Chapter 36 ppt Fluids & Electrolytes

Card Set Information

Author:
tford7
ID:
81802
Filename:
Chapter 36 ppt Fluids & Electrolytes
Updated:
2011-04-26 22:40:54
Tags:
Chapter ppt Fluids Electrolytes
Folders:

Description:
Chapter 36 ppt Fluids & Electrolytes
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user tford7 on FreezingBlue Flashcards. What would you like to do?


  1. ICF fluids
    Intracellular fluids (within the cells)
  2. ECF fluids
    Extracellular fluids (Interstitial or intravascular)
  3. Tissue fluid; the fluid between cells, in tissue spaces
    Interstitial fluid
  4. That portion of the total body fluid contained within blood and lymphatic vessels
    Intravascular fluid
  5. True or False: Movement through selectively permeable membranes does so to maintain homeostasis
    TRUE!
  6. In regards to fluid intake, the Institute of Medicine recommends ___ mL/day
    2700
  7. __% of fluid is taken in from food and metabolism
    20
  8. ___ is a major regulator of fluid intake
    Thirst
  9. What is the main intake method of fluids?
    Drinking them
  10. What is the normal amount of fluid elimination through urine daily?
    1500mL/day
  11. What is the normal amount of fluid elimination through feces daily?
    100-200 mL/day
  12. What are the two types of insensible loss of fluids?
    • Skin - perspiration
    • Lungs - Exhalation
    • Note* Patients with pneumonis, COPD, fevers, etc. are losing a larger amount of fluids upon exhalation due to their excessive respiration. It is important to monitor these patients.
  13. A hormone that increases the reabsorption of sodium and water and the release (secretion) of potassium in the kidneys
    Aldosterone
  14. This increases blood volume, and therefore increases blood pressure
    Aldosterone
  15. Commonly referred to as arginine vasopressin; is a 9 amino acid peptide secreted from the posterior pituitary
    Antidiuretic hormone (ADH)
  16. The excretion of abnormal amounts of sodium in the urine
    Natriuresis
  17. One of the peptides that causes natriuesis
    Natriuretic Peptides
  18. The arrangement of blood vessels in the body or any part of it, including their relationship and functions
    Vasculator
  19. This is produced by the heart and vasculator
    Natriuretic Peptides
  20. Secreted largely by the atrial myocardium in response to dilation
    A-type natriuretic peptides
  21. Manufactured mainly by the ventricular myocardium
    B-type natriuretic peptides
  22. Produced by endothelial cells that line the blood vessels
    C-type natriuretic peptides
  23. Acidosis due to excess ketone bodies; it occurs in individuals who do not produce adequate insulin to sustain normal fat metabolism
    Ketoacidosis
  24. A decreased blood volume that may be caused by internal or external bleeding, fluid losses, or inadaquate fluid intake
    Hpyovolemia
  25. 2 Risk factors of fluid volume deficit
    • 1. Hypovolemia
    • 2. Dehydration
  26. A result of fluid volume deficit: An abnormally rapid heart rate, greater than 100bpm in adults
    Tachycardia
  27. A result of fluid volume deficit: A fine, scarcely perceptible pulse
    Thready pulse
  28. A result of fluid volume deficit: A decrease of the systolic and diastolic pressure to below normal
    Hypotension
  29. A result of fluid volume deficit: Abnormally rapid respiration
    Tachypnea
  30. A result of fluid volume deficit: An oxygen deficiency in body tissues
    Hypoxia
  31. The following are a result of what?
    Thirst, dry furrowed tongue, nausea, vomitting, acute weight loss, weakness, confusion, dizziness, cool clammy skin, sunken eyeballs, flattened neck veins:
    Fluid volume deficit
  32. A result of fluid volume deficit: Urinary output of less than 400mL/day; this can result in renal failure if it is not reversed
    Oliguria
  33. A result of fluid volume deficit: Transient loss of consciousness accompanied by an inability to maintain an upright posture
    Syncope
  34. A result of fluid volume deficit: Profuse sweating
    Diaphoresis
  35. Hct stands for ___.
    Hematocrit
  36. Laboratory findings that support fluid volume deficits are:
    Increased Hct, Osmolality greater than 300, increased sodium; specific gravity of urine increased
  37. Lab finding in support of fluid volume deficit: Osmotic concentration; the characteristics of a solution determined by the ionic concentration of the dissolved substances per unit of solvent
    Osmolality
  38. 2 risk factors of fluid volume excess:
    • 1. Hypervolemia
    • 2. Overhydration
  39. An abnormal increase in the volume of cirrculating blood
    Hypervolemia
  40. A result of fluid volume excess: An abnormally rapid heart rate, greater than 100bpm in adults
    Tachycardia
  41. A result of fluid volume excess: A pulse that reaches a higher intensity than normal, then disappears quickly; best detected when the arm is held aloft
    Bounding pulse
  42. A result of fluid volume excess: Abnormally high BP in relation to the patient age and condition
    Hypertension
  43. The following are a result of what?
    Confusion, muscle weakness, crackles, weight gain, edema, distended neck veins:
    Fluid volume excess
  44. A result of fluid volume excess: The abnormal accumulation of fluid in the peritoneal cavity
    Ascites
  45. A result of fluid volume excess: Abnormally rapid respiration
    Tachypnea
  46. A result of fluid volume excess: Air hunger in labored or difficult breathing, sometimes accompanied by pain
    Dyspnea
  47. A result of fluid volume excess: Labored breathing that occurs when lying flat and improves when standing or sitting up (classic symptom if left ventricular heart failure - can also occur in other cardiac or respiratory illnesses)
    Orthopnea
  48. Laboratory findings that support fluid volume excess:
    • Decreased Hct, electrolytes, BUN, Creatinine, Osmolsrity (less than 270 Mosm/L)
    • ABG: Respiratory alkalosis = pH > 7.45, PaCO2<35mmHg
    • Chest x-ray = pulmonary congestion
  49. 3 types of fluid replacements:
    • 1 Isotonic
    • 2 Hypertonic
    • 3 Hypotonic
  50. Type of fluid replacement: Same solute concentration, expands vascular volume:
    Isotonic (administered thru IV normal saline, Lactated Ringers, blood, etc.)
  51. Type of fluid replacement: Higher solute concentration - pulls fluid into the blood stream and out of the cells - increases vascular volume
    Hypertonic (treated with Albumin, Dextran - large molecules that expand volume)
  52. Type of fluid replacement: Lower solute concentration - pulls fluid into the cells and out of the blood stream - decreases vascular volume
    Hypotonic (treated with .45% saline, D5W)
  53. A nurse is collecting data from an older client who states he has had vomiting and diarrhea for he last 48 hours. What findings should indicate to the nurse that the clients is hypovolemic? (Select all that apply)
    a. Bradycardia
    b. Hypertension
    c. Tachypnea
    d. Furrowed tongue
    e. Sunken eyeballs
    c, d, e
  54. A nurse is providing teaching about a healthy lifestyle for a group of young adults who are training for a marathon. What should the nurse include in the teaching session?
    A. Decrease fluid intake after training
    B. Increase intake of fluids containing caffeine
    C. Decrease fluid intake in high altitudes
    D. Increase fluid intake in dry climates
    D. Increase fluid intake in dry climates
    (this multiple choice question has been scrambled)
  55. A nurse on a medical-surgical unit has been assigned to care for four clients. Which of the following clients is at risk for fluid volume excess (hypervolemia)?
    A. A client who is 4 hours poetoperative and is receiving nasogastric suction
    B. A client who has lost 500mL of blood during surgery
    C. A client who is receiving a loop diuretic
    D. A client who has heart failure
    D. A client who has heart failure
    (this multiple choice question has been scrambled)
  56. Salts and minerals are examples of what?
    Electrolytes
  57. ___ regulate fluid balance, strengthen skeletal structures, and act as catalysts for conduction, contraction, and metabolism
    Electrolytes
  58. Electrolytes are distributed in the ___ & ___.
    ICF and ECF
  59. ___ can be measures within the plasma but not within the cells.
    Electrolytes
  60. What is the normal range of sodium in the blood?
    135-145mEq/L
  61. What is the major electrolyte in the ECF?
    Sodium
  62. True or false: Sodium is reabsorbed in the pancreas.
    FALSE! Sodium is reabsorbed in the kidney
  63. True or False: Sodium regulates the fluid volume.
    TRUE!
  64. ___ is essential for active and passive transport mechanisms.
    Sodium
  65. True or False: Sodium is essential for irritability and conduction of nerve and muscle tissue, and maintaining acid-base balance.
    TRUE!
  66. What are some of the major sources of sodium?
    table salt, cheese, milk, butter, ketchup, nuts, canned products, etc.
  67. A decreased concentration of sodium in the blood.
    Hyponatremia (NA+ < 135mEq/L)(Osmolarity < 280)
  68. In regards to electrolyte imbalances, what are the following indicitive of?
    Anorexia, nausea, vomiting, weakness, lathargy, confusion, muscle cramps or twitching, and seizures
    Hyponatremia
  69. What are the treatment options for hyponatremia?
    Monitor I&O, Monitor sodium level, Increase oral sodium intake, Administer IV saline infusion if severe (hypertonic then isotonic therapy)
  70. What are some common causes of hyponatremia?
    Diuretics, GI fluid loss, Adrenal insufficiency, Excessive intake of hypotonic solutions such as water or D5W IV fluids
  71. An elevated concentration of sodium in the bloodstream.
    Hypernatremia (Na+ > 145mEq/L)(Osmolarity > 300)
  72. In regards to eletrolyte imbalances, what are the following indicitive of?
    Thirst, elevated temperature, dry mouth, sticky mucous membranes; if severe --> hallucinations, irritability, lethargy, seizures
    Hypernatremia
  73. What are the treatment options for hypernatremia?
    Monitor I&O, Monitor sodium lever, Monitor vital signs and level of consciousness, Restrict sodium in the diet, Beware of hidden sodium in foods and medications, Increase water intake, Administer IV solutions that do not contain sodium (Hypotonic then Isotonic therapy)
  74. What are some common causes of hypernatremia?
    Excessive sodium intake, Water deprivation, Increased water loss through profuse sweating, heat, stroke, or diabetes insipidus, Administration of hypertonic tube feeding
  75. What is the normal range for potassium?
    3.5-5.0mEq/L
  76. ___ is a major cation in the ICF
    Potassium
  77. True or False: Potassium is eliminated by diaphoresis.
    FALSE! Potassium is eliminated by the kidneys
  78. True or False: Potassium has a reciprocal action with sodium.
    TRUE!
  79. ___ is essential for cell metabolism, transmission of nerve impulses, functioning of cardiac, lung, and muscle tissue, and acid-base balanve
    Potassium
  80. What are some major sources of potassium?
    Avacados, broccoli, dairy products, dried fruit, oranges, cantalope, bananas, chocolate, potatoes, tomatoes
  81. An abnormally low concentration of potassium in the blood
    Hypokalemia (K= < 3.5mEq/L)
  82. In regards to electrolyte imbalances, what are the following indicitive of?
    Fatigue, Anorexia, Nausea, Vomiting, Muscle weakness, Decreased GI motility, Dysrhythmias, Paresthesia, Flat T wave on ECG, Increased sensitivity to digitalis
    Hypokalemia
  83. What are some common causes of hypokalemia?
    Diuretics, GI fluid loss through vomiting, gastric suction, or diarrhea, Steroid administration, Hyperaldosteronism, Anorexia, or Bulimia
  84. What are the treatment options for hyopkalemia?
    Monitor potassium level, If client is taking digoxin-monitor pulse and observe for toxicity, Encourage foods rich in potassium, Administer potassium supplements (*note: IV supplements must be well diluted and asministered slowly; never give bolus)
  85. An excessive amount of potassium in the blood
    Hyperkalemia (K+ > 5.0mEq/L)
  86. In regards to electrolyte imbalances, what are the following indicitive of?
    Muscle weakness, Dysrhythmias, Flassid Paralysis, Intestinal colic, Tall T waves on ECG
    Hyperkalemia
  87. What are some common causes of hyperkalemia?
    Renal failure, Potassium-sparing diuretics, Hypoaldosteronism, High potassium intake coupled with renal insifficiency, Acidosis, Major trauma, Hemolyzed serum sample produces pseudohyperkalemia
  88. What are the treatment options for hyperkalemia?
    Monitor potassium level, Caution about potassium-rich food intake in patients with elevated creatinine levels, Cautiously administer IV potassium supplements, If severe, monitor ECG; prepare to administer a cation exchange resin and glucose and insulin, Renal dialysis may be required
  89. What is the normal range for calcium?
    9.0-10.5mg/dL
  90. ___ is essential for blood clotting, bone and teeth formation, cardiovascular/neuromuscular/endocrine function
    Calcium
  91. True or False: Chronic insufficiency of calcium leads to osteoporosis.
    TRUE!
  92. What are some major sources of calcium?
    Dairy products, green leafy veggies, fish, etc.
  93. Abnormally low blood calcium
    Hypocalcemia
  94. In regards to electrolyte imbalances, what are the following indicitive of?
    Diarrhea, Numbness and tingling of extremities, Muscle cramps, Tetany, Convulsions, Laryngeal spasms, Cardiac irritability, Positive Trousseau's and Chostek's signs
    Hypocalcemia
  95. What are some common causes of hypocalcemia?
    Hypoparathyroidism, Malabsorption, Pancreatitis, Alkalosis, Vitamin D deficiency, ESRD
  96. What are the treatment options for hypocalcemia?
    Monitor serum calcium, Encourage increased calcium intake, Administer calcium supplements, If severa-monitor patency of airway, institute seizure and safety precautions, and administer calcium
  97. An excessive concentration of calcium in the blood.
    Hypercalcemia
  98. In regards to electrolyte imbalance, what are the following indicitive of?
    Muscle weakness, Constipation, Anorexia, Nausea, Vomiting, Polyuria, Polydipsia, Kidney Stones, Bizarre behavior, Bradycardia
    Hypercalcemia
  99. What are some common causes of hypercalcemia?
    Hyperparathyroidism, Malignant bone disease, Prolonged immobilization, Excess calcium supplementation, Thiazide diuretics
  100. What are the treatment options for hypercalcemia?
    Monitor I&O, Encourage fluid intake to prevent stone formation, Encourage fiber to prevent constipation, Eliminate calcium supplements and limit calcium-rich foods, Avoid calcium-based antacids, Renal dialysis may be required
  101. Abnormally low production of cortisol. Primary ___ ___ results inadequate cortisol production by the adrenal glands, such as Addison's disease. Secondary ___ ___ results from a decrease in the production of adrenocorticotropic hormone (ACTH) or its release from the pituitary gland.
    Adrenal insufficiency
  102. Loss of appetite
    Anorexia
  103. Excessive and insatiable appetite
    Bulimia
  104. Excessive urination caused either by inadequate amounts of circulating vasopressin (antidiuretic hormone) in the body (hypothalamic DI) or by failure of the kidney to respond to antidiuretic hormone (nephrogenic DI). Urinary output is often massive (e.g., 5 to 15 L/day), which may result in dehydration in patients who cannot drink enough liquid to replace urinary losses (e.g., those with impaired consciousness). The urine is dilute (specific gravity is often below 1.005), and typically the patient's serum sodium level and osmolality rise as free water is eliminated as urine. If water deficits are not matched or the urinary losses are not prevented, death will result from dehydration.
    Diabetes insipidus (abbrev. DI)
  105. What is gastric suction (aka gastric lavage, stomach pumping, NG tube suction)
    A test performed to remove excess medications, or other harmful poisons or materials from the stomach, OR to clean the stomach before an upper endoscopy if the patient has been vomiting blood, OR to collect stomach acid, OR to releive pressure if the patient has had a blockage in the intestines. It is done by inserting a tube through the nose or the mouth down the esophogus and into the stomach
  106. The excessive production of aldosterone by the adrenal gland.
    Hyperaldosteronism
  107. Abnormal, disordered, or disturbed rhythm.
    Dysrhythmia
  108. An abnormal or unpleasant sensation that results from injury to one or more nerves, often described by patients as numbness or as a prickly, stinging, or burning feeling.
    Paresthesia
  109. An antiarrhythmic and cardiotonic drug, derived from the dried leaves of Digitalis purpurea, the common foxglove. It is also found in smaller quantities in the leaves of other plants, such as rhododendrons.
    Digitalis
  110. The most frequently prescribed digitalis glycoside. It may be used orally or intravenously to treat patients with congestive heart failure, atrial fibrillation, atrial flutter, and supraventricular tachycardias.
    Digoxin
  111. A condition characterized by decreased aldosterone in the blood associated with hypotension and increased salt excretion.
    Hypoaldosteronism
  112. An actual or relative increase in the acidity of blood due to an accumulation of acids (as in diabetic acidosis or renal disease) or an excessive loss of bicarbonate (as in renal disease). The hydrogen ion concentration of the fluid is increased, lowering the pH.
    Acidosis
  113. Acidosis due to an excess of ketone bodies. It occurs in individuals who do not produce adequate insulin to sustain normal fat metabolism.
    Ketoacidosis
  114. Paralysis in which there is loss of muscle tone, loss or reduction of tendon reflexes, and atrophy and degeneration of muscles. It is caused by lesions of the lower motor neurons of the spinal cord.
    Flaccid Paralysis
  115. Abdominal colic, typically associated with intestinal obstruction or ileus.
    Intestinal colic
  116. A condition caused by an insufficient or absent secretion of the parathyroid glands.
    Hypoparathyroidism
  117. Inflammation of the pancreas, sometimes accompanied by damage to neighboring organs such as the bowel, lungs, spleen, or stomach, or by a systemic inflammatory response.
    Pancreatitis
  118. An actual or relative increase in blood alkalinity due to an accumulation of alkalies or reduction of acids.
    Alkalosis
  119. Intermittent tonic muscular spasms that typically involve the arms or legs.
    Tetany
  120. A muscular spasm of the hand and wrist resulting from pressure applied to nerves and vessels of the upper arm. It is indicative of latent tetany, usually as a result of hypocalcemia.
    Trousseau's sign
  121. A spasm of the facial muscles following a tap on the facial nerve; seen in hypocalcemic tetany.
    Chvostek's sign
  122. What is the normal range of Magnesium?
    1.3-2.1mE/L
  123. Magnesium is mostly found in the ___ but small amounts are found in body cells and the ___.
    bones & ECF
  124. ___ is essential for carbohydrate metabolism and muscle contraction.
    Magnesium
  125. What are some major sources for magnesium?
    Dairy products & dark green veggies
  126. Decreased magnesium in the blood.
    Hypomagnesemia
  127. In regards to electrolyte imbalance, what are the following indicitive of?
    Neuromuscular irritability, Disorientation, Mood changes, Tachycardia, Increased sensitivity to digitalis
    Hypomagnesemia
  128. What are some common causes of hypomagnesemia?
    Chronic alcoholism, Malabsorption, Diabetic ketoacidosis, Prolonged gastric suction
  129. What are the treatment options for hypomagnesemia?
    Monitor I&O, Encourage foods high in magnesium, Acoud alcohol intake, If client is taking digoxin, monitor pulse and observe for toxicity, Institute safety precautions
  130. DTR stands for what?
    Deep tendon reflex
  131. Abnormally decreased amount of phosphates circulating in the blood.
    Hypophosphatemia
  132. In regards to electrolyte imbalance, the following are indicitive of what?
    Paresthesia, Joint stiffness, Seizures, Cardiomyopathy, Impaired tissue oxygenation
    Hypophosphatemia
  133. What are some common causes for hypophosphatemia?
    Refeeding after starvation, Alcohol withdrawel, Diabetic ketoacidosis, Respiratory acidosis
  134. What are the treatment methods for hypophosphatemia?
    Monitor serum phosphate level, Monitor calcium levels as phosphate is replaced, Start TPN slowly to avoid drops in phosphate
  135. An abnormal amount of phosphorus in the blood.
    Hyperphosphatemia
    • In regards to electrolyte imbalance, what are the following indicitive of?
    • Short term: tetany symptoms-tingling of extermities and cramping; Long term: calcification in soft tissue
    • Hyperphosphatemia
  136. What are some common causes of hyperphosphatemia?
    Renal failure, Hyperthyroidism, Chemotherapy, Excess use of phosphate-based laxitives
  137. What are the treatment methods for hyperphosphatemia?
    Monitor serum phosphate level, Monitor for tetany, If severe, administer aluminum hydroxide with meals to bind phosphorus
  138. A nurse is reviewing the laboratory findings for a group of clients. Which of the following findings should be reported to the provider?
    A. Serum chloride 99 mEq/L
    B. Serum sodium 143 mEq/L
    C. Serum potassium 4 mEq/L
    D. Serum calcium 8.5 mg/dL
    D. Serum calcium 8.5 mg/dL (WE NEED THIS CONFIRMED WITH JELFO - PPT DIFFERS FROM BOOK)
    (this multiple choice question has been scrambled)
  139. A nurse on a medical-surgical unit is caring for a client who is hypernatremic. Which of the following should be included in the plan of care?
    A. Infuse hypotonic IV fluids
    B. Restrict oral intake of water
    C. Administer a loop diuretic
    D. Increase sodium intake
    A. Infuse hypotonic IV fluids
    (this multiple choice question has been scrambled)

What would you like to do?

Home > Flashcards > Print Preview