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N306 E4 F&E Part 1

N306 Fluid Balance, Electrolytes, Acid-Base [Ch 31] Pt 1

QuestionAnswer
What type of ion is released by the lungs to help maintain the correct pH level in the body? Carbon dioxide
Who has more water content: adults or peds? Peds
Do fluids and molecules move easily cross between the ECF and ICF? Water does, but NOT large molecules or ions
Excess fluid volume can lead to _____.(3) HTN, CHF, and peripheral edema
Fluid volume depletion can lead to ______. (3) dehydration and shock
intracellular space contains water inside the cells
extracellular space contains water outside the cells
Identify the 2 parts of the ECF. intravascular space (fluid in the plasma); interstitial space (fluid between cells)
Adults have more fluid in the ______ and peds have more fluid in the ______. Adults have more fluid in the ICF; peds more in the ECF
fluid balance continuous exchange and mixing of fluids occurs between various compartments, which are separated by membranes
Describe the fluid movement within the capillary beds. Constant movement of fluids between ECF fluids, interstitial and intravascular
Identify the 2 processes that govern the movement of large molecules and ions between compartments. Diffusion and active transport
TRUE/FALSE: The older you get, the less water body weight. TRUE
Identify the most important physiologic regulator of fluid intake. Thirst mechanism
thirst mechanism Osmoreceptors in the hypothalamus sense that the ECF has become hypertonic
Fluid intake must be ______ before reaching vascular compartment, due to ______> must be absorbed; due to osmotic forces
How is water output achieved? (5) Through the kidneys, lungs, skin, feces, sweat
intercellular movement of fluid between cells
intracellular movement of fluid inside cells
osmolality concentration of particles (solutes) dissolved in fluid
Identify the three solutes that determine osmolality. Sodium, glucose, and urea
tonicity ability of a solution to cause change in water movement across a membrane due to osmotic forces
Normal plasma is considered ______. [hypertonic/hypotonic/isotonic] isotonic
_____ solutions have the same concentration of solutes as plasma. Isotonic
_____ solutions have a greater concentration of solutes than plasma. Hypertonic
_____ solutions have a lesser concentration of solutes than plasma. Hypotonic
If you give a hypotonic soln, where does the fluid go and how does it affect the cell? Hypotonic: Fluid goes INTO THE CELL; makes the cell bigger; make them burst
If you give a hypertonic soln, where does the fluid go and how does it affect the cell? Hypertonic: Fluid will move OUT OF CELL into the ECF; cells will shrink
Identify fluid loss through abnormal routes. (7) Vomiting, NGT, bleeding, wounds, burns, 3rd space fluid accumulation (e.g. ascites), paracentesis
paracentesis perforation of a cavity of the body or of a cyst or similar outgrowth, esp. with a hollow needle to remove fluid or gas
During what period is ADH released? Periods of high osmolality
How are fluid deficit disorders treated? oral of IV fluids
How are fluid excess disorders treated? Diuretics
electrolytes are minerals in your blood and other body fluids that carry an electric charge
Are electrolytes located in the ICF or ECF? Both
What are sources of electrolyte intake? (3) Diet, medications, blood tranfusion
Where are electrolytes absorbed? GI tract
Can drug therapy cause electrolyte imbalance? Yes
What affects electrolyte distribution? (4) Medications, hormones, cells, bones
Identify 3 methods in which electrolytes are excreted. Urine, feces, sweat
Aggressive therapy with loop diuretics can rapidly deplete _______ and _______. sodium and potassium
hyponatremia less salt in ECF, water excess in ECF
Hyponatremia causes ________. water to move into cells, causing swelling of cells
What 3 process does sodium have a central role in? Neuromuscular physiology, acid-base balance, overall fluid distribution
When sodium increases, osmolality _______. increases
Identify early signs of hyponatremia. n/v, anorexia, abdominal cramping
Identify late signs of hyponatremia. altered neurological function, i.e. confusion, irritability, lethargy, convulsions, coma, muscle twitching, tremors
How is hyponatremia treated? Oral or IV sodium chloride; or with IV fluids containing salt, e.g. normal salie or lactated ringer's
hypernatremia more salt in ECF; less water in ECF
Hypernatremia causes ________. Water moves OUT of cells leading to cellular dehydration and shrinkage
hypovolemic of or relating to a decrease in the volume of circulating blood
hypervolemic condition consisting of an increase in the volume of circulating blood
How do you treat a pt with hypernatremia who is hypovolemic? Infuse hypotonic fluids such as dextrose 5% or 1/2 NS, which will increase plasma volume while reducing plasma osmolality
How do you treat a pt with hypernatremia who is hypervolemic? Diuretics to remove sodium and fluid from the body
Edema is fluid _______. between cells (interstitial compartment)
What conditions or diseases cause edema? (5) Burns, CHF, cancer, lymphatic problems, liver problem
Clinical manifestations of edema include ________. (2) puffy extremities, pitting edema
Treatment for edema is ________. diuretics
What processes require potassium? (2) Proper nerve and muscle functioning; maintaining acid-base balance
What organ will be majorly affected by high or low potassium? Heart
hypokalemia low potassium in the ECF
Identify the etiology/pathogenesis of hypokalemia. Diet (low potassium intake) and use of loop diuretics
Both hyper- and hypokalemia are associated with ____________. Fatal dysrhythmias and serious neuromuscular disorders
Why is adequate daily intake of potassium necessary? Body does not have large stores of it
Identify the clinical manifestations of hypokalemia. Muscle weakness, lethargy, anorexia, DYSRHYTHMIAS, IRREGULAR HEART BEAT, palpitations, cardiac arrest, HIGH/LOW HR [Note: Heart and muscle related]
Treatment for MILD hypokalemia includes _______. Increase in dietary intake of potassium-rich foods
Treatment for moderate/severe hypokalemia includes _______. Oral or parenteral potassium supplements
Why can't potassium be given IV push? It will stop the heart
Why must IV doses of potassium be small and delivered through a pump? Needs to be controlled because of effects on heart; potassium is irritating to veins, must check for phlebitis
phlebitis inflammation of walls of a vein
hyperkalemia high potassium in the ECF
Identify the etiology/pathogenesis of hyperkalemia. Diet, medications (potassium sparing diuretics), CHF, renal failure
Identify the clinical manifestations of hyperkalemia. DYSRHYTHMIAS, HEART BLOCK, fatigue, twitching, cramping, dyspnea
Identify the treatment option(s) for moderate/severe hyperkalemia. Glucose and insulin; sodium bicarbonate (for concurrent acidosis); polystyrene sulfonate (Kayexalate) orally or rectally
Polystyrene sulfonate (Kayexalate) for treatment of hyperkalemia must be given concurrently with _______. Why? laxative, such as sorbitol, to promote rapid evacuation of potassium
______ or _______ may be administered to counteract potassium toxicity to the heart. Calcium gluconate or calcium chloride
A pt is on digoxin and potassium is low, what is the nurse's first action? Notify the doctor
hypocalcemia` low calcium in the ECF
Identify the etiology/pathogenesis of hypocalcemia. Insufficient intake or absorption, renal failure
Identify the clinical manifestations of hypocalcemia. Neuromuscular excitability (tingling, spasms), intestinal cramping, MUSCLE AND BONE PAIN DUE TO SOFTENING
Identify the function(s) of calcium. Metabolic processes, bone and teeth, hormone regulator, plasma membrane stability/permeability
Where does the body get calcium when the conc. is too low in the blood? Blood will get calcium from bones, thus making them soft and eventually causing hypocalcemia
Identify calcium-rich foods. Dairy products, milk, cheese, yogurt, fortified cereals/OJ, green leafy vegetables, sardines, soybeans
hypercalcemia high calcium in ECF
Identify the etiology/pathogenesis of hypercalcemia. DIET, excess vit D, cancer, endocrine problems, low phosphate
Identify the clinical manifestations of hypercalcemia. KIDNEY STONES, impaired renal function, bone pain, cardiac problems, many nonspecific
______ has an inverse relationship with ______. PHOSPHATE has an inverse relationship with CALCIUM.
S/s of hypophosphatemia are the same as with ________. hypercalcemia [Note: The inverse relationship]
hypophosphatemia low phosphate in ECF
Identify the etiology/pathogenesis of hypophosphatemia. Hypercalcemia, resp. alkalosis, s/t cancer, thyroid problems, renal impairment
Identify the clinical manifestations of hypophosphatemia. Similar to hypercalcemia: KIDNEY STONES, impaired renal function, bone pain, cardiac problems, many nonspecific
hyperphosphatemia high phosphate in ECF
Identify the etiology/pathogenesis of hyperphosphatemia. Excretion problems, renal failure
Identify the clinical manifestations of hyperphosphatemia. Similar to hypocalcemia: nerve/muscle function, irritability, confusion, possible resp. failure; Neuromuscular excitability (tingling, spasms), intestinal cramping, MUSCLE AND BONE PAIN DUE TO SOFTENING
hypomagnesemia low magnesium in ECF
Identify the clinical manifestations of hypomagnesemia. Diet, alcoholism, s/t heart disease, cancer, MSK probs
Identify the etiology/pathogenesis of hypomagnesemia. DYSRHYTHMIAS, SEIZURE, TUMORS, MUSCLE WEAKNESS,
torsades de pointes ventricular tachycardia that is characterized by fluctuation of the QRS complexes around the electrocardiographic baseline and is typically caused by a long QT interval
hypermagnesia high magnesium in ECF
Identify the etiology/pathogenesis of hypermagnesia. renal failure
Identify the clinical manifestations of hypermagnesia. Cardiac problems (hypotension, bradycardia), muscle weakness, decreased reflex in deep tendons,
Created by: nikkirosety