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Chapter 9.
Fluids And Electrolytes
| Question | Answer |
|---|---|
| Intracellular Compartment | All fluids inside the cell |
| Extracellular Compartment | All fluids outside the cell |
| Intravascular Compartment | Fluids within the blood vessels |
| Interstitial Fluids | Fluids between the cell and blood vessels |
| Third-Spacing | Trapped fluids represents a volume and is unavailable for normal physiological process |
| Diffusion | Spreads the molecules from an area with high concentration to an area with a low concentration |
| Osmosis | Draws water from an area of low concentration to an area of high concentration |
| Filtration | Movement from great pressure to less pressure |
| Hydrostatic Pressure | Force exerted by the weight of a solution |
| What is a Isotonic Solutions? | Equal in concentration |
| What are some examples of Isotonic Solutions? | - 0.9% Normal Saline (NS) - 5% Dextrose in water (5%D/W) - 5% Dextrose in 0.225% saline (5% D/1/4 NS) - Lactated Ringer's Solution (NA chloride, K Chloride, CA Chloride, NA Lactate in distilled water) |
| What is a Hypotonic Solution? | Contains lower concentration of salt or solute |
| What are some example of Hypotonic Solution? | 0.45% Saline (1/2 normal saline [NS]) |
| What is a Hypertonic Solution? | High concentration of solute than any other solution |
| What are some examples of Hypertonic Solution? | - 5% dextrose in lacted ringers solution - 5% dextrose in 0.45% saline (5% D/1/2 NS) - 5% dextrose in 0.9 saline (5%D/NS) - 10% dextrose in water (10% D/W) |
| Fluid Volume Deficit | Dehydration in which the body's fluid intake is not sufficient to meet the body's fluid needs |
| Causes of Fluid Volume Deficit | Vomiting,dehydration, GI suctioning, ileostomy/colostomy, continuous GI irrigation, drainage wounds,burns,or fistulas |
| Sign and Symptoms of Fluid Volume Deficit | Thirst, poor skin turgor, confusion, decrease urine volume, dark color urine, increase hematocit, flat neck/hand veins, incrase heart rate, thready pulse |
| Treatments for Fluid Volume Deficit | Lactated Ringers Solution, 0.9% NS, monitor weight, I&O, mucous membranes and skin turgor |
| Fluid Volume Excess | Fluid intake or fluid retention exceeds the body's fluid needs |
| Sign and Symptoms of Fluid Volume Excess | Cough,dyspnea, increase b/p, bouning pulse, decrease hematocrit, neck/hand vein distention, increase heart rate and resp, lung crackles, edema |
| Treatments for Fluid Volume Excess? | Semi-fowlers position, check edema, monitor I&O, weight, admin diuretics, decrease sodium |
| Hypokalemia | Postassium level less than 3.5 mEq/L |
| Treatments for Hypokalemia | Monitor for neuromuscular activity, take with jucie or other desired liquids, do not take supplements on empty stomach, report abd pain, distention, vomiting, diarrhea, or GI bleeding, always diluted |
| Causes of Hypokalemia | excessive gastric suctioning, cushing's syndrome, chronic corticosteriods use, alkalosis |
| Sign and Symptoms of Hypokalemia | leg, abd cramp, lehtargy, weakness, shallow resp, thready pulse, decrease or absent reflexes, hypoactive bowel, peaked P waves, flat T waves, depressed ST segments and U waves |
| Hyperkalemia | Potassium level greater than 5.1 mEq/L |
| Causes of Hyperkalemia | Renal failure, metabolic acidosis, addison's disease, intestinal obstruction |
| Treatments for Hyperkalemia | Monitor I&O, administer Kayexalate orally or with enema (it absorbs K into GI for excretion, monitor cardiac changes |
| Sign and Symptoms for Hyperkalemia | Wide flate P waves, wide QRS, prolong PR intervals, depressed ST segments, and narrow peaked T waves, muscle weakness, hypotension, diarrhea, hyperactive bowel |
| Hyponatremia | Sodium level less than 135 mEq/L |
| Treatments for Hyponatremia | Monitor I&O, skin turgor, and mucouse membranes, restrict water intake and void tap water enema, use NS than sterile water, monitor lithium level due to decreased lithium excretion = toxicity |
| Causes for Hyponatremia | GI suctioning, DKA, retention of fluids, excessive intake of water, increased perspiration, burns |
| Sign and Symptoms for Hyponatremia | Rapid, thready pulse, weakness, abd cramp, decrease skin turgor, muscle twitching, seizures |
| Hypernatremia | Sodium level greater than 145 mEq/L |
| Treatments for Hypernatremia | increase water intake orally, up to 8-10 glasses a day |
| Causes for Hypernatremia | Decreaseed water intake or excessive loss of water, hyperventilation, fever, excessive perspiration, dehydration, cushing's syndrome diabetes insipidus, increase sodium bicarbonate |
| Sign and Symptoms of Hypernatremia | Dry mucous membranes, loss of skin turgor, thirst, flushed skin, increased temperature, muscle twitching, fatigue, confusion, seizures |
| Hypocalcemia | Calcium level less than 8. mg/dL |
| Treatments for Hypocalcemia | Monitor Chvostek's and Trousseau's sign, initiate seizure precaution, admin Calcium supplements 1-2 hours after meal, keep 10% Gluconate for acute hypocalcemia |
| Causes of Hypocalcemia | Inadequate Vitamin D, diarrhea, acute pancreatitis, crohn's disease, excessive admin of blood |
| Signs and Symptoms of Hypocalcemia | Tachycardia, hypotension, twitching, positive Chvostek's and Trousseau's sign |
| Hypercalcemia | Calcium level greater than 10 mg/dL |
| Treatments for Hypercalcemia | Increase mobility, move client carefully, monitor for severe flank or abd pain, monitor for LOC, neurological changes and confusion |
| Causes of Hypercalcemia | Excessive calcium or vitamin D, adernal insufficency, renal failure, lithium, hyperparathyroidism, increased bone reabsorption or destruction |
| Sign and Symptoms of Hypercalcemia | Increase HR and B/P, bounding pulse, bradycardia, short QT, wide T wave, muscle weakness (hypotonocity), abd distention |
| Hypomagnesium | Magnesium level less tha 1.6 mg/dL |
| Treatments for Hypomagnesium | Monitor dysrhythmias, neuromuscluar changes, initiate seizure precaution |
| Causes of Hypomagnesium | Malnutrition, alcoholism, diabetic ketoacidosis, eclampsia, celiac disease, crohn's disease, chemotherapy, sepsis |
| Signs and Symptoms of Hypomagnesium | Twitching, hyperactive reflexes, confusion, shallow resp, irritability, tetany, seizures, tachycardia, positive Chvostek's and Trousseau's sign |
| Hypermagnesium | Magnesium level greater tahn 2.6 mg/dL |
| Treatments for Hypermagnesium | Monitor resp. depression, hypotension,bradycardia and dysrhythmias, neurological and muscluar activity, LOC - greater tahn 7mg/dL admin calcium chloride or calcium gluconate, avoid laxatives and antacids with magnesium |
| Causes of Hypermagnesium | Overuse of laxatives and antacids, renal insufficency and renal failure |
| Signs and Symptoms of Hypermagnesium | Hypotension, bradycardia, weak pulse, sweating and flushing, resp. depression |
| Hypophosphatemia | Phosphate less than 2.7 mg/dL |
| Treatments for Hypophosphatemia | Monitor respiration, renal system before admin., decreased neuromuscular activity |
| Causes of Hypophosphatemia | Malnutrition, renal failure, hyperparathyroidism, malignancy, hypercalcemia, diabetic ketoacidosis, alcohol withdrawal, resp. alkalosis |
| Signs and Symptoms of Hypophosphatemia | Confusion, seizures, weakness, shallow resp, immunosuppression, bone pain |
| Hyperphosphatemia | Phosphate greater tahn 2.6 mg/dL |
| Treatment for Hyperphosphatemia | monitor hypocalcemia, hyperrefelxia, tetany, seizures, take meds with meals or immediately after meal |
| Signs and Symptoms of Hyperphosphatemia | Neuromuscular irritability, muscle weakness, tetany, Positive Chvostek's and Trousseau's sign |
| Causes of Hyperphosphatemia | Vitamin D intoxication, hypoparathyroidism, renal insufficency, chemotherapy |
Created by:
ivanr_calara
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