Fluid and Electrolytes Pt II
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In a pt with a protien deficiency, what kind of diet should be prescribed and why?
Diet high in protien and carbs. This way the carbs will be used as energy and the protien will be spared to build muscle
What can cause a fluid shift from plasma to intersitial fluid?
- Increased capillary hydrostatic pressure
- Decrease plasma protein
- Increase cap. permeability
What is a manifestation of a fluid shift?
What are S/S of shock?
- low bp
What can cause a fluid shift from interstitial to plasma?
- Decrease in cap. hydrostatic pressure
- Increase in colloidal osmotic pressure
- Re-mobilization of fluid following burns or trauma
What are the manifestations of a interstitial to plasma fluid shift?
Symptoms of fluid overload: BP will go up, kidney will excrete a lot, urine will be dilute, Bounding heart beat, (if hypoxic… tachycardia), and anytime you have a pt in fluid overload…. Assess lungs for pulmonary edema
Hyperosmolar conditions cause the cells to ______. Hyperosmolar conditions are caused by?
- Decreased water intake
- extracellular solute excess
- *manifests itself as dehydration symptoms
What would you do for a pt who is hypo osmolar?
- IV Isotonic solution
- Utilize oral liquids with electrolytes
Pt is experiencing isotonic dehydration, the nurse expects to find the pts sodium level to be….
Within Normal Limits
- Used to describe the distribution of body water
- First Spacing – normal distribution of ICF and ECF
- Second Spacing – abnormal accumulation in interstitial space (edema)
- Third Spacing – is trapped fluid and essentially unavailable. It is a distributional shift of fluid in a space that is not easily exchanged with the ECF (peritonitis)
- Pseudo: Do not treat. Redraw blood.
- Example: when pts finger is milked after a fingerstick and K level is high and “hemolyzed” means it is false and must be redrawn
What is the normal range of BUN
Normal Hematocrit for male and female
- Normal Hematocrit Male: 43-49
- Normal Hematocrit Female: 38-45
An elevated BUN is reflective of what?
- renal disease or dehydration.
- To decide between the 2…. If creatinin is normal… its dehydration. If creatinin is elevated=renal failure
What is the normal Osmolarity of urinalysis
The pH of urine is
- This should fluctuate; if it doesn't, that is indicative of renal disease.
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