NP2 2011: Fluid & Electrolyte Prof.Kamhoot
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| What percent of the body is extracellular fluid? | show 🗑
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| show | 66%
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| Extracellular fluid is... | show 🗑
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| show | Transport nutrients to and from the cells Manintains blood volume Acts as a lubricant for tissues Aides in maintance of acid-base balance Assists in heat regulation via evaporation
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| Daily water intake and output is approx. _______ mL. | show 🗑
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| show | Food: 1000 mL
Oxidation: 300 mL
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| Average Insensiable output of skin, sweat, feces, and lungs is... | show 🗑
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| show | thirst dizzines weakness poor skin turgor weight loss elevated HR postural hypotension decrease urine output mental status change dry mucus membranes weak,rapid pulse
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| S/S Orthrostatic/Postural Hypotension | show 🗑
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| Nursing Interventions for fluid volume deficit/hypovolemia are | show 🗑
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| Causes of fluid volume excess/hypervolumia are... | show 🗑
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| show | -Increase HR/BP -Tachypnea/dyspnea -Distended veins -Edema -Weight gain -I&O -Crackles in lungs -Pulmonary edema
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| Treatment of fluid volume excess/hypervolumia is... | show 🗑
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| show | -Asses for cause
-Daily weights
-I&O
-Asses VS
-Skin assessment/care
-Assess/monitor respiratory rate
-Restrict Na and fluid intake
-Administer meds as ordered
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| show | replacement of lean muscles to fat, kidneys are less able to concentrate urine, decrease in mobility decreases thirst, incontinent, over salt food, mild disorientation, orthostatic hypotension, constipation
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| Nephrons filter blood at a rate of ___mL per minutes or about ___L/day. | show 🗑
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| show | 30mL/hr
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| show | 1 kg or 2.2 lb
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| show | extracellular
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| Passive transport processes that move fluids into and out of cells are... | show 🗑
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| show | energy
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| show | substances dissolved in a liquid, move from an area of higher concentration to an area of lower concentration
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| Solvent | show 🗑
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| show | used to describe fluids outside the body
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| show | used to describe fluids inside the body
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| show | movement of particles in all directions through a solution or gas; water can move freely
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| show | the movement of WATER from an area of lower concentration to an area of higher concentration through a selectively permeable membrane
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| show | A solution of higher osmotic pressure, pulls fluids from the cells
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| Isotonic solution... | show 🗑
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| show | A solution of lower osmotic pressure, moves into cell, causing them to enlarge
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| show | D5 1/2NS: 5% dextrose in 0.45% sodium
chloride
D5NS: 5% dextrose in 0.9% sodium chloride
D5LR: 5% dextrose in lactated ringers
D10W: 10% dextrose
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| show | NS: 0.9% sodium chloride
LR: lactated ringers
D5W: 5% dextrose in water
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| show | 1/2NS: 0.45% sodium chloride
D2.5W: 2.5% dextrose
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| show | draws fluid across membrane, major force that PULLS fluid from the tissue space to the vascular space
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| show | force within the fluid compartment, major force that PUSHES fluid out of the vascular system
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| show | Osmotic pressure exerted by colloids,protein is a major colloid
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| Facillitated diffusion involves _______ ______ and requires _____ energy. | show 🗑
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| show | the transfer of water and dissolved substances from an area of higher pressure to an area of lower pressure
hydrostatic pressure is the force
pumping action is the heart
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| show | synthesized, secreted, inhibited
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| show | indirect, renin-angiotension
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| Glucocorticoids (cortisol) is released and produced by the ___________, when the body is stressed. Promotes renal _________ of sodium and water. | show 🗑
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| show | stretched by high blood volume or high bp
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| Atrial natriurtic peptide (ANP) lowers blood volume and bp by.... | show 🗑
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| show | cardiac
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| show | vasodilates, decreases release of aldosterone, causes diuresis with excretion of both Na+ and H20
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| show | requires, the chemical adenosine triphosphate
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| show | the movement of molecules into cells without regard for their positive or negative charge and against concentration factors, moves fluids from an area of low concentration to an area of high concentration
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| show | sodium, potassium, calcium, iron, hydrogen, amion acids and glucose
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| During dehydration, the serum osmolality ________; during overhydration the serum osmolality _________. | show 🗑
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| show | Hypothalmus
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| The pituitary store/releases ______ | show 🗑
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| The pituitary releases ADH when... | show 🗑
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| show | decrease ADH, dehydration
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| show | Osmoreceptors in hypothalmus stimulate posterior pituitary to screte ADH->ADH increases tubule permeability -> increase reabsorption of H20 into blood -> Unrine output decreases which causes serum/blood osmolality decreese as the water dilutes fluids
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| Decrese in blood osmolality causes.... | show 🗑
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| show | increasing serum glucose,and has an antiinflammatory effect
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| show | enhancing sodium retention and potassium excretion
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| Normal SG is ______ | show 🗑
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| show | dilute urine. may be caused by excess fluid intake, inability to concentrate unrine
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| SG > 1.025 means... | show 🗑
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| Atrial natruuretic factor (ANF) is released from cells in the atria of the heart in respone to ______ blood volume. ANF suppresses _____, _________, and ____ hormones. | show 🗑
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| Atrial natriuretic factor (ANF) promotes ______ and ______ excretion, vasodialation and ________ inhibition. | show 🗑
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| show | 135-145 mEq/L
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| show | regulate ECF volume and distribution, maintaining blood volume, transmitting nerve impulses and contraction muscles.
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| ____ is the most abundant cation in ECF. | show 🗑
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| Intracellular fluid (ICF) is 2/3 of bodys water and consists of cations that are mostly _______, some ________ and ________. Anions that are mostly _____ and some ________, ________, _______, and ________. | show 🗑
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| show | sodium, potassium, calcium chloride, bicarbonate, phosphate
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| show | Potassium (K+) Calcium (Ca+2) Sodium (Na+) Magnesium (Mg+2)
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| show | Sodium bicarbonate (HCO3-) Chloride (Cl-) Phosphate (PO4-3)
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| Hyponatremia (serum sodium < 135 mEq/L) caused by sodium loss s/s include... | show 🗑
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| Hyponatremia caused by loss of sodium can be caused by... | show 🗑
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| show | CHF, excessive hypotonic IV fluids, primary polydipsia, SIADH, excessive intake of water
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| show | h/a, fatigue, apathy, weakness, confusion, nausea, vomiting, wt.gain, postural hypotenstion, muscle spasms, seizure, coma
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| show | insensible water loss (diarrhea) and perspiration, diabetes insipidus, osmotic diuresis, water deprivation
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| show | intense thirst, dry swollen tongue, restlessness, agitation, twitching, confusion, seizure, coma, weakness, postural hypotension, wt.loss, low urinary output
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| show | intense thirst, restlessness, agitation, twitching, seizure, coma, flushed skin, WEIGHT GAIN, peripheral and pulmonary edema
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| show | IV salin soulutions (D5NS, sodium bicarbonate, excessive NS), primary hyperaldosteronism, saltwater drowning, excessive salt intake
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| Nursing intervention for water/sodium imbalances... | show 🗑
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| Potassium (K+) function | show 🗑
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| show | 3.5-5.0 mEq/L
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| show | dark yellow and orange fruits, avocados, dark green leafy vegetables, sweet potatoes, meat, nuts and pb, cola drinks, instant tea and coffee
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| show | vomiting, diarrhea, fistules, NG suctioning, illeostomy, metabolic alkalosis
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| show | fatigue, muscle weakness, leg cramps, nausea, vomiting, ileus, soft flabby muscles, parethesias, decreased deep tendon reflexes, weak, irregular pulse, polyuria, hypergylcemia, venticular arrhythmia (PVC), bradycardia, enhanced digitalis effect
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| Treatment's of hypokalemia | show 🗑
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| Hyperkalemia (serum potassium > 5.0 mEq/L) can be caused by | show 🗑
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| S/S of hyperkalemia (>5.0 mEq/L) | show 🗑
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| show | calcium gluconate iv, regular insulin and glucose administered iv, sodium bicarbonate, dialysis, sodium polystyrene sulfonate (kayexalate)
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| show | 95-108 mEq/L
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| show | regulate acid base balance, functions with sodium, major component of gastric juice as hydrochloric acid (HCL), acts as buffer in the exchange of O2 and CO2 in RBC's
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| Hypochloremia (< 95 mEq/L) s/s | show 🗑
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| Hyperchloremia (> 108 mEq/L) s/s | show 🗑
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| Sources of chloride (Cl-) | show 🗑
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| Normal calcium total serum includes bound and unbound calcium and is | show 🗑
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| show | coagulation, nerve impulse transmission, contraction and relaxation of skeletal muscles, hormone secretion, normal cell function and memebrane stability,
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| What percent of calcium is in bones/teeth? | show 🗑
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| where is the 1% of calcium in the body located? | show 🗑
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| Calcium sources | show 🗑
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| S/S of hypercalcemia (>10.5 mg/dL or > 5 mEq/L) | show 🗑
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| Normal ionized serum calcium | show 🗑
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| Causes of increased total calcium (hypercalcemia >10.5 mg/dL) | show 🗑
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| show | acidosis
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| show | easy fatigability, depression, anxiety and confusions, numbness & tingling in extremities & around mouth, hyperreflexia, muscle cramps, chvostek's sign, trousseau sign, laryngeal spasm, tetany, seizures
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| Causes of hypocalcemia (< 4.0 mEq/L or < 8.5 mg/dL) | show 🗑
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| Phosphorus is chiefly an __________ anion. | show 🗑
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| Normal phosphorus serum level | show 🗑
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| Phosphorus and ________ have an inverse relationship in the body; an increase in one causes a decrease in the other. | show 🗑
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| show | phosphorus
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| show | essential to function of muscles, RBC's, and nervous system
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| An adequate intake of Vitamin ____ is necessary for the absorption of both calcium and phosphorus | show 🗑
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| Hypophosphatemia (< 2.8 mg/dL) is caused from | show 🗑
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| Hypophosphatemia (< 2.8 mg/dL) S/S | show 🗑
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| show | oral supplement, foods high in phosphorus, may need iv of Na or K phosphate
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| Hyperphosphatemia (> 8.5 mg/dL) may be caused from | show 🗑
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| show | tetany, numbness & tingling around the mouth, and muscle spasms
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| Treatment of hyperphosphatemia (> 8.5 mg/dL) | show 🗑
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| show | energy production, synthesis of essential molecules (protien,DNA), active transport, cell signaling, cell migration-wound healing
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| Normal serum level of magnesium | show 🗑
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| More than half of _________ (electrolyte) is found in bone and muscle | show 🗑
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| Causes of hypermagnesiumia (> 2.5 mEq/L) | show 🗑
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| S/S of hypermagnesiumia (> 2.5 mEq/L) | show 🗑
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| show | prevention/indentify and eliminate cause, EKG monitor, IV CaCl or calcium gluconate, fluids, neuro assessment, discontinue medications that contribute
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| show | diet-malnutrition, drinking ETOH, diarrhea and malabsorption, diabetes mellitus, diuretics, drugs
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| show | hyperactive deep tendon reflexes, tremors, seizures, cardiac arrthymias, confusion
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| show | oral supplements, increase dietary intake
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| show | plasma
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| show | (rare) anorexia, malnutrition, starvation, fad dieting, poorly balanced vegetarian diets
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| show | edema, slow healing, anorexia, fatigue, anemia, muscle loss, ascites
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| Nursing interventions for hypoprotienemia | show 🗑
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| Bicarbonate is a manin anion of the ________ fluid | show 🗑
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| Normal serum level of bicarbonate | show 🗑
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| show | extracellular
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| show | the regulation of the acid-base balance
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| show | homeostasis, hydrogen
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| The hydrogen ion concentration is determined by the ratio of __________ acid to __________ in the extracellular fluid | show 🗑
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| show | PH
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| show | acidic, neutral
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| More hydrogen ions = | show 🗑
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| Less hydrogen ions = | show 🗑
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| ABG's measure | show 🗑
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| show | 7.35-7.45
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| show | 35-45 mm Hg
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| show | 22-26 mEq/L
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| show | 80-100 mm Hg
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| show | 95-100%
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| show | blood buffers, lungs, kidneys
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| Blood buffers work to keep the PH in the range of normal by | show 🗑
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| show | blood & tissues, H+
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| show | speeding up or slowing down respirations, the lungs can increase or decrease the amt. of carbon dioxide in the blood. Responds in minutes to hours
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| The kidneys work to keep the PH in the range of normal by | show 🗑
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| show | any condition that impairs normal ventilation, perfusion, or diffusion
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| show | a retention of carbon dioxide occurs with a resultant increase of carbonic acid in blood; PH < 7.35; PaCO2 > 45mg; HCO3 normal early on then it increases
Compensation: kidneys retain HCO3
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| Respirtory Acidosis causes | show 🗑
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| show | lethargy, disorientation, occipital h/a, decrease deep tendon reflexes, dizziness, tremors, weakness, tachycardia, hypertension, dyspnea
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| Treatment of respiratoy acidosis | show 🗑
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| show | an increase in respratory rate, depth, or both that results in loss of excessive amounts of carbon dioxide with a resultant lowering of the carbonic acid level in the blood.
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| ABG results of respiratory alkalosis | show 🗑
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| show | hyperventilation, anxiety, fear, head injuries, ASA overdose, pneumonia, disorders of the CNS, hypoxia, high fever, pulmonary emboli
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| show | anxious appearance, irritability, numbness & tingling of the hands/toes, fainting, dizziness, tachypnea, cardiac arrhythmias, tetany, muscle weakness, chest tightness & palpations
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| Treatment of respiratory alkalosis | show 🗑
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| show | a gain of hydrogen ions or a loss of bicarbonate: retaining too many acids or losing too many bases
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| show | PH < 7.35
PaCO2 Normal
HCO3 < 22mEq/L
Compensation: lungs excrete CO2
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| Metabolic acidosis cause's | show 🗑
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| Clinical S/S of metabolic acidosis | show 🗑
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| show | reverse underlying cause, administer Na HCO3, insulin
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| show | when a significant amount of acid is lost from the body or an increase in the bicarbonate level
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| show | PH > 7.45 HCO3 > 24mEq/L PaCo2 Normal Compensation: lungs retain CO2
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| Metabolic alkalosis cause's | show 🗑
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| Clinical S/S of metabolic alkalosis | show 🗑
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| Treatment of metabolic alkalosis | show 🗑
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| PH 7.29 PaCO2 54 HCO3 25 What is this? | show 🗑
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