fluid & electolyte med surge I (Erin's slides)
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| What % of body wt is fluid? | show 🗑
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| show | Elderly have a lower % of body water
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| How does gender affect % of body fluid? | show 🗑
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| How does body fat affect % of body fluid? | show 🗑
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| show | Water; a liquid that dissolves other substances
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| show | it is necessary to sustain life; affects cell shape and size; maintains body temp; transports gases & wastes throughout the body; almost every organ in the body plays a vital role in maintaining electrolyte balance.
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| Intracellular space (ICF)= | show 🗑
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| Extracellular space (ECF)= | show 🗑
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| Third Space fluid= "Held Prisoner" | show 🗑
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| What is the function of Homeostasis? | show 🗑
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| show | Intracellular (ICF) and Extracellular (ECF); "Act as a Dam"
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| show | intravascular (inside the vessels) to extravascular (outside the vessels) and from intracellular (inside the cells) to extracellular (outside the cells)
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| Fluid regulation is dependent on a balance between? | show 🗑
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| Electrolytes are... | show 🗑
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| show | + charge; Na+, K+, Ca++, Mg++, & H+ ions
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| Anions...(has the "A" with a - in it) | show 🗑
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| show | ECF (outside the cells) b/c of easier access
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| Na+ is highly concentrated in________and an important _____________? | show 🗑
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| show | ICF (inside the cell)
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| In order to keep Na+ levels higher in ECF (outside the cell) and K+ levels higher in ICF (inside the cell) the body must use_____? | show 🗑
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| show | water (fluid) moves from LOW solute (electrolyte) concentration to a HIGH solute (electrolyte) concentration; a passive process and does not require energy.
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| show | # of particles of solute in a unit of fluid based on WEIGHT (mOsm/kg)[wt of the electrolyte, not of the IV bag]; remember
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| Osmolarity= # of particles of solute in a unit of fluid based on ________ | show 🗑
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| show | Tonicity
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| Hypotonic solutions= Hypo "LOW" Osmolality; 0.45% NaCl (Normal Saline) | show 🗑
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| Isotonic solutions= Normal Osmolality; 0.9% NaCl (Normal Saline) | show 🗑
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| show | USED TO DECREASE EDEMA POST-OPERATIVELY & REGULATES URINE OUTPUT & BP; More electrolytes and less water
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| Why would you give an isotonic solution? | show 🗑
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| Why would you give a hypertonic solution? | show 🗑
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| When would you NOT give Normal Saline? | show 🗑
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| Sodium potassium pump... | show 🗑
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| Diffusion is a ..."fish downstream" | show 🗑
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| F & E Homeostasis uses almost every organ in our body in order to maintain fluid balance to regulate homeostasis...a problem with one...? | show 🗑
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| show | Cardiac Output (CO)= the amount of blood pumped by the heart/min
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| show | CO; affects how much blood or fluid reaches the kidneys.
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| show | insensible fluid loss; and are involved in acid-base balance; (acid= sour; base= bitter)
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| show | by the "Thirst Center" located in the hypothalmus
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| show | ADH; Anti-Diuretic Hormone
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| What does ADH do? | show 🗑
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| show | it is the most significant factor in determining whether excreted urine is concentrated (dark) or dilute (straw color)
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| show | Releases aldosterone
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| What affect does Aldosterone have on fluid & electrolyte balance to regulate homeostasis? | show 🗑
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| What affect does the Parathyroid Gland have on fluid & electrolyte balance to regulate homeostasis? | show 🗑
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| PTH causes... | show 🗑
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| show | The pituitary releases ADH which stimulates water reabsorption and ↓'s U.O. (urinary output); remember...it keeps you from peeing.
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| show | causes vasoconstriction which ↑'s arterial perfusion pressure which stimulates thirst
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| The sympathetic nervous system stimulates release of...? | show 🗑
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| show | volume
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| show | regulates BP and water balance; a low BP causes the kidneys to secrete renin, renin stimulates Angio I & Aldosterone which ultimately causes the kidneys to hold onto Na+ and water; ↑'s BP (if BP gets too high need to give ACE inhibitors...-sartans)
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| show | sense changes in Na+ concentration in our body
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| show | A cardiac hormone; opposite of renin-angiotensin-aldosterone; ANP ↓'s BP,↑'s U.O. ("ANP makes you Pee"); stimulates vasodilation which ↑'s water excretion/U.O.
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| show | ↑'d risk of F&E disorders b/c experience changes in F&E's quicker r/t decreased renal, pulmonary (lung), and adrenal function
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| What do you need to assess in geriatric clients to evaluate F&E's? | show 🗑
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| show | The end product of muscle metabolism. The most definitive way of measuring kidney function [better than BUN (blood urea nitrogen]; but will use BUN & CC to measure kidney function.
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| show | Oral, IV, SubQ, Enteral (via gut)
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| What are routes of fluid loss? | show 🗑
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| What is the expected fluid loss per day for the kidneys? | show 🗑
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| What are insensible losses of fluid? | show 🗑
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| What is the term for Fluid Volume Deficit (FVD)? | show 🗑
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| What is the definition of hypovolemia? or When does hypovolemia occur? | show 🗑
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| show | water and electrolytes in the same proportion; an isotonic imbalance.
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| show | loss of fluid; but tends to have a high sodium concentration; (thus, the loss of water is not equal to the loss of electrolytes and cannot be called the same thing as hypovolemia.)
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| show | hypovolemia
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| show | vomiting, diarrhea, GI suctioning, GI fistula
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| show | diuretics, Addison's (↓ Aldosterone), Diabetes Insipidus (↓ ADH), osmotic diuresis
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| What are some insensible causes of hypovolemia/isotonic imbalances? | show 🗑
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| show | Hypovolemic Shock
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| What is ascites? | show 🗑
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| show | Administer fluids: Oral route is preferred; may give isotonic IV fluids 0.9% NS or LR (remember they do not cause huge fluid shifts); this will also increase BP
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| show | I&O; Daily wts (most sensitive indicator of fluid changes); VS; Notify the MD of lack of response or worsening of symptoms (SBAR)
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| show | Elderly, renal failure, diarrhea, C.diff (pooping q 5 seconds), vomiting.
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| show | If they are able to receive fluids orally, teach to drink some fluids every hour, etc.
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| show | vital signs and daily weights
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| show | Expansion of ECF (outside the cell); isotonic imbalance of fluids and electrolytes; circulatory overload
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| show | ...your body will try to compensate for fluid overload by fine tuning the circulatory or circulating levels of Aldosterone, ADH & ANP; by altering these levels it causes the kidneys to release additional water and sodium
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| What are the primary Signs/Symptoms of hypervolemia (we are expected to know)? | show 🗑
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| How do you manage FVE (fluid volume excess)? | show 🗑
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| show | I&O, daily wts, and VS's; notify MD if there is a change in symptoms
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| What pts are at risk for FVE? | show 🗑
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| show | via GI tract
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| Where are electrolytes excreted? | show 🗑
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| What is the #1 ECF cation? | show 🗑
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| show | controls water distribution; and affects muscle contraction/nerve impulse transmission
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| Why is it important to correct sodium imbalances "slowly"? | show 🗑
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| show | A loss or gain in water; (Water follows salt)
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| show | < 120 mEq/L;
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| show | Seizures, caused by H2O moving into the brain cell
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| Na+ is regulated by...? | show 🗑
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| What happens when sodium levels become severely low in the blood (< 120 mEq/L) | show 🗑
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| show | HYPONATREMIA
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| Signs and symptoms of hyponatremia depend on...? | show 🗑
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| show | Anorexia, N/V, cramping
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| What are the neurological signs and symptoms of hyponatremia? | show 🗑
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