Card Set Information

2012-09-01 12:58:11
chapt med surg

electrolytes, fluids, acid and bases
Show Answers:

  1. The process by which a solute moves from an area of higher concentration to an area of lower concentration is
  2. a fluid that has the same osmolarithy as blood is said to be

    ex: normal saline
  3. a fluid that has a higher osmolarity than blood is said to be
  4. a decrease in blood volume
  5. electrolytes in the blood that have a positive charge
  6. the patient with an excess of sodium in the blood has
    hypernatremia/ sodium imbalance
  7. not enough potassium in the blood has

    muscle weakness; weak pulse
  8. not enough calcium in the blood

    kidney stones; muscle weakness
  9. this occurs when the ph level falls below 7.35
  10. if the serum ph is too high the condition is called
  11. fluid balance and mental status changes
    hyponatremia/sodium imbalance
  12. muscle cramps; irregular heartbeat
  13. osteoperosis; hyperactive reflexes
  14. which of the following intravaneous solutions is hypotonic? a) normal saline b)0.045% saline c) ringers Lactate d) 5% dextrose in normal saline
    B) 0.045% saline
  15. which of the following hormones  retains sodium in the body? a) antidiuretic hormones b)thyroid hormone c) aldosterone d) insulin
    c)  Aldosterone
  16. which food should be avoided by the patient on a low sodium diet?  apples, cheese, chicken, broccoli
  17. which food is recommended for the patient who must increase intake of potassium? Bread, egg, potato, cereal
  18. which is the best way to monitor fluid balance? daily intake/output; daily weight; vital signs; skin turgor
    daily weight
  19. elderly patient goes to the ER with severe vomiting, diarrhea, sweating, and rapid heartbeat, but has normal temperature, what should the nurse 1st suspect? Hypervolemia; dehydration; edema; hyponatremia
  20. which patient is most at risk for fluid volume overload? 40 yo meningitis; 35 kidney failure; 60 psoriasis; 2 yo influenza
    35 year old with kidney failure
  21. an elderly patient shows signs of dehydration and has become confused; which electrolyte imbalance is most likely involved
  22. what percent of an adults body weight is water
  23. what percent is elderly body weight is water
  24. infants and children body weight of water
  25. examples of electrolytes
    • sodium
    • potassium
    • calcium
    • magnesium
    • acids
    • bases
  26. water that surrounds the bodys cells and includes lymph
  27. fluid with arteries veins and capillaries
    intravascular fluid or blood plasma
  28. fluids in specific compartments of the body such as cerebralspinal fluid digestive juices and synovial fluid in joints
  29. a substance that causes kidneys to excrete more fluid
    antidiuretic hormone
  30. a solution that has a lower osmolarity than blood
    ex: when the water in the solution leaves the blood and other ECF areas  and enters the cell 
  31. When the solutions exert greater osmotic pressure than blood.

    EX: when given to a patient water leaves the cells and enters the bloodstream and other EFC spaces
  32. not enough fluid in the body especially in the blood; fluid deficit
  33. common causes of dehydration
    • diarrhea
    • profuse diaphoresis sweating
    • vomiting
    • hemorrhage
  34. hypovalemia can also occur when fluid fromt he intravascular space moves into the interstitial fluid space.
    third spacing
  35. examples of third spacing
    • burns
    • cirrhosis of the liver
    • extensive trauma
  36. a substance tha causes the kidneys to excrete more fluid
    ADH antidiuretic hormone
  37. signs/symptoms fluid imbalance

    blood volume decreases; thirst;  heart pumps fast not powerfully; LBP; decrease tear formation; dry skin ;dry mucous membranes; poor turgor

    30ml/hour input/output
  38. Signs/symptoms fluid imbalances

    blood volume increases; BP increases; pulse pounding; neck veins distended respirations increased shallow; skin pale cool; pitting edema(swelling) kidney increase urine output urine diluted; gains weight
  39. signs/syptoms electrolyte imbalances

    sodium  /  hyponatremia
    cation maintains serum osmolarity; ECF; sodium level below 135 mEq/l; decrease serum;mental status change; disoriented; weakness; nausea; vomiting
  40. signs/symptoms electrolyte imbalance

    sodium  /  hypernatremia
    cation; ECF; level above 145 mEq/l; thirst; mental status change; aggitation(highly); seizure; skeletol muscle weakness; respiratory failure
  41. Signs/symptoms electrolyte imbalance

    potassium / hypokalemia (k+)=kalemia
    Metabolic Alkolosis (98%ICF  2% ECF)
    • deficit blood range below3.5 mEq/l; cation
    • muscle cramps; vital signs diminish;shallow ineffective respirations; weak pulse; cardiac arrest; BP drops when stands up; altered mental status
  42. Signs/symptoms electrolyte imbalance

    potassium / hyperkalemia (k+)=kalemia Metabolic Acidosis (98%ICF  2% ECF)
    blood range higher than 4.5 mEq/l; cation; twitches; low BP; cramps; diarrhea; mucsle weakness; slow irregular heart rate

    • meds-kayexalate; spironolactone(aldactone)
    • ph is less 7.35 (acidic)
  43. signs/sypmtoms electrolyte imbalance

    calcium/hypocalcemia (ECF) cation lower 4.5 mEq/l
    drug: aluminum hydroxide
    • chronic HC - broken hip Actue HC surgery pancreatitis; increased irreg heart Rate; mental status change; hyper active deep tendon reflexes; seizures
    • 2 classic signs; trousseau -bp cuff 1-4 min
    • chvostek - cheek tap face twitching
  44. signs / symptoms electrolyte imbalance

    calcium / hypercalcemia (ECF) cation ^5.5mEql  drug:hydrochlorothiazide
    • increased heart Rate; BP; skelotol muscle weakness; decreased GI motility
    • Kidney stones (renal or urinary calculi) muscle weakness; heart failure (Dysrhythmia)
  45. Signs / symptoms electrolyte imbalance

    magnesium  / hypomagnesmia <1.5 mEq/l
    • malnutrition; starvation; severe diarrhea; chrones disease; alcholism; certain drugs;
    • trousseau signs -bp cuff 1-4 min twitching
    • chvostek signs -  tap cheek facial twitching
  46. signs  symptoms electrolyte imbalance

    Magnesium / hypermagnesmia ^2.5 mEq/l cation
    bradycardia; dysrythmia; hypotension; lethargy; drowsiness; skeletol muscle weakness; coma respiritory failure; cardiac failure
  47. signs symptoms acid base imbalance

    respiratory acidosis (lungs)CNS Muscleskeletol system
    acidic condition; altered mental status; polonged confussion; lethargy; coma; resp shallow; muscle weakness
  48. signs symptoms acid base imbalances

    metabolic acidosis
    • severe diarrhea; prolonged intestinal suction
    • s/s same as resp acidosis w/exception of resp pattern the lungs compensate by getting rid of extra carbon diox through deep rapid resp.
  49. signs / symptoms acid base imbalances

    respiritory alkolosis
    hyperventilation; anxious; fearful; rapid shallow resp; light headed; confused; HR increases; pulse weakens
  50. signs symptoms acid base imbalances

    metabolic alkolosis (hypokalemic) Low k+
    • muscle cramps; shallow respiration; pulse weak; irregular thready; cardiac arrestl hypotension
    • trousseau signs
    • chvosteks signs
  51. list types of shock
    • hypovolemic
    • cardiogenic
    • extracardiac obstuctive
    • distributive shock (3)
    •    anaphalactic
    •    septic
    •    neurogenic
  52. signs / symptoms shock
    • tachycardi-decreased cardiac output
    • tachypnea - decreased tissue oxygenation
    • hypotension
    • oliguria- reduced blood to kidney
    • cyanosis
    • altered mental status
    • cool clamy - reduced blood to the skin
    • pallor reduced blood volume
  53. nursing interventions for shock patients
    • Airway
    • breathing resp support
    • cardiovascular support
    • circulatory volume
    • control bleeding
    • assess neurologic status
    • treat life threating injury
    • determine treat shock
  54. nursing assessment /intervention

    maintain airway; give oxygen; monitor vital signs; I/O adequate fluid intake; elevate head if sob; provide quiet restful environment
  55. nursing assessment / intervention

    monitor heart rate; cardiac rythym with ekg; assess skin nailbeds and or give meds and ox ordered
  56. sever loss of body fluid; dehydrationl int/ex hemmorrhage; fluid loss; burns; vomiting; diarrhea; trauma; heat exhaustion; heat stroke; sweating

    s/s restlessness; pale; cool; clamy; decreased jugular vein; A.M.S. inc BP
    hypovolemic shock
  57. heart fails as a pump; (AMI) acute myocardio infarction- occurs in 5-10% of pat; dystended neck veins ; heart failure; pulmonary edema(swelling)
    cardiogenic shock
  58. blockage of blood flow in cardivascular circuit outside heart