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Cert - Fluid & Elect

AMSN - fluid and electroyltes

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