Fluids and Electrolytes

Gwen Paparone
Flashcards by Gwen Paparone, updated more than 1 year ago
Gwen Paparone
Created by Gwen Paparone almost 4 years ago
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NCLEX NURSING 110 (Exam 2 ) Flashcards on Fluids and Electrolytes , created by Gwen Paparone on 10/06/2016.

Resource summary

Question Answer
What is the primary body fluid? Water
What is the adult water weight %? 55-60% water
How much weight loss results from 10% body fluid loss? SERIOUS- 8 %
How much weight loss results from 20% body fluid lost? FATAL- 15% weight loss
What is the average amount of fluid gained and lost every day? 2-3 Liters
What is the minimum output per hour necessary to maintain renal function? 30 ml/hr
Examples of fluid intake? PO fluids/Tube Feeding IV Fluids Blood and Blood products
Examples of Output? Urine Vomit Blood Drainage
Osmolarity Concentration of particles in a solution
Posterior pituitary releases ADH (anti diuretic hormone) in response to increased serum osmolarity- causes renal absorption of water.
Normal Serum osmolarity? 280-295 mosm/kg
What increases the osmotic pressure? Increased osmolarity
Hypothalamus Triggers Thirst mechanism in response to increased serum osmolarity
Renal Regulation nephron receptors sense low osmolarity (pressure) and secrete renin
Renin stimulates production of angiotensin I- followed by angiotension II
Angiotensin II causes Na and h20 retention by kidneys. Stimulates the adrenal cortex.
Adrenal Cortex Secretes aldosterone when stimulated by angiotension II.
Aldosterone Secreted by the adrenal cortex following angiotension production. - Causes kidneys to secrete Potassium (k) and retain Na and H2o.
Hypertonic High osmolarity (More than serum)
Hypotonic low osmolarity (less than serum)
Isotonic Equal osmolarity to the normal serum level
What are Isotonic imbalances? When water and sodium levels have decreased or increased in volume but osmolarity is maintained.
Fluid Volume Defecit (FVD) AKA hypovolemia Fluid volume low
Causes of FVD decreased water or salt intake Increased output hemorrhage, burns Increased sweating
Assessment of FVD Weight loss, Postural hypotension, Thready pulse, Dry mucous membranes- poor turgor, dark urine, thirst, restlessness, confusion, oliguria, cold clammy skin, hypotension,
Labs for FVD Increased hematocrit (hCt) and BUN
Normal Hemoglobin labs women 12-16g/100mL men 13-18g/100mL
Normal Hematocrit Labs Women 40-48% Men 42-50%
Normal Blood urea nitrogen labs 10-20mg/dl
Normal Serum creatinine 0.7-1.2mg/dl
Fluid Volume Deficit Nursing Diagnosis Examples Defecit fluid volume related to excessive fluid loss Risk for hypovolemic shock Risk for injury related to dizzyness Risk for impaired skin integrity
FVD interventions Isotonic fluids and medications as ordered Reassessment I's and O's and lab results Comfort measures
Etiology of FVE Excessive administration of isotonic fluids Renal retention of sodium and water Heart failure, cirrhosis, aldosterone excess
FVE Assessment Sudden weight gain Dependent Edema NVD Pulmonary edema Decreased Hct and BUN
Hypernatremia Loss of more water than salt or gain of more salt than water
What would the serum sodium level be for a patient with hypernatremia? Sodium above 145 mEq/L
What would the serum osmolality be for a patient with hypernatremia? Serum osmolality above 300 mOsm/kg
Hyponatremia Gain of more water than salt or loss of more salt than water
What would the serum sodium levels be for a patient with hyponatremia? Sodium levels below 135 mEq/L
What would the serum osmolality be for a patient with hyponatremia? Serum osmolality below 280 mOsm/kg
What osmolality imbalance is associated with ADH deficiency and why? Hypernatremia. Because ADH is an anti diuretic hormone and without it the body would not retain as much water.
What osmolarity imbalance is associated with an excessive amount of ADH? Hyponatremia. Because the body retains more water.
What neurological symptom is a risk in both hyponatremia and hyponatremia? Seizures. Especially when severe or sudden.
Clinical dehydration A combination of volume and osmolarity imbalance. Water intake is less than output.
What osmolarity imbalance would be found in dehydration? Hypernatremia
What symptoms are common with dehydration? Commonly causes Fever. Commonly caused by severe vomiting or diarrhea.
Electrolytes Solutes measured in mEq units. Sodium Potassium Calcium Magnesium
Sodium ranges 135-145 mEq/L (ECF)
Potassium Ranges 3.5-5.5 mEq/L (ICF)
Calcium Ranges 8.5- 10.5 mg/100ml Or 4.5-5.5 mEq/L
Magnesium Ranges 1.5-2.5 mEq/L
Anions Chloride (Cl) Phosphate (Po4) Bicarbonate(HCO3-)
Chloride levels 95-105 mEq/L
What is the chief electrolyte in the ECF? Sodium
Role of sodium Regulate volume of bodily fluids Needed for nerve impulses and muscle Fiber transmission
What regulates sodium levels? The kidneys/ Hormones
What is the chief electrolyte in the ICF? Potassium (K)
Roles of Potassium? Major mineral in all cellular fluids Aids in muscle contraction Regulates enzyme activity Assists in acid base balance Regulates IC H20 Content
Hypokalemia Serum Potassium level < 3.5 mEq/L
What causes hypokalemia? Decreased intake loss via GI/Renal and potassium depleting diuretics
What are some effects of hypokalemia? Life threatening. Muscle weakness- cramps Decreased GI motility, Arrythmias
What are some treatments for hypokalemia? diet Supplements IV therapy
Hyperkalemia Serum Potassium levels >5 mEq/L
What causes hyperkalemia? Excessive intake trauma crush injuries Burns Renal Failure
What are signs and symptoms of hyperkalemia? Muscle weakness, arrhythmias, N/V (nausea/vomit) Parathesias of face.fingers/tongue
What are the treatments for hyperkalemia? Diet supplements IV therapy
What are the normal ranges for calcium? 4.5-5.5 mEq/L or 8.5-10.5 mg/1ooml
What is the most abundant electrolyte in the body? Calcium
What percentage of total body calcium is present in the teeth and bones? 99%
What are some of the functions of calcium? Nerve transmission Vitamin B12 Absorption Muscle Contraction Blood Clotting
What electrolyte does calcium have an inverse reaction with? Phosphorus
What vitamin is needed for Ca absorption? Vitamin D
What are the serum levels for hypocalcemia? < 4.3 mEq/L
What are the causes of hypocalcemia? Low intake Loop diuretics Parathyroid disorders Renal Failure
What are the symptoms of hypocalcemia? Osteomalacia EKG changes Numbness in fingers muscle cramps tetany Chovstek sign Trousseau sign
What are the treatments for hypocalcemia? Diet and IV therapy
Chovstek Sign Wincing when cheek is poked sin of hypocalcemia
Trousseau's sign Hand fasiculations when BP cuff is inflated
Hypercalcemia Serum Levels > 5.3 mEq/L
What causes hypercalcemia? Hyperparathyroidism cancers prolonged immobilizations
Signs and symptoms Muscle weakness renal calculi Fatigue Altered LOC Decreased GI motility Cardiac Changes
Treatment for Hypercalcemia Medication IV therapy
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