Fluid & Electrolyte Review Terms
Terms in this set (75)
Water accounts for what percent of adult body weight?
Approximately 2/3 of body water is located where?
Within the cells-Intracellular fluid
How much does 1 liter of water weigh?
What is the most commonly used unit of measure for electrolytes?
In the ECF, what is the main Cation?
In the ECF, what is the main Anion?
In the ICF, what is the main cation?
In the ICF, what is the main anion?
Who is most succeptible to water loss?
What 3 fluids are defined as ECFs?
Intravascular (plasma-Causes BP)
Effects of water status on RBC's-Hypotonic solution
More fluid/less stuff=RBC swells
Effects of water status on RBC's-Isotonic solution
Just like body fluids=Not much of a fluid shift
Effects of water status on RBC's-Hypertonic solution
More stuff/less fluid=RBC shrinks
Fluid Shifts-Plasma to Interstitial shift results in...
Elevation of hydrostatic pressure (BP)
Decrease in plasma oncotic pressure (from loss of proteins)
Elevation of of interstitial oncotic pressure (crushing injury/burns)-protein has leaked out but still holding onto fluid
Protein is too large to fit through capillaries normally but crushing will allow protein to leak out causing....
Fluid Shifts-Intertitial fluid to plasma results in...
-Fluid drawn into plasma space will increase in plasma osmotic or oncotic pressure
-Compression stockings decrease peripheral edema
Fluid movements between ECF and ICF-Water deficit (increased ECF osmolality)
Symptoms that result from cell shrinkage as water is pulled into vascular system
ECF is more concentrated
Will start to see neurological impairment due to effects on the brain
Fluid movements between ECF and ICF-Water excess (decreased ECF osmolality)
Develops from gain or retention of excess water
Patient would be given hypotonic solution to cause the RBCs to swell
Urine concentration-Low specific gravity
Urine is diluted
More fluid/less stuff
Urine concentration-High specific gravity
Urine is concentrated
Less fluid/more stuff
Moisture escaping from the mouth when talking
What you can't see
What you can see
What are the primary organs for regulating fluid and electrolyte balance?
Renal tubules are sites of what two things?
ADH and Aldosterone
What do we do as nurses if we see a patient with concentrated urine?
Force fluids on them
Gastrointestinal regulation-What accounts for most of our water in our body?
Gastrointestinal regulation-Small amounts of water are eliminated by what?
Gastrointestinal tract in feces
Gastrointestinal regulation-What 2 things can lead to significant fluid and electrolyte loss?
Diarrhea and vomiting
How much fluid is lost a day via insensible water loss?
Gerontologic considerations-Structural changes in kidneys decrease ability to what?
Gerontologic considerations-Hormonal changes lead to a ____________ in Renin and Aldosterone with an increase in ADH and ANP
Gerontologic considerations-Loss of subcutaneous tissue leads to increased loss of what?
Gerontologic considerations-Reduced thirst mechanism results in decreased what?
2 most common ways to deal with fluid and electrolyte imbalances are...
IV fluid replacement and diuretics
Extracellular fluid volume imbalances-ECF volume deficit is known as...
Symptoms/causes/treatments of ECF volume deficit (hypovolemia)
-Acute weight loss, low BP, High respirations, High heart rate, poor skin turgor
-Diarrhea, fistula drainage, hemorrhage, inadequate intake
-Replace water and electrolytes with balanced IV solutions-Isotonic solution
Symptoms/causes/treatments of ECF volume excess (hypervolemia)
-Weight gain, High BP, bounding pulse, increased respirations, distended neck veins
-Excessive intake of fluids, orally or through IV
-Fluid restriction, Give diuretics to help patient urinate
Nursing management for Hypovolemia/Hypervolemia
Monitor cardiovascular changes
Assess respiratory changes
Symptoms of excess sodium
Increase interstitial fluid
Symptoms of excess Potassium
Symptoms of excess Calcium
Increase interstitial fluid
Symptoms of excess Magnesium
Loss of deep tendon reflexes
Depression of CNS
Depression of neuromuscular funtion
Symptoms of deficit: Sodium
Symptoms of deficit: Potassium
Symptoms of deficit: Calcium
Symptoms of deficit: Magnesium
Sodium imbalances are typically associated with what?
Parallel changes in osmolality
Sodium plays a major role in...
ECF volume and concentration
Generation and transmission of nerve impulses
What drugs are the main reason for fluid imbalance?
normal urine output for adult is how much?
Elevated serum sodium occurring with water loss or sodium gain (dehydration/drinking salt water)
Causes hyperosmolality leading to cellular dehydration
Primary protection is thirst from hypothalamus
Symptoms/treatments for hypernatremia
Thirst, lethargy, agitation, will appear flushed, seizures
Treat underlying cause, force fluids, IV solution of 5% dextrose in water or hypotonic solution, diuretics
Results from loss of sodium-containing fluids or from water excess
Symptoms/treatments for hyponatremia
Confusion, nausea, vomiting, seizures, weakness, skin turgor, BP changes, cool and clammy
Restrict fluids, small amount of IV hypertonic solution, assess vital signs, monitor weight, avoid tap water enemas
What is normal range of potassium in the body?
3.5-5.0 mEq/l or mmol/L
What is Potassium necessary for in the body?
Transmission and conduction of nerve and muscle impulses
Maintenance of cardiac rhythms
Sources of Potassium
Fruits and Veggies
Symptoms/treatments for Hyperkalemia
Cramping leg pain, weak skeletal muscles, cardiac standstill, abdominal cramping, diarrhea
Cardiac monitor patient, eliminate oral and parenteral K intake, Loop diuretics, dialysis, Kayexalate-will give patient diarrhea, Force K from ECF to ICF by IV insulin, administer Calcium gluconate IV
Which electrolyte do we NEVER push through IV and why?
Potassium, extreme pain for patient
Symptoms/treatments for Hypokalemia
Cardiac dysrhythmias, skeletal leg muscle weakness, decreased gastrointestinal motility, depression
MONITOR HEART RATE, Monitor VS, K supplements, never give K on empty stomach, K supplements,
DO NOT GIVE MORE THAN 10-20 mEq/hr OF K
Symptoms/treatments for Hypercalcemia
Decreased memory, confusion, disorientation, fatigue, constipation, thirsty
Excretion of Ca with loop diuretic (Lasix), hydration with isotonic saline infustion, heart monitors, ambulation
Symptoms/treatments for Hypocalcemia
Positive Trousseau's or Chvostek's sign, Laryngeal stridor, Dysphagia, Tingling around the mouth or in extremities
Treat the cause, Oral/IV calcium supplements, treat pain and anxiety to prevent hyperventilation
Symptoms/treatments for Hyperphosphatemia
Calcified deposition in soft tissue such as joints, arteries, skin, low calcium, arrythmias
Treat underlying cause, restrict foods containing phosphorus, hydration, dialysis
Symptoms/treatments for Hypophosphatemia
CNS depression, confusion, muscle weakness/pain, dysrhythmias, cardiomyopathy, slurred speech
Oral supplementation, ingestion of foods high in phosphorus, IV administration of sodium or K phosphate, monitor resp. status
Symptoms/treatments for Hypermagnesemia
Drowsiness, nausea, impaired reflexes, somnolence, respiratory arrest, decreased muscle and nerve activity
Prevention, emergency treatment-IV CaCl, fluids to promote urinary excretion
Symptoms/treatments for Hypomagnesemia
Confusion, deep tendon reflexes, tremors, seizures
Oral supplements, increase dietary intake, parenteral IV or IM magnesium, assess renal funtion
What are the main 2 purposes for giving IV fluids?
1. Maintenance-When oral intake is not adequate
2. Replacement-When losses have occurred
What is normal body range for Chloride
What is normal body range for Phosphate
What is normal body range for Potassium
What is normal body range for Magnesium
What is normal body range for Sodium
What is normal body range for Calcium
As Sodium levels go up, what will come down?
As Calcium levels go up, what will come down?
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