Flashcards › Fluids and Electrolytes set #1

What is the nursing role related to fluid and electrolyte imbalances? To help prevent and treat fluid and electrolyte disturbances A person's percentage of body fluid varies based on what three factors? Age, body size, and gender What are electrolytes? Active chemicals that carry positive and negative electrical charges What is the major cation in ECF? Sodium (normal value 135 - 145) What is the major cation in ICF? Potassium (normal value 3.5 - 5) What is the pressure exerted on the walls of blood vessels called? Hydrostatic pressure What is the pressure exerted by the protein in the plasma called? Osmotic pressure What is the movement of fluid from an area of lower solute concentration to an area of higher solute concentration? Osmosis What is the movement of particles up a concentration gradient requiring ATP? Active Transport What is the movement of particles and ions from an area of higher concentration to an area of lower concentration? Diffusion What is the movement of water and solutes from an area of higher hydrostatic pressure to an area of lower hydrostatic pressure through a selectively permeable membrane? Filtration What is fluid volume deficit? Hypovolemia What is fluid volume excess? Hypervolemia What are the causes of Fluid Volume Deficit? vomiting, diarrhea, GI suctioning, sweating, decreased intake, and inability to gain access to fluid What does dehydration refer to? loss of water alone with increased serum sodium level What are some of the physical signs of fluid volume deficit? rapid weight loss, decreased skin turgor, oliguria, concentrated urine, postural hypotension, rapid and weak pulse, increased temperature, cool and clammy skin due to vasoconstriction, lassitude, thirst, nausea, muscle weakness, and cramps. What is some laboratory data indicating fluid volume deficit? elevated BUN in relation to serum creatinine, increased hematocrit, and possible serum elecrolyte changes What nursing interventions should be provided to a client with Fluid Volume Deficit? Monitor intake and output and volumetric solution (VS), monitor for symptoms like skin and tongue turgor, mucosa, urinary output, and mental status. Iniitate measures to minimize fluid loss, provide oral care. Administer parenteral fluids What is Fluid Volume Excess due to? Fluid overload or diminished homeostatic mechanisms What are the risk factors of Fluid Volume Excess? heart failure, renal failure, and cirrhosis of the liver What are some factors that contribute to Fluid Volume Excess? Excessive dietary sodium or sodium-containing IV solutions What are some of the physical signs of Fluid Volume Excess? edema, distended neck veins, abnormal lung sounds (crackles), tachycardia, increased blood pressure/pulse pressure/and CVP, increased weight, increased urinary output, shortness of breath, and wheezing What sort of medical management should be provided to people with Fluid Volume Excess? Restrict fluids/sodium and administer diuretics What nursing interventions should be provided to a client with Fluid Volume Excess? Take I&O and daily weights, assess lung sounds, check for edema, monitor repsonses to diuretics, promote adherence to fluid restrictions and patient teaching related to sodium and fluid restrictions, monitor and avoid sources of excessive sodium (includes medications), promote rest, use semi-fowlers position for orthopnea, provide skin care and positioning/turning serum sodium levels less than 135mEq/L hyponatremia serum sodium levels greater than 145 mEq/L hypernatremia What is the electrolyte imbalance referring to high potassium? hyperkalemia What is the electrolyte imbalance referring to low potassium? hypokalemia What are some of the causes of Hyponatremia? Adrenal insufficiency, water intoxication, SIADH, and losses by vomiting/diarrhea/sweating/and diuretics What are some of the physical signs of Hyponatremia? Poor skin turgor, dry mucosa, headache, decreased salivation, decreased BP, nausea, abdominal cramping, and neurologic changes What could extreme cases of Hyponatremia lead to? Seizures What are some of the causes of Hypernatremia? Excess water loss, excess sodium administration, diabetes insipidus, heat stroke, and hypertonic IV solutions What are some of the physical signs of Hypernatremia? Thirst, elevated temperature, dry swollen tongue, sticky mucosa, neurologic symptoms, restlessness, and weakness Hypokalemia refers to serum potassium levels less than? 3.5 mEq/L What are some of the causes of Hypokalemia? GI losses, medications, alterations of acid-base balance, hyperaldosteronism, and poor dietary intake. What are some of the physical signs of Hypokalemia? Fatigue, anorexia, nausea, vomiting, dysrhythmias, muscle weakness, cramps, parasthesias, glucose intolerance, decreased muscle strength, and deep tendon reflexes (DTRs) What is the medical management concerning Hypokalemia? Increased dietary potassium, potassium replacement, and IV for severe deficit What sort of nursing specific management should be provided to a client with Hypokalemia? Monitoring of the electrocardiogram (ECG), arterial blood gases (ABGs), dietary potassium, and providing nursing care related to IV potassium, administration of KCL Hyperkalemia refers to serum potassium levels greater than? 5.0 mEq/L What are some of the causes of Hyperkalemia? It is usually treatment related, impaired renal function, hypoaldosteronism, tissue trauma, and acidosis What are some of the physical signs of Hyperkalemia? Cardiac changes and dysrhythmias, muscle weakness with potential respiratory impairment, parasthesias, anxiety, and GI manifestations What sort of nursing specific management should be provided to a client with Hyperkalemia? Assess serum potassium levels, mix well IVs conatining K, monitor medication effects and initiate dietary potassium restriction and dietary teaching for patients at risk Salt substitutes and medications may contain? Potassium What may potassium sparing diuretics cause? Elevation of potassium What are some of the physical signs of Hypocalcemia? Tetany, circumoral numbness, parasthesias, hyperactive DTR's, Trousseau's sign, Chovtek's signs, seizures, respiratory symptoms of dyspnea and laryngospasm, abnormal clotting, and anxiety What sort of nursing specific management should be provided to a client with Hypocalcemia? Weight bearing exercises to decrease bone calcium loss, patient teaching related to diet and medications and nursing care related to IV calcium administration What are some of the physical signs of Hypercalcemia? Muscle weakness, incoordination, anorexia, constipation, nausea and vomiting, abdominal and bone pain, polyuria, thirst, ECG changes, and dysrhythmias What sort of nursing specific management should be provided to a client with Hypercalcemia? Encourage ambulation, provide fluids containing sodium, (unless contraindicated) and fiber for constipation. Helpful review of DeWit Chapter 25

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