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NURS 319: F & E
Chapter 7 Fluid and Electrolytes
| Question | Answer |
|---|---|
| hyponatremia | low sodium in blood |
| hyponatremia | <135 MEQ/L |
| signs and symptoms of hypovolemic hyponatremia | thirst, hypotension, tachycardia, neurological deficits |
| signs and symptoms of hypervolemic hyponatremia | headache, lethargy, confusion, muscle cramps |
| causes of hypovolemic hyponatremia | adrenal insufficiency: no/ too little ADH osmotic diuresis diuretics use GI issues: excess diarrhea, sweating, vomitting |
| causes of hypervolemic hyponatremia | water is high in the blood vessel and washes sodium out (water moves from ECF to ICF, causes cell swelling) |
| hypernatremia | high sodium in blood |
| hypernatremia lab value | >145 MEQ/L |
| hypernatremia can be with or without | fluid overload |
| causes of hypernatremia | water loss, too much sodium, adrenal gland issue |
| hypernatremia signs and symptoms (with water retention) | edema, weight gain, hypertension, mental changes, pulmonary edema |
| hypernatremia signs and symptoms (no fluid overload- too much sodium, water is fine) | dehydration, thirst, tachycardia, oliguria |
| hypernatremia signs and symptoms (with water loss) | decrease salivation, irritability, flushed skin, dry mucous membranes, decreased skin turgor, decreased reflexes, weak/thready pulse, hyper/hypotension- based on water |
| hypokalemia | low potassium |
| hypokalemia lab value | < 3.5 MEQ/L |
| most loss of potassium is through | renal system |
| rapid administration of potassium can cause | cardiac arrest |
| causes of hypokalemia | diuretic therapy, potassium deficiencies in diet, hyperaldosteronism, GI surgery, alkalosis, laxative abuse, excess IV dextrose, burns/vomiting/diarrhea |
| IV dextrose does what | causes secretion of insulin, diabetes insipidus, use restroom! |
| No potassium? | impacts muscles in intestines, causes constipation and bloating |
| signs and symptoms of hypokalemia | sluggish bowel, cardiac arrhythmias, prominent U wave on ECG, postural hypotension, muscle fatigue, weakness, leg cramps, decrease deep tendon reflexes |
| hyperkalemia | high potassium |
| hyperkalemia lab value | > 5.2 MEQ/L |
| when you have hyperkalemia, your | risk of cardiac arrest is increased |
| causes of hyperkalemia | excessive intake of potassium, aldosterone deficiency, acidosis, tissue trauma/ burns, extreme exercise, renal failure, Addison's disease, hemolysis, potassium-sparing diuretics, ACE inhibitors |
| role of aldosterone | normally keeps sodium in and releases potassium |
| why does renal failure cause hyperkalemia? | no potassium, sodium, or water output |
| why does Addison's disease cause hyperkalemia? | lack of cortisol, and not enough aldosterone |
| signs and symptoms of hyperkalemia | nausea, vomiting, diarrhea, intestinal cramping, numbness, tingling of extremities, muscle weakness/ cramping, dizziness/ apathy/ mental confusion, tall peaked T wave in ECG and wide QRS in ECG |
| calcium is in a _______ relationship with phosphate | reciprocal |
| calcium normal range | 8.5 to 10.5 |
| hypocalcemia | low calcium |
| hypocalcemia lab value | < 8.5 MG/DL |
| hypocalcemia causes | hypoparathyroidism, malabsorption syndrome, hypomagnesemia, hyperphosphatemia, renal failure, insufficient vitamin D, hypoalbuminemia, diuretic therapy, diarrhea, acute pancreatitis, gastric surgery, massive blood transfusions |
| hypocalcemia signs and symptoms | numbness/ tingling around mouth, hands and feet, muscle spasms in face, body-wide muscle cramps (tetany), laryngeal spasm, seizures, hypotension, arrhythmias |
| chronic hypocalcemia signs and symptoms | bone pain, fragility, dry skin and hair, cataracts, depression, dementia |
| hypercalcemia | high calcium |
| hypercalcemia lab value | > 10 MG/DL |
| hypercalcemia signs and symptoms | muscle flaccidity, muscle weakness of lower extremities, bone tenderness/ weakness (possible fractures), constipation, renal calculi, ventricular arrhythmias, dulled consciousness, depressions, anorexia, nausea, vomiting, ulcers |
| causes of hypercalcemia | hyperparathyroidism, cancer, excessive calcium in diet, excessive Vitamin D, immobility, hypophosphatemia, diuretics, ACE inhibitors, lithium therapy, prolonged immobility, malignancy of bone or blood |
| magnesium normal range | 1.8-3.0 |
| hypomagnesemia | low magnesium |
| hypomagnesemia lab value | serum Mg < 1.5 MEQ/L |
| hypomagnesemia causes | prolonged diarrhea, malnutrition/ malabsorption, alcoholism/cirrhosis, laxative abuse, increased renal excretion of magnesium, DKA (diabetic ketoacidosis), sepsis, burns, serious wounds |
| hypomagnesemia signs and symptoms | tetany, Chvostek's sign, Trousseau's sign, cardiac arrhythmias, ECG similar to those of hypokalemia (U-wave), respiratory muscle paralysis, complete heart block, coma |
| hypermagnesemia | high magnesium |
| hypermagnesemia lab value | > 2.5 MEQ/L |
| hypermagnesemia signs and symptoms | diminished neuromuscular function, hyporeflexia, muscle weakness, cardiovascular effects (hypotension and arrhythmias), lethargy, confusion |
| hypermagnesemia causes | kidney failure, excessive use of Mg- containing laxatives and antacids, untreated diabetic ketoacidosis, excessive Mg infusion |
| what do you need to know about magnesium? | too much magnesium will shut the heart down and your patient will quit breathing |
| what to know about phosphate | essential component to bone and RBC integrated into nucleic acid of RNA and DNA and phospholipid of the cell membrane |
| phosphate normal range | 2.5-4.5 |
| hypophosphatemia | low phosphate |
| hypophosphatemia lab value | <2.5 MG/DL |
| hypophosphatemia causes | ingestion of excess antacids, severe diarrhea, lack of vitamin D, hypercalcemia, alkalosis, hyperparathyroidism, diabetic ketoacidosis |
| hypophosphatemia signs and symptoms | tremors, lack of coordination, paresthesia's, hyporflexia, anorexia, dysphagia, confusion, ataxia, muscle weakness, joint stiffness, bone pain, osteomalacia |
| hyperphosphatemia | high phosphate |
| hyperphosphatemia lab value | > 4.5 MG/DL |
| hyperphosphatemia causes | kidney failure |
| hyperphosphatemia is usually accompanied by | hypocalcemia |
| hyperphosphatemia has similar symptoms to | low calcium levels |
| hyperphosphatemia signs and symptoms | paresthesia's, muscle cramps, tetany, hypotension, cardiac arrythmias |
| what type of solution has an equal distribution of sodium and water in the ICF and ECF? | isotonic |
| What type of fluid would you give to an isotonic patient? | isotonic solution |
| What type of IV fluid would an isotonic solution be? | 0.9% NaCl |
| A hypotonic patient has | a lower concentration of solute inside than outside |
| you should give a hypotonic patient what solution | hypertonic |
| a hypertonic patient has | a higher concentration of solute outside than inside |
| you should give a hypertonic patient what solution | hypotonic |
| what happens to a hypertonic cell and why? | cell shrinks because there is all solute and no water in the cell |
| what happens to a hypotonic cell and why? | cell swells because there is no solute and all water in the cell |
| osmosis | movement of water through semipermeable membrane (less concentrated to more concentrated) water in and out of cells |
| diffusion | movement of ions/molecules across a semipermeable membrane (high to low concentration) |
| filtration | solid particles removed by a filter medium |
| active transport | moves particles from low to high; requires ATP; movement through ion channels |
| sodium potassium pump | assist in maintenance of neuromuscular excitability and acid-base balance |
| What two pressures are higher at venular end of capillary and force fluids back into capillary space? | osmotic and oncotic pressure |
| Which type of pressure comes from the arteries and pushes water out of the capillaries to the ISF? | hydrostatic pressure |
| If excess fluid is left in the interstitial space due to a problem with hydrostatic, oncotic, or osmotic pressures, what condition can occur? | hyper/ hypotension |
| hormones of RAAS | renin, angiotension (1 and 2), aldosterone |
| What hormone is stimulated by the posterior pituitary gland when the blood pressure is low and causes the kidneys to retain water in the blood to help elevate BP? | antidiuretic hormone |
| What hormone is released when there is too much fluid sensed in the right atrium of the heart which stimulates diuresis (release of fluid in the form of urine from the kidneys)? | atrial natriuretic peptide |
| What hormone is released when blood vessels in brain and the left ventricle of the heart sense excess fluid in the vessels which stimulates diuresis? | brain natriuretic peptide (used to diagnose left sided heart failure) |
| water can be lost by what two types of water loss? | hyponatremic and hypernatremic |
| ______ and _______ should be roughly equal in the blood. | sodium and water |
| when there is _____ water, the patient is said to be dehydrated | less |
| who is at greatest risk for dehydration (hypovolemia)? | elderly |
| some causes of hypovolemia | reduced fluid intake, reduced/unresponsive ADH, burns/fever/perspiration, hypernatremia |
| what are some symptoms of dehydration? | poor skin turgor, hypotension, dark-colored urine, weight loss, tachycardia |
| who is at greatest risk for retaining fluid (hypervolemia)? | heart failure and bedbound patients |
| cause of fluid overload | heart failure |
| symptoms of fluid overload | weight gain, swelling, headache, cramping, shortness of breath, bounding pulse |
| what electrolyte is impaired due to water shifting? | sodium |
Created by:
lcorlew1
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