Foundations 2 - Fluids & Electrolyte - Flashcards

« Previous card

Next card »

INCORRECT CORRECT

Click Card to flip

2 Major Fluid Compartments

Water makes up 55-60% of total body weight

Intracellular fluid - 2/3 total body h20 (25 Liters)

Extracellular fluid - 1/3 total body h20 (15 Liters)
-Composed of 20% plasma and 80% interstitial fluid

Click Card to flip

Filtration

Filtration is commonly the mechanical or physical operation which is used for the separation of solids from fluids (liquids or gases) by interposing a medium through which only the fluid can pass.

Click Card to flip

Hydrostatic Pressure

The force of the weight of water molecules pressing against the confining walls of a space.

Water-Pushing pressure

Click Card to flip

Diffusion

The free movement of solute (particles) across a permeable membrane down a concentration gradient.

Click Card to flip

Osmosis

The movement of solvent (water) through a selectively permeable membrane.

From area of more dilute into area of more concentration

Click Card to flip

Osmolarity

Osmolarity is the measure of solute (particle) concentration, defined as the number of osmoles (Osm) of solute per liter (L) of solution (osmol/L or Osm/L).

Click Card to flip

Milliosmole

The total number of solute particles contained in a solution

Click Card to flip

Active Transport

Active transport is the movement of a substance against its concentration gradient (from low to high concentration).

Requires energy

Uses Na+/K+ pumps.
-More Na+ in ECF
-More K+ in ICF

Click Card to flip

Aldosterone

Aldosterone is a hormone that increases the reabsorption of sodium ions and water.

Secreted by the adrenal cortex

Release stimulated by decreased Na+ in ECF or increased Na+ in urine.

Preserves Na+ loss

Click Card to flip

Antidiuretic Hormone

AKA: Vasopressin

Acts on kidney tubules making them more permeable to water, which increases water reabsorption and causes dilution of the blood.

Produced in the brain and stored in the posterior pituitary gland

Release controlled by the hypothalamus in response to change in blood osmolarity

Click Card to flip

Natriuretic Peptide

Natriuretic peptide refers to a peptide which induces natriuresis (the discharge of sodium through urine).

Secreted by cells in the lining of the atria and ventricles

Secreted in response to increased blood volume and increased BP

Causes increase urine output and increased glomerular filtration rate.

Click Card to flip

Hypervolemia

Hypervolemia, or fluid overload, is the medical condition where there is too much fluid in the blood (ECF).

Rarely happens in people with normal kidney and heart function.

Monitor patients with CHF, chronic renal failure, and chronic liver disease.

Click Card to flip

Symptoms of Hypervolemia

Weight gain
Distended neck veins (JVD)
Polyuria
Hypertension
Full, bounding pulses
Crackles in lungs (pulmonary edema, SOB)
Elevated RR
Ascites
Peripheral edema
Decreased Hct, BUN (dilution)

Click Card to flip

Ions

Cations (+)

Anions (-)

Body fluids maintain neutral balance

Most enter the body via ingested food.

Click Card to flip

Sodium (Na+)

Normal lab value: 136-145 mEq/L

Most abundant cation (+) in ECF

Controls ECF volume and water distribution

Regulated by the kidney hormones Angiontensin II and Aldosterone

Na+ content of the body may change, but concentration will remain constant due to corresponding water volume changes.

Average dietary intake: 6-14g/day

Click Card to flip

What does Sodium (Na+) do?

Na+ is vital for:
Skeletal muscle contraction

Cardiac contraction

Nerve impulse transmission

Normal ECF osmolarity

Normal ECF volume

Click Card to flip

Potassium (K+)

Normal lab value: 3.5-5.0 mEq/L

Most abundant cation (+) in ICF

Regulated by changing amount secreted in the kidney tubules

Average dietary intake: 2-20 g/day

Click Card to flip

What does Potassium do? (K+)

Functions of K+:
Regulation of protein synthesis

Regulation of glucose use and storage

Maintenance of action potentials

Click Card to flip

Calcium (Ca++)

Normal lab value: 9.0-10.5 mg/dL or 2.25-2.75 mmol/L

Regulated by Parathyroid and Thyrocalcitonin

Enters via dietary intake

Requires Vitamin D

Excess stored in bones

Average daily intake: 800-1200mg

Click Card to flip

What does Calcium (C++) do?

Functions of Ca++:
Bone strength and density

Activation of enzymes or reactions

Skeletal muscle contraction

Cardiac muscle contraction

Nerve impulse transmission

Blood clotting

Click Card to flip

Phosphorus (P)

Normal lab value: 3.0-4.5 mg/dL or 0.97-1.45 mmol/L

Major anion (-) of ICF

80% is found in bones

Average daily intake: 1-2g

Plasma levels exist in balance with Ca++ levels

Click Card to flip

What does Phosphorus (P) do?

Functions of P:
Activating B-complex vitamins

Forming and activating adenosine triphosphate (ATP)

Assisting in cell division

Cooperating in nutrient metabolism. (Carbohydrates, Proteins, and Lipids)

Click Card to flip

Magnesium (Mg++)

Normal lab value: 1.3-2.1 mg/dL or 0.65-1.05 mmol/L

Forms a cation (+) when dissolved in H20

Mostly found in the ICF

Excreted by the kidneys and absorbed in the GI tract

Average daily intake: 300mg

Click Card to flip

What does Magnesium (M++) do?

Functions of Mg++:
Skeletal muscle contraction

Carbohydrate metabolism

ATP formation

B-complex vitamin activation

DNA synthesis

Protein synthesis

Regulate blood coagulation

Click Card to flip

Hyponatremia

Low sodium (<136 mEq/L)

Most common electrolyte disorder

Common causes: Diuretics, vomiting, sweating, bleeding, Renal failure, Movement out of ECF, Failure of Na/K pump, Diabetic ketoacidosis, Hypoxia, Liver failure (third spacing), Fresh water drowning, and over administration of hypotonic solutions

Click Card to flip

S/S of Hyponatremia

Confusion
Headache
N&V
Generalized muscle weakness progressing to coma (late stage)
Fatigue
Postural hypotension
Anorexia
Abdominal cramps
Weight loss

Click Card to flip

Treatment of hyponatremia

Monitor I&O, Wt, VS, LOC

Monitor serum sodium, serum osmolarity

Restrict hypotonic fluids

Encourage foods or fluids high in Na+

Careful use of hypertonic IV fluids

Click Card to flip

Hypernatremia

High sodium (>145 mEq/L)

Common causes: Renal failure (inability to excrete Na+), Hypertonic IV fluids and/or tube feedings, Excessive salt ingestion, and decreased fluid intake

Click Card to flip

S/S of Hypernatremia

Thirst
Dry, sticky mucous membranes
Low UOP
Muscle twitching
Hypertension
Firm, rubbery tissue turgor
Manic excitement (severe)
Tachycardia (severe)
Death (severe)

Click Card to flip

Treatment of Hypernatremia

Monitor: I&O, Wt, VS, LOC
Monitor serum sodium levels and serum osmolarity
Careful use of hypotonic or isotonic IV fluids
Restrict foods, fluids, meds high in Na+
Seizure precaution

Click Card to flip

Hypocalcemia

Low calcium (<9.0 mg/dL or < 2.25 mmol/L)

Usually due to a failure of normal regulatory mechanisms, such as acute or chronic renal failure, but can also occur with malabsorption syndromes, acute pancreatitis, and alkalosis

Low levels increase excitability of nerves and muscles (especially GI)

If serum levels are low, bones release calcium and become osteoporotic

Click Card to flip

S/S of Hypocalcemia

Muscle spasms, cramps, tremors
Hyperactive reflexes
Diarrhea
Tingling of fingers, toes, lips, face
Tetany
Positive Trousseau’s sign-carpopedal spasm (hand spasms when BP cuff inflated 3-4 minutes)
Seizures
Arrhythmias
EKG changes

Click Card to flip

Treatment of Hypocalcemia

Monitor labs
Cardiac monitoring
Seizure precaution
Decrease stimuli
Oral Ca++ supplements and/or Vit D (give supplements between meals for better absorption)
IV Ca++
Teach pt about foods high in Ca++

Click Card to flip

Hypercalcemia

High calcium (>10.5 mg/dL or >2.75 mmol/L)

Common causes:Excessive intake, Malignancy, Hyperparathyroidism, Decreased renal secretion, and diuretic use

Click Card to flip

S/S of Hypercalcemia

Decreased excitability of nerves
Muscle weakness
N/V, constipation
Hypoactive bowel sounds
Extreme thirst
Polyuria (if normal kidney function)
Kidney stones
Blood clots
Arrhythmias
EKG changes

Click Card to flip

Treatment of Hypercalcemia

Monitor high risk pts: long term bedrest, CA, hyperparathyroidism
Increase fluid intake to 3-4 liters per day
Assess Homan’s sign
Cardiac monitoring
Safety (muscle weakness)
Assess bowel sounds
Early and frequent ambulation
Teach pt. to avoid foods high in Ca++ or not to overuse supplements

Click Card to flip

Hypomagnesemia

Low MG++ (<1.3 mg/dL or <0.65 mmol/L)

Common causes: Frequently co-exists with hypokalemia, Vomiting, Diarrhea, suctioning, Prolonged malnutrition, renal disorders, burns, diabetic ketoacidosis, and hypercalcemia

Click Card to flip

S/S of Hypomagnesemia

Tachycardia
Arrhythmias
Hypotension
Muscle spasms
Tetany
Hyperactive reflexes
Positive Trousseau’s
LOC changes-confusion, agitation
Seizures

Click Card to flip

Treatment of Hypomagnesemia

Cardiac monitoring
Seizure precautions
Oral, IM, or IV Mg salts
Monitor labs
VS
LOC
DTRs
Safety- LOC changes
Teach patient to increase foods high in Mg++

Click Card to flip

Hypermagnesemia

High Mg++ (>2.1 mg/dL or >1.05 mmol/L)

Rare

Common causes:
Increased intake and decreased excretion
Antacids
Laxatives
IV adm of Mg++
Renal insufficiency

Click Card to flip

S/S of Hypermagnesemia

Lethargy and drowsiness
Depressed respirations
Low B/P
Bradycardia progressing to cardiac arrest
Hypoactive reflexes
Coma
Decreased UOP

Click Card to flip

Treatment of Hypermagnesemia

VS frequently (can decrease rapidly)
Labs
Monitor reflexes, lung sounds, DTRs
Cardiac monitoring
I&O
Safety: drowsiness, hypotension, bradycardia
Teach pt to avoid foods/meds high in Mg++

Click Card to flip

Hypokalemia

Low K+ (<3.5 mEq/L)

Common causes:
Excessive vomiting, suctioning, diarrhea
Diuretics, laxatives, insulin
Alkalosis
Hemodilution from overhydration, renal disease
Acute alcoholism

Click Card to flip

S/S of Hypokalemia

Muscle weakness and atony
N/V
Constipation
Hypotension, elevated pulse (due to decreased cardiac output)
Alkalosis

Click Card to flip

Treatment of Hypokalemia

Cardiac monitoring
Safety (hypotension & muscle weakness)
UOP
Oral K+ supplements (with food)
NEVER give K+ IV push
Teach pt to increase potassium intake
Treat underlying cause

Click Card to flip

Hyperkalemia

High K+ (>5.0 mEq/L)

Common causes:
Use of salt substitute or K+ supplements
Malfunctioning Na/K pump
Cell distruction, crushing injuries, burns, hemolysis
Surgery
Inadequate potassium excretion
Sepsis
Fever

Click Card to flip

S/S of Hyperkalemia

Muscle weakness, paralysis
N/V/D
Alterations in cardiac muscle stimulation and relaxation
Dysrhythmias, bradycardia, cardiac arrest
LOC changes
Numbness in hands and feet

Click Card to flip

Treatment of Hyperkalemia

Cardiac monitoring
VS
Safety – bradycardia, muscle weakness, LOC
Kayexalate enema or oral
Calcium gluconate
Glucose and insulin mixture (moves K+ into cells)
Teach client to avoid foods high in K+: cantaloupe, bananas, apricots, broccoli, salt substitutes

      Mode:   CARDS LIST       ? pages   PRINT EXIT

2 Major Fluid Compartments	Water makes up 55-60% of total body weight Intracellular fluid - 2/3 total body h20 (25 Liters) Extracellular fluid - 1/3 total body h20 (15 Liters) -Composed of 20% plasma and 80% interstitial fluid
Filtration	Filtration is commonly the mechanical or physical operation which is used for the separation of solids from fluids (liquids or gases) by interposing a medium through which only the fluid can pass.
Hydrostatic Pressure	The force of the weight of water molecules pressing against the confining walls of a space. Water-Pushing pressure
Diffusion	The free movement of solute (particles) across a permeable membrane down a concentration gradient.

Generated by Koofers.com

Osmosis	The movement of solvent (water) through a selectively permeable membrane. From area of more dilute into area of more concentration
Osmolarity	Osmolarity is the measure of solute (particle) concentration, defined as the number of osmoles (Osm) of solute per liter (L) of solution (osmol/L or Osm/L).
Milliosmole	The total number of solute particles contained in a solution
Active Transport	Active transport is the movement of a substance against its concentration gradient (from low to high concentration). Requires energy Uses Na+/K+ pumps. -More Na+ in ECF -More K+ in ICF

Generated by Koofers.com

Aldosterone	Aldosterone is a hormone that increases the reabsorption of sodium ions and water. Secreted by the adrenal cortex Release stimulated by decreased Na+ in ECF or increased Na+ in urine. Preserves Na+ loss
Antidiuretic Hormone	AKA: Vasopressin Acts on kidney tubules making them more permeable to water, which increases water reabsorption and causes dilution of the blood. Produced in the brain and stored in the posterior pituitary gland Release controlled by the hypothalamus in response to change in blood osmolarity
Natriuretic Peptide	Natriuretic peptide refers to a peptide which induces natriuresis (the discharge of sodium through urine). Secreted by cells in the lining of the atria and ventricles Secreted in response to increased blood volume and increased BP Causes increase urine output and increased glomerular filtration rate.
Hypervolemia	Hypervolemia, or fluid overload, is the medical condition where there is too much fluid in the blood (ECF). Rarely happens in people with normal kidney and heart function. Monitor patients with CHF, chronic renal failure, and chronic liver disease.

Generated by Koofers.com

Symptoms of Hypervolemia	Weight gain Distended neck veins (JVD) Polyuria Hypertension Full, bounding pulses Crackles in lungs (pulmonary edema, SOB) Elevated RR Ascites Peripheral edema Decreased Hct, BUN (dilution)
Ions	Cations (+) Anions (-) Body fluids maintain neutral balance Most enter the body via ingested food.
Sodium (Na+)	Normal lab value: 136-145 mEq/L Most abundant cation (+) in ECF Controls ECF volume and water distribution Regulated by the kidney hormones Angiontensin II and Aldosterone Na+ content of the body may change, but concentration will remain constant due to corresponding water volume changes. Average dietary intake: 6-14g/day
What does Sodium (Na+) do?	Na+ is vital for: Skeletal muscle contraction Cardiac contraction Nerve impulse transmission Normal ECF osmolarity Normal ECF volume

Generated by Koofers.com

Potassium (K+)	Normal lab value: 3.5-5.0 mEq/L Most abundant cation (+) in ICF Regulated by changing amount secreted in the kidney tubules Average dietary intake: 2-20 g/day
What does Potassium do? (K+)	Functions of K+: Regulation of protein synthesis Regulation of glucose use and storage Maintenance of action potentials
Calcium (Ca++)	Normal lab value: 9.0-10.5 mg/dL or 2.25-2.75 mmol/L Regulated by Parathyroid and Thyrocalcitonin Enters via dietary intake Requires Vitamin D Excess stored in bones Average daily intake: 800-1200mg
What does Calcium (C++) do?	Functions of Ca++: Bone strength and density Activation of enzymes or reactions Skeletal muscle contraction Cardiac muscle contraction Nerve impulse transmission Blood clotting

Generated by Koofers.com

Phosphorus (P)	Normal lab value: 3.0-4.5 mg/dL or 0.97-1.45 mmol/L Major anion (-) of ICF 80% is found in bones Average daily intake: 1-2g Plasma levels exist in balance with Ca++ levels
What does Phosphorus (P) do?	Functions of P: Activating B-complex vitamins Forming and activating adenosine triphosphate (ATP) Assisting in cell division Cooperating in nutrient metabolism. (Carbohydrates, Proteins, and Lipids)
Magnesium (Mg++)	Normal lab value: 1.3-2.1 mg/dL or 0.65-1.05 mmol/L Forms a cation (+) when dissolved in H20 Mostly found in the ICF Excreted by the kidneys and absorbed in the GI tract Average daily intake: 300mg
What does Magnesium (M++) do?	Functions of Mg++: Skeletal muscle contraction Carbohydrate metabolism ATP formation B-complex vitamin activation DNA synthesis Protein synthesis Regulate blood coagulation

Generated by Koofers.com

Hyponatremia	Low sodium (<136 mEq/L) Most common electrolyte disorder Common causes: Diuretics, vomiting, sweating, bleeding, Renal failure, Movement out of ECF, Failure of Na/K pump, Diabetic ketoacidosis, Hypoxia, Liver failure (third spacing), Fresh water drowning, and over administration of hypotonic solutions
S/S of Hyponatremia	Confusion Headache N&V Generalized muscle weakness progressing to coma (late stage) Fatigue Postural hypotension Anorexia Abdominal cramps Weight loss
Treatment of hyponatremia	Monitor I&O, Wt, VS, LOC Monitor serum sodium, serum osmolarity Restrict hypotonic fluids Encourage foods or fluids high in Na+ Careful use of hypertonic IV fluids
Hypernatremia	High sodium (>145 mEq/L) Common causes: Renal failure (inability to excrete Na+), Hypertonic IV fluids and/or tube feedings, Excessive salt ingestion, and decreased fluid intake

Generated by Koofers.com

S/S of Hypernatremia	Thirst Dry, sticky mucous membranes Low UOP Muscle twitching Hypertension Firm, rubbery tissue turgor Manic excitement (severe) Tachycardia (severe) Death (severe)
Treatment of Hypernatremia	Monitor: I&O, Wt, VS, LOC Monitor serum sodium levels and serum osmolarity Careful use of hypotonic or isotonic IV fluids Restrict foods, fluids, meds high in Na+ Seizure precaution
Hypocalcemia	Low calcium (<9.0 mg/dL or < 2.25 mmol/L) Usually due to a failure of normal regulatory mechanisms, such as acute or chronic renal failure, but can also occur with malabsorption syndromes, acute pancreatitis, and alkalosis Low levels increase excitability of nerves and muscles (especially GI) If serum levels are low, bones release calcium and become osteoporotic
S/S of Hypocalcemia	Muscle spasms, cramps, tremors Hyperactive reflexes Diarrhea Tingling of fingers, toes, lips, face Tetany Positive Trousseau’s sign-carpopedal spasm (hand spasms when BP cuff inflated 3-4 minutes) Seizures Arrhythmias EKG changes

Generated by Koofers.com

Treatment of Hypocalcemia	Monitor labs Cardiac monitoring Seizure precaution Decrease stimuli Oral Ca++ supplements and/or Vit D (give supplements between meals for better absorption) IV Ca++ Teach pt about foods high in Ca++
Hypercalcemia	High calcium (>10.5 mg/dL or >2.75 mmol/L) Common causes:Excessive intake, Malignancy, Hyperparathyroidism, Decreased renal secretion, and diuretic use
S/S of Hypercalcemia	Decreased excitability of nerves Muscle weakness N/V, constipation Hypoactive bowel sounds Extreme thirst Polyuria (if normal kidney function) Kidney stones Blood clots Arrhythmias EKG changes
Treatment of Hypercalcemia	Monitor high risk pts: long term bedrest, CA, hyperparathyroidism Increase fluid intake to 3-4 liters per day Assess Homan’s sign Cardiac monitoring Safety (muscle weakness) Assess bowel sounds Early and frequent ambulation Teach pt. to avoid foods high in Ca++ or not to overuse supplements

Generated by Koofers.com

Hypomagnesemia	Low MG++ (<1.3 mg/dL or <0.65 mmol/L) Common causes: Frequently co-exists with hypokalemia, Vomiting, Diarrhea, suctioning, Prolonged malnutrition, renal disorders, burns, diabetic ketoacidosis, and hypercalcemia
S/S of Hypomagnesemia	Tachycardia Arrhythmias Hypotension Muscle spasms Tetany Hyperactive reflexes Positive Trousseau’s LOC changes-confusion, agitation Seizures
Treatment of Hypomagnesemia	Cardiac monitoring Seizure precautions Oral, IM, or IV Mg salts Monitor labs VS LOC DTRs Safety- LOC changes Teach patient to increase foods high in Mg++
Hypermagnesemia	High Mg++ (>2.1 mg/dL or >1.05 mmol/L) Rare Common causes: Increased intake and decreased excretion Antacids Laxatives IV adm of Mg++ Renal insufficiency

Generated by Koofers.com

S/S of Hypermagnesemia	Lethargy and drowsiness Depressed respirations Low B/P Bradycardia progressing to cardiac arrest Hypoactive reflexes Coma Decreased UOP
Treatment of Hypermagnesemia	VS frequently (can decrease rapidly) Labs Monitor reflexes, lung sounds, DTRs Cardiac monitoring I&O Safety: drowsiness, hypotension, bradycardia Teach pt to avoid foods/meds high in Mg++
Hypokalemia	Low K+ (<3.5 mEq/L) Common causes: Excessive vomiting, suctioning, diarrhea Diuretics, laxatives, insulin Alkalosis Hemodilution from overhydration, renal disease Acute alcoholism
S/S of Hypokalemia	Muscle weakness and atony N/V Constipation Hypotension, elevated pulse (due to decreased cardiac output) Alkalosis

Generated by Koofers.com

Treatment of Hypokalemia	Cardiac monitoring Safety (hypotension & muscle weakness) UOP Oral K+ supplements (with food) NEVER give K+ IV push Teach pt to increase potassium intake Treat underlying cause
Hyperkalemia	High K+ (>5.0 mEq/L) Common causes: Use of salt substitute or K+ supplements Malfunctioning Na/K pump Cell distruction, crushing injuries, burns, hemolysis Surgery Inadequate potassium excretion Sepsis Fever
S/S of Hyperkalemia	Muscle weakness, paralysis N/V/D Alterations in cardiac muscle stimulation and relaxation Dysrhythmias, bradycardia, cardiac arrest LOC changes Numbness in hands and feet
Treatment of Hyperkalemia	Cardiac monitoring VS Safety – bradycardia, muscle weakness, LOC Kayexalate enema or oral Calcium gluconate Glucose and insulin mixture (moves K+ into cells) Teach client to avoid foods high in K+: cantaloupe, bananas, apricots, broccoli, salt substitutes

Generated by Koofers.com

© Copyright 2012 , Koofers, Inc. All rights reserved.

The information provided on this site is protected by U.S. and International copyright law, and other applicable intellectual property laws, including laws covering data access and data compilations. This information is provided exclusively for the personal and academic use of students, instructors and other university personnel. Use of this information for any commercial purpose, or by any commercial entity, is expressly prohibited. This information may not, under any circumstances, be copied, modified, reused, or incorporated into any derivative works or compilations, without the prior written approval of Koofers, Inc.