkalemia
cardiac irregularities
rich source of potassium
apricots
if the IV does not flush easily what should you do
assess the IV site; aspirate and attempt to flush it again
what is the lab test commonly used in the assessment and treatment of acid-base balance
arterial blood gas
if phlebitis occurs what should you do
discontinue the IV promptly and apply warm compresses to the affected site for relief
what client will have more adipose tissue and less fluid
a woman
common causes of fluid volume excess
failure of the heart to function as a pump- resulting in accumulation of fluid in the lungs (crackles)
what the physiologic process that drives the thirst factor
decreased blood volume and intracellular dehydration
candidates for TPN
patients with: major trauma or burns, liver and renal failure, inflammatory bowel disease
which electrolyte primarily controls water distribution throughout the body
sodium
what is an expected nursing diagnosis based on the effects of fluid and electrolyte imbalance on human functioning?
altered thought process related to cerebral edema, including mental confusion and disorientation
what is the liquid constituent of the blood
intravascular fluid
the body eliminates excess sodium through which organ
kidneys
what is the most abundant electrolyte in the body
calcium
"pumping uphill" would describe which means of transporting materials to and from intracellular compartments
active transport
what should you consider when determining a site for an IV infusion
scalp veins should be selected for infants because of their accessibility
which type of blood is called universal
Type O
the chief regulator of cellular enzyme activity and cellular water content
sodium
necessary for nerve impulse transmission and blood clotting
calcium
controls and regulates the volume of body fluids
sodium
the primary regulator of ECF volume
sodium
important for the metabolism of carbs and proteins
magnesium
a catalyst for muscle contraction
calcium
assists in the regulation of acid-base balance by cellular exchange with H+
potassium
necessary for protein and DNA synthesis, DNA and RNA transcription, and translation of RNA
magnesium
it acts with sodium to maintain the osmotic pressure of the blood
chloride
important for cell diversion and for the transmission of hereditary traits
phosphate
important in the buffering system thats activated by the exchange of oxygen and carbon dioxide between body tissues and red blood cells
chloride
found primarily within cells and is associated with intracellular protein
sulfate
essential for the production of hydrochloric acid in gastric cells
chloride
arterial blood gases
most commonly used to assess and treat acid-base imbalances
when do acid-base imbalances occur
when the extracellular fluid and intracellular fluid carbonic acid or bicarbonate levels become disproportionate
kidneys
primary controller of the body's carbonic acid supply
normal blood plasma is slightly...
alkaline
alkali
a substance that can accept or trap hydrogen ions
ingested liquids
make up the largest amount of water normally taken into the body
electrolytes
substances capable of breaking into electrically charged ions and dissolved in a solution
the human body is composed of _____ water by weight
50-60%
What is the nurse's primary concern regarding fluid & electrolytes when caring for an elderly pt who is intermittently confused?
risk for dehydration
The nurse is planning care for a pt with severe burns. Which of the following is this pt at risk for developing?
intracellular fluid deficit
A pt is receiving intravenous fluids postoperatively following cardiac surgery. Nursing assessments should focus on which postoperative complication?
fluid volume excess
A pt is diagnosed with severe hyponatremia. The nurse realizes this pt will mostly likely need which of the following precautions implemented?
seizure
A pt is diagnosed with hypokalemia. After reviewing the pt's current medications, which of the following might have contributed to the pt's health problem?
corticosteroids
A pt prescribed spironolactone is demonstrating ECG changes & complaining of muscle weakness. The nurse realizes this pt is exhibiting signs of which of the following?
hyperkalemia
The nurse is planning care for a pt with fluid volume overload & hyponatremia. Which of the following should be included in this pt's plan of care?
restrict fluids
When caring for a group of pts, the nurse realizes that which of the following health problems increases the risk for metabolic alkalosis?
bulimia
An elderly pt does not complain of thirst. What should the nurse do to assess that this pt is not dehydrated?
assess urine for osmolarity
what finding may indicate hypomagnasemia
hyperactive deep tendon reflexes
Pt. is complaining of burning at the site. You see no redness, swelling, heat, or coolness upon inspection. You suspect..
that the fluid is infusing too rapidly for comfort
What is the physiologic process that drives the thirst factor?
Decreased blood volume and intracellular dehydration
signs/symptoms of phlebitis
redness, warmth, pus, induration, pain, local acute tenderness, slight edema above insertion site
systemic infection includes manifestations such as
chills, fever, tachycardia, and hypotension
infiltration signs
swelling, coolness, and pallor at the catheter insertion site
A nurse monitoring a patient's IV infusion auscultates the patient's lung sounds and finds crackles in the bases in lungs that were previously clear. What would be the appropriate intervention in this situation?
Notify primary care provider immediately for possible fluid overload.
common cause of fluid volume excess
heart fails to function as a pump
signs of hypokalemia
muscle weakness and leg cramps, fatigue, paresthesias, and dysrhythmias
what should you do if phlebitis occurs
discontinue the IV promptly
Which of the following statements most accurately describes the process of osmosis?
Water moves from an area of lower solute concentration to an area of higher solute concentration.
A decrease in arterial blood pressure will result in the release of
renin
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