Card Set Information
Fluids electrolytes hazards pain
Fluids and electrolytes
affected by urea, creatine and uric acid
Hypervolemia- excess fluid which can cause edema (water is pulled from cells) causing accumulation of fluids in interstitial spaces.
may be caused by malfunctioning kidneys, failure of heart to pump
Edema can be around eyes, finers, ankles, sacral area and in or around organs
More water than Na...
0.45% NaCl (1/2 strength of NS)
D5W hypotonic in BODY
WATER moves From lOw solute concentration to high solute concentration
Caused by; GI losses, water intox. psychogenic polydipsia, hypoglycemia, SIADH, use of diuretics.
: coma, cerebral edema, muscle twiches, R & W
: Na replacement: water restriction, 0.9 NS LR ISO, lasix for SIADH.
increased Aldosterone causes?
Sodium & Water retention, K+ Loss
Secretes parathyroid hormone--> regulates Ca and Phosphorus
"PULLING force" back into capillaries
: GI loss, decreased fluid intake. Risk factors; DI, adrenal insufficiency, hemorrhage, coma
water out of cells, cells shrink
osmolarity >300 mOsm/L
reflects the concentration of fluids that affects the movement of water between fluid compartments by osmosis
"pusHing force" out of capillaries into interstitial tissues.
Chloride, bicarb, phosphate, and sulfate
0.9% NaCl (NS)
D5W (5% DEXTROSE IN WATER)
Higher concentration of solutes.
5% Dextrose in .45% NaCl
10% Dextrose in water
5% dextrose in 0.9% NaCl (NS)
ONLY insulin you can give IV
drugs ability to INITIATE BIOLOGIC ACTIVITY as a result of binding to receptor site.
combines with recpetors and initiates biochemical and physiologic changes.
Treatment for allergic reactions?
Epi- stimulates alpha and beta-adrenergic receptors causing
and relieving congestion in bronchial mucosa and pulmonary vessels.
what drugs must be always be checked with a second nurse?
thirst factor driven by?
decreased BVol & intracellular dehydration
located in hypothalamus (makes ADH)
Na-142- 146- 15
K- 5- 5- 150
Ca- 5- 3- 27
Mg- 2- 1- 27
: excess water loss (water deprivation) or excess NA intake (hypertonic),
, excess insensible water loss (heatstroke).
increased Temp & Thirst,
r & w
: 0.3 NaCl, D5W
: GI losses, starvation, DEcrease in
., use of diuretics.
: K replacement (IV PO), K diet: milk, eggs, grain, coffee, tea, fruits, veggies. Ca Gluconate (severe), monitor
Caused by renal failure,
aldosteronism, Addisons Disease, Burns, meds such as K Cl-, ACE inhibitors, NSAIDs, K sparing diuretics. Pseudohyperkalemia, acidosis.
weakness and paralysis, dysrhythmias, anxiety
occurs < hypokalemia, but this is more dangerous.
: Kayexalase, EKG, Dialysis, Limit K diet, IV Ca gluconate
EFC < 8.6 mg/dL
parathyroidism, excess Ca loss, pancreatitis.
. Numbness/tingling of fingers, mouth, feet.
Trousseau & Chevosteks
sign, seizures, mental changes,
: Vit D,
in D5W Bolus,
weight bearing excerises
Severe is life threatning
EFC >10.5 mg/dL
: cancer and
parathyroidism, bone loss due to immolbilization, Excess
Vit D & Ca
(NM) Cardiac arrest,
muscle weakness, slurred speech/confusion, deep bone pain, polyuria, N & V
: 0.9 NaCl, Lasix, PO4++, encourage walking, 3-4 L/daily fluids, monitor
< 1.5 mEq/L
: GI losses, Chronic alcoholism,
, Decreased K and Ca, HYPER: parathyroidism & aldosteronism, malabsoption, diuretics
: NM irritability,
weakness, seizures, heart block, DTRs, resp paralysis, Trousseau & Chevostecks, Increased BP
: Diet high in Mg: green leafy veggies, nuts, grains, seafood.
> 2.5 mEq/L
, excessive Mg intake, DKA, hypothyroidism, loss of DTRs
. N&V, weakness,
Dc BP, resp depression
. Flushed skin.
: Ca Gluconate, NaCl LR, Lasix
< 1.8 mEq/L
: Decreased K, Mg, Vit D, hyperventilation,
: NM. Cardiomyopathy, resp failure, seizures, confusion, bone pain, muscle weakness
: Sodium Phosphase, potassium phosphate, milk
> 2.6 meq/L
, excess Vit D & phosphate, chemotherapy
: tetany, muscle spasms/weakness, tachycardia
: Renegel (binds to phosphate to excrete it in GI), avoid laxatives and enemas.
< 96 mEq/L
: Addisons disease, Loss of Na & K cause Cl loss, diuretics
muscle cramps, tetany, seizures, coma, shallow resp
: 0.45 NS, avoid free water, Cl- diet
> 108 mEq/L
: Ic Na (Cl- follows Na),
, Dc cardiac output, tachycardia, coma, edema, dysrhythmias.
: diuretics (lower Na, lowers Cl), hypotonic IV LR, sodium bicarb
K replacement: peripherally & centrally?
NEVER GIVE K+ IV PUSH
No more than 40 mEq/L peripherally
No more than 60 mEq/L centrally
Max 10 mEq/Hr peripherally
Max 20 mEq/Hr centrally