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Cert - Fluid & Elect
AMSN - fluid and electroyltes
| Question | Answer |
|---|---|
| What is the total umbrella figure of body water (intracelluar and extracellular)? | 40 L |
| What percentage/fraction of body water is in the intracellular space? | 3/4 body water |
| What percentage/fraction of body water is in the intracellular space? | 1/4 body water |
| Men or women have more body water? | Men as women have more fat cells and fat cells do not contain/hold water |
| Baby or adults have more body water? | babies have more water |
| Who is at the highest risk for hypovolemia when vomiting and diarrhea of gastroenteritis occurs? | elderly women |
| Are the same electroyltes in both the extracellular and intracellular compartments? | Yes but in different amounts. |
| Blood work provides electroylte levels of the intracellular or extracellular space? | Extracellular space |
| What is the normal range for sodium? | 135 - 145 mEq/L |
| Na (sodium) is responsible for? | 1. Protein synthesis inside the cell 2. maintaining fluid volume in extracellular spaces |
| What two lab values responsible for maintaining fluid volume in the extracellular space? | Na and Albumin |
| What are the two types of hyponatremia? | 1. Dilutional - too much fluid ingested and Na not lost 2. True - loss of body sodium which leads to loss of body water |
| What can cause true hyponatremia? | Burns, fistulas |
| What are the symptoms of dilutional hyponatremia? | confusion caused by cerebral edema and peripheral edema |
| What is the treatment of dilutional hyponatremia? | fluid restrictions and diuretics |
| What symptoms are associated with true hyponatremia? | dry skin, increased pulse, decreased blood pressure, dry skin, dry mucous membranes |
| What is the treatment for true hyponatremia? | replacement of sodium, fluids (LR or NS) |
| Hypernatremia is most commonly caused by? | fluid loss without sodium loss. |
| What can cause fluid loss without sodium loss (hypernatremia) | fevers, hyperventiliation for extended period of time, (rarely) - high protein tube feedings if not enough water is given along with it. |
| What is the treatment for hypernatremia? | fluids which include Na and withholding Na intake |
| What is the normal range for K+? | 3.5 - 5.0 mEq/L |
| Potassium is an irritant to what? | Neuromuscular junction |
| Will increased potassium levles effect brain function? | No |
| Hyperkalemia can cause? | Muscular irritability - cardiac arrhythmias, increased peristalisis and diarrhea and skeletal muscle twicthing |
| Hypokalemia can cause? | loss of muscle tone - cardiac arrhythmias (as heart cells will attempt to maintain muscle tone), loss of skeletal muscles |
| What is the tx for hyperkalemia? | If not an emergency: Kaexalate as it will take aproximately 6 hours to work. In an emergency use regular insulin with glucose or dialysis. |
| Regular insulin can drive what three things into the cell? | glucose, potassium, phosphate |
| Wat is the relationship between potassium and pH? | Inverse relationship |
| What can cause hyperkalemia? | Cell destruction as the contents of the cell are released into the blood stream. |
| Cell destruction can be caused by? | 1. Trauma 2. chemotherapy - especially if the kidney is functioning poorly 3. increased intake of food with postassium 4. potassium supplements |
| What can cause hypokalemia? | 1. decreased intake of K+ 2. excessive amts of diuretics given 3. NG tubes in place for long periods of time |
| What do NG tubes placed for long periods of time cause hypokalemia? | they pull hydrogen ions, causing a rise in pH resulting with a decrease in K+ |
| What is at risk if potassium levels drop below 2.5 mEq/L? | extreme risk for cardiac arrest due to poor muscle tone |
| What foods are VERY HIGH in K+ | Avocados, dried fruits |
| What foods are HIGH in K+ | potato skin |
| What food have MEDIUM amt of K+ | orange juice, bananas, milk |
| What is the function of calcium? | 1. To carry nerve messages from the brain in the nerve cells 2. coagulation - w/o it clotting factors cannot activate |
| What occurs when calcium levels are too high (hypercalcemia)? | 1. sedation 2. decreased muscle tone 3. renal stones |
| What occurs when calcium levels are too low (hypocalcemia)? | 1. muscle irritability as too many messages enter the nervous system. 2. bleeding |
| What is the mortality rate for rapid hypercalcemia? | 50% mortality rae |
| What can cause hypercalcemia? | 1. increased intake of Ca 2. Parathyroid tumor |
| What is the tx for hypercalcemia? | 1. decreased calcium intake 2. increased fluid intake |
| Chvostek's | tapping in front of the ear will cause twitching of that side of the face - caused by hypocalcemia |
| Trousseau's | carpal/pedal spasms - fingers curl toward palm of the hand as BP cuff inflates - caused by hypocalcemia |
| Laryngospasm | triggered by swallowing - caused by hypocalcemia |
| Hypocalcemia can cause what three hyperactive deep tendon reflexes? | 1. Chvostek's 2. Trousseau's 3. Laryngospasm |
| What is the tx for hypocalcemia? | If severe - calcium gluconate via IV if moderate - calcium carbonate or foods high in calcium |
| What is the normal range for Calcium | 9.0 - 10.5 mg/dl |
| What is the normal range for phosphate? | 3.0 - 4.5 mg/dl |
| What happens to calcium when serum phosphate is too high? | calcium cannot be absorbed in the body through the GI tract no matter how much is present |
| What is the normal range for Mg? | 1.3 - 2.1 mEq/L |
| What is the function of Mg? | nerve impulse transmission |
| What is the only route of excretion for Mg? | through the kidneys |
| What is a common reason for hypermagnesemia? | renal failure |
| What symptoms are associated with hypermagnesemia? | 1. sedation 2. decreased muscle tone |
| What can occur if Mg levels rise to high levels quickly (Mg citrate given to a pt with renal failure)? | repiratory failure |
| What is the tx for hypermagnesemia? | prevent excessive doses being given |
| What causes hypomagnesemia? | 1. dietary loss 2. person recovering from an extended ETOH binge |
| What are the symptoms associated with hypomagnesemia? | 1. hyper-irritability of the mucles 2. seziure activity can occur 3. resemble hypocalcemia |
| What is the tx for hypomagnesemia? | magnesium supplementation |
| Define serum osmolarity? | 1. how thick is this solution |
| What is a quick way to calculate serum osmolarity? | multiple Na x 2 |
| What does serum osmolarity determine? | how many (Na, BUN and glucose) can be counted in a liter of serum. |
| Water will be pulled from _____ osmolarity into the one with ______ osmolarity? | lower osmolarity into the one with higher osmolarity. |
| What is the thickness of isotonic solution? | same thickness as serum |
| Where will isotonic solution go in the body? | vascular space - resulting in increase volume |
| Isotonic solutions are also known as _____? | volume expanders |
| What type of patients should receive isotonic solutions? | hypovolemic patients |
| What is the thickness (in relation to serum) is hypertonic solutions? | thicker than serum |
| What fluid shift will hypertonic solutions cause? | Pull fluid off the tissue into the vascular space. |
| What are hypertonic solutions used for? | To pull fluid from edema or third-spaced fluid which occurs to traumatized patients. |
| What fluid should NEVER be given to dehydrated patients? | HYPERTONIC FLUIDS |
| What is the thickness (in relation to serum) is hypotonic solution? | less thick than serum |
| What type of patients should receive hypotonic solutions? | patient's with dry tissue or mucous membranes 2/2 dehydration. |
| What fluid shift will hypotonic solution cause? | Fluid will leave the vascular space and go into the tissues |
| What is the most common complication of giving hypotonic solution? | EDEMA (especially cerebral edema) |
Created by:
lydia.koo
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