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Fluid and Electrolyt

Napa Nurs141

QuestionAnswer
Serum Value for Sodium Na+ 135-145
Serum Value for Potassium K+ 3.5-5.0
Serum Value for Ionized Calcium CA+2 4.4-5.5
Bicarbonate 22-26 arterial, 24-30 venous
Chloride Cl- 95-105
Magnesium Mg 2+ 1.5-2.5
Phosphate PO4 3- 2.8-4.5
6 functions of fluids Transport of nutriets to and wastes from cells, maintain nL body temp,lubricates and cushions,facilitates digestion and elimination,maintains vascular volume and solvent for e-lytes
4 functions of e-lytes body water regulation and osmolality,acid-base balance,enzyme activity,neuromuscular activity
% of intracellular fluids 40
% of extracellular fluids 20 (5 intravascular, 15 Intertitial)
Average L of water in adult 28L M 20L women
Contains lymph,fluid between the cells and outside the blood vessels Interstitial fluid
Blood plasma found in vascular system Intravascular fluid
Fluid seperated from other fluids by a cellular barrier Transcellular
Increase in TBW Infants
Increase in TBW Muscle
Decrease in TBW Elderly
Decrease in TBW Fat (more adipose tissue)
An element or compound that, when dissolved in water or another solvent seperates into ions that are electrically charged Electrolyes
+ charged e-lytes cations
ICF Cations (+) Potassium, Magnesium, Sodium
ICF Anions (-) Phosphates, sulfates, Bicarbonates, Proteniates
MEq/L represents the number of grams of the specific e-lyte dissolved in a L of plamsa (solution)
4 processes fluids/solutes move across membranes osmosis, diffusion, filtration, active transport
Osmosis The movement of a pure solvent, (water) across a semi-permmeable membrane from an area of LOW concentration to HIGH concentration
Osmolarity The concentration of solutions, reflects the number of molecules in a L of solution (mOsm/L)
Diffision Solution across a semi-permenable membrane from HIGH to LOW area of contrentration
H+ ion concentraion in the blood PH
NL pH 7.35-7.45
A product of metabolism Hydrogen
Donates H+ ions Acids
Accepts H+ ions Bases
Most effective way to measure/evaluate acid-base balance ABG Aterial blood gas
Increased pH Alkalosis
Decreased pH Aciddosis
Excessive vomiting and excessive fluid loss Hypovolemia
Unble to respond to thrist mechanism Dehydration
The concentrations of of solutions Osmolarity
nL serum osmolatity 275-295 mOsm/kg
<275 hypotonic
>295 hypertonic
Fluid body gains foos, fluids,oxidative metabolsim
Fluid body loss Lungs, skin, GI tract and kidneys
One key way a cell gains useful energy oxidative metabolsim
Movement of fluids from low conc to high conc osmosis
move together across a memebrane in response to fluid ppressure filtration
primamary regulator of fluid intake thirst
6 mechanisms that trigger the thirst center Increase plasma osmolality, angiontension 2, dry oropharyngeal, psychological factords, decrease potassium or increase sodium, decrease plasma volume
horomone that increases BP angiotension
major organ for retention and excretion of fluids kidneys
pressure excerted by a fluid at equalirium due to the force of gravity hydrostatic pressure
GFR 125mL/min
nL urine output 20-30m/hr
process of renin-angiotension-aldosterone system decreased BP or decreased Na triggers glomerulsu to excrete renin that then triggers the LIVER to convert angiotension to angiotension 1 to LUNGS to then convert abgiotension 1 to angiotension 2 which triggers adreanals to secrete aldosterone
What does aldosterone do after its secreted by the adrenals increases reabsorption of Na and water to release K in the kidneys which increases blood volume and increases BP
Causes vasoconstriction and production of alsodterone, resulting in increase of BP Angiotension 1 and 2
Drugs that interfere with the secretion or action of aldosterone antihypertensives
Sodium % in ECF 90
nL ECF serum sodium 135-145 mEq/L
Role of sodium balance control water distribution and volume
nL serum for NaCL 50-90mEq
Organ that excretes Na as needed kidney
requires metabolic activity and expenditure of energy to move substances across cell membrane (ATP) Active Tranport
Functions of Potassium regulation of ICF, nerve impulses, maint of acid-base balance
Irregular HR if decreased Potassium (K+)
Food sources of K+ meats, bananas, avacados, dried fruits, nuts, chocolate
K+ < 3.5 hypokalemia
Causes of hypokalemia Inadequate butrient intake, GI losses, renal loss, stress, strriods, alkalosis
sxs of hypokalemia weakness, paralyisis, leg cramps, anorexia, vomiting, SOB, apnea, polyuria (excessive urine)
Calcium serum levels 8.5-10.5
99% stored in teeth, bones Calcium
Bound with protein and ionized Calcium
Ionized Calcium serum levels 4.5-5.5 mEq/L
Regulation of calcium vit d, phosphates, PTH, Calcitonin
PLasma serum concentrations 1.5-2.5 mEq/L
2/3 found in bones, 1/3 in ICF, 1% ECF Magnesium
Small bowel Magnesium absorbed
kidney Magnesium excreted
Major chemical buffer in ECF and ICF HCO3 (Bicarbonate)
nL serrum Bicarbonate 20-26
< 22 HCO3 Metabolic acidosis
> 26 HCO3 Metabolic alkalosis
Regulated by the kidneys Bicarbonate
< 7.35 pH Acidosis
>7.45 pH Alkalosis
PaCO2 serum levels 35-45mmHg
<35 PaCO3 hypocapnia (decreased o2 consumption)
>45 PaCO2 hypercapina (increased o2 consuption)
HCO3 serum levels 20-26mEq/L
<20 HCO3 acidosis
>26 HCO3 alkalosis
The accumulation of fixed acids and loss of base (high acid in the blood) Metabolic acidosis
Diahhrea, renal disease, ketacidosis, ingestion ASA, renal tubular acidosis causes of metabolic acidosis
Kussamuls respirations, starvation, headache, hyperventation, hypotension, decresed pH decreased HCO3, decreased PaCO3 sxs of metabolic acidosis
Inadequate excretion of CO2 and acute/chronic respiratory alterations Respiratory acidosis
headache, hypertension, hyperkalemia, hypoxemia(decreawsed O2 in blood) dyspensea (sweating)increased RR, decreased pH sxs of respiratory acidosis
hypoventalation, increased HR, decreased LOC, hpokalemia, hypocholoermia, tetany, increased pH, increased HCO3 sxs of metabolic alkalosis
hyperventalation, hypoxemia, anxiety, fever causes (hyperventalation) of respiratory alkalosis
lightheaseded, inability to concentrate, palpations, dry mouth, hypotension, blurred vsision, increased pH, decreased PaCO2 sxs of respiratory alkslosis
3 influencing factors of TBW Body fat, sex and age
lose more fliuid due to insensible water loss infants
infants decreased ability to concentrate urine
deminished thrist respone elderly
elderly altered ADH response
Risks for F/E imbalances CHF, renal failure, cirrohsis, ADH stimulation (Stress), excess sodium containing fluids.foods, IV solutions
druds, GI, restraints, skin, fever, blood loss alterations in fluid intake and output
B U N blood urea nitrogen
BUN serum levels 7-20 mg/dL
Serum plasma creatinine .7-1.2 mg/dL
Measures hydration, status, electrolyte concentration in bld plasma and acid-base balance Diagnostic tests for FVD or FVE
decrease intravascular and interstitial fluids hypovolemia (FVD)
equal water and electrolyle loss, = hypovolemia or dehydration Isotonic FVD
Isotonic defiect sxs decreased pulse, decreased BP, decreased skin turgor, decreased weight, decreased LOC, increased RR and temp
Diagnostic tests 4 FVD serum increase sodium >145, BUN > 25, hematocrit > 50%, specif gravity > 1.025
Abnormal fluid reetention in intravascular and interstitual space (sodium and water retained) extracellular FVE
CHF, renal failure excessive sodium intake, increased serum aldosterone, steriods Isotomic FVE causes
FVE sxs weight gain, distended veins, constant cough, dsypnea (upset stomach), cynosis
FVE diagnsotic tests decreased sodium levels, decreased hematocrit, decreasewd specific gravity, BUN
Hypoosmolor FVE water gain and electrolyle gain
Hyperosmolar FVD water loss and electrolyte loss
ICFVE fluid shift from extracellular spaces to intracellular, due to serum serum hypo-osmolality
Potassium falls below 3.5 Hypokalemia
Imbalance of Na on cell >145 meQ/L Hypernatremia (cell shrinks)
overexcitment of nervous system, twinges in fingers and toes alkalosis
CNS changes from failure of swollen cells, confusion, anxiety, anorexia, nasusea sxs of hyponatremia
deep rapid breathing, Kussamuls, decreased pH evidence that the compensory mechanisms are working in metaboilicacidosis
What is the major cause od metabolic acidosis kidney disease
water leaves the cells and moves to the bloodstream dehydration
Na < 135mEq/L Hyponatremia
sxs of hypernatremia thrist, weakness, disorientation, lethargy, muscle irritabilty
sxs of hyponatremia nausea, malaise, headache, fatigue
causes of hyperkalemia (K+) decreased K ewxcretion, high potassium intake, shift K out of cells
sxs hyperkalemia nausea, hyperactive bowel sounds, cardiac arrest, dysrythemias, EKG changes, anuria (non passaage of urine) paresthesia
causes for hypercalcemia metastatic cancer, immobolization, hyperthyroidism, intake of diueretics, Lithium, excess intake of Ca anatcids
sxs of hypercalcemia nuero weakness, polyuria, hypercalcuria, decreased peridtsalisis, cardiovacular
sxs of hypocalcemia tetany, parasthia, trousseaua sign, chvostek's
dimished nuero transmission, decreased muscle funciton, hypotension, respr depression, cardiac arrest hypermagnesemia sxs
<1.8 mg/dL hypomagnesemia
Losses from GI tract, alcoholism causes of hypomagnesemia
DVD, FVE, Ineffective breathing pattern, Impaired mobility, Impoaired skin ingrity, Altered oral mucous membranes Nursing Diagnosises
Nursing Interventions Assess colume status
Obtain daily weights Nursing Intervention
Monitor Lab vlaues Nursing Interventions
Mouth Care, protect skin, measure I and O Nursing Interventions
Purpose of fluid therapy Maintain fluid and electrolyte balance, replacement and correction in elctrolyle disturbances
Aqeuos solution mineral salts or other water soluble molecles Crystalloids
Crystalloids sodium chloride solutions, 0.45% NaCl, hypotonic
Balance electrolyle solutrystalloidsions (Lactate Ringers) Crystalloids
Colliods Protien or starcth molecules in fluid
Increase osmotic pressure-volume expansion for fluid replacement Colliods
Dextran Colliods
Hetastarch Colliods
Created by: 1067216917
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