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Med surg electrolyte

NRTC

QuestionAnswer
What percentage of water in body weight. What percentage of water in body weight in older person 55-60% 50-55%
what is the pulling of water into and out of the cells by osmotic pressure osmosis
what requires ATP to move electrolytes against the concentration gradient into the cell membrane active transport
this is the movement of fluids across the capillaries filtration
balance is maintained through what input and output
fluid output occurs in what kidneys skin lungs and gastrointestinal tract
are the major Regulators of fluid output the kidneys
where is interstitial fluid located between the cells and outside of the blood vessels
where is transcellular body fluids located secreted by epithelial cells cerebrospinal pleural peritoneal and synovial fluids
intravascular fluid is the liquid part of blood or plasma
2/3 of fluid within the cells is called intracellular
in an adult average fluid intake is what and ranges from what milliliters per day 2500 ml per day (range 1800 to 3600 ml per day)
osmosis is movement of water through a semi-permeable membrane draw water toward an area of Greater concentration is osmotic pressure
substance requires assistance from a carrier molecule to pass through a semi-permeable membrane passive and facilitated diffusion
promotes movement of fluid and chemicals according to pressure differences filtration
osmoreceptors are neurons that sends blood concentration regulates fluid volume by triggering thirst when blood concentration is high triggers pituitary to make ADH reabsorption of water
what does osmoreceptors help you restores normal serum osmolarity increased circulatory blood volume improves cardiac output and maintains blood pressure
what happens when aldosterone is released in the renin-angiotensin one Angiotensin 2 aldosterone system kidneys reabsorb sodium and increase blood pressure and blood volume
hypovolemia what are some causes low volume of extracellular fluid caused by vomiting, diarrhea, wounds ,profuse urination, altered intake,diuretic therapy
when a person is hypovolemic they are usually dehydrated
assessment findings of hypovolemia include thirst, furrowed tongue, concentrated urine, poor skin turgor, thready pulse, hypotension, tachycardia
some diagnostic findings for hypovolemia would be elevated hematocrit and blood cell count, elevated urine specific gravity, elevated serum sodium
people with hypovolemia or at more risk for kidney stones and blood clots
treating ideology first is treating the problem first
with hypovolemia teach to drink 8 glasses of water per day respond to thirst avoid alcohol and caffeine ,monitor vital signs ,slow position change for safety and, at least 30 ml per hour i&o
what is hypervolemia high volume of water in intravascular fluid compartment caused by excessive oral intake IV fluids heart failure kidney disease or adrenal gland dysfunction
hypervolemia can lead to a fluid volume that exceeds what is normal for intravascular space and can compromise cardio pulmonary function which is called circulatory overload
hypervolemia diagnostic findings would be low in blood count low urine specific gravity and hemo dilation or decreased sodium
what would be some medical management for hypervolemia restrict oral or peritoneal fluid, diuretics, limit sodium
what are some assessment findings with hypervolemia with hypervolemia weight gain of 2 lbs in 24 hours crackles with lung sounds, BP HR and resp increase, skin edematous cracks and break down
planning and interventions for hypervolemia monitor I and O, daily weight, administer diuretics, monitor potassium level, Elevate head of bed, prevent skin breakdown, sodium restrictions patient education
what is third spacing translocation of fluid from intravascular to tissue compartments
causes for third spacing would consist of hypoalbuminemia, burns, severe allergic reaction
what are some diagnostic findings for third spacing blood count borderline and hemoconcentration which would be hypovolemic, dry mouth, dizziness
what to do for third spacing albumin infusion helps pull trap fluid back into intravascular space and IV diuretic which reduces potential for overload
this occurs as deficits and or excess accompanied by fluid changes electrolyte imbalance
what would be a cause for electrolyte imbalance deficits, excess
priority electrolyte imbalances sodium, potassium, calcium, magnesium
what is the major electrolyte found outside the cell extracellularly sodium
what electrolyte regulates and distributes fluid volume, maintains normal nerve and muscular activity, regulates osomatic pressure, preserves acid base balance sodium
what are some causes for hyponatremia profuse diaphoresis, diuresis, loss of GI secretions, Burns, Addison's disease, low sodium intake
what are some assessment findings for hyponatremia seizure precautions low CNS crave salt, hypothermia, tachycardia, hyperactive bowel sounds, abdominal cramping, muscular weakness, lethargy and mental confusion
what are some causes for hypernatremia diarrhea excessive salt intake, high fever, excessive water loss, decreased water intake
what are some assessment findings for hypernatremia thirst, dry sticky membranes, decreased urine output, fever, edema, irritability
what is Semana medical management for hypernatremia water intake IV solution of .45% NaCl or 5% dextrose and I&o, VS, dietary restrictions
what are some functions for potassium vital role in cell metabolism, transmission of nerve impulses, function cardiac muscle tissues, acid-base balance
causes of hypokalemia potassium wasting diuretics, GI tract fluid loss, corticosteroids, IV insulin and glucose
why would insulin and glucose contribute to hyperkalemia insulin pushes glucose as well as potassium in to cell
what are some assessment findings for hypokalemia mental confusion fatigue weakness nausea cardiac dysrhythmias. decreased GI Mobility, constipation and leg cramps Labs decrease serum potassium changes an electrocardiogram
what is the medical management for hypokalemia potassium sparing diuretics like spironolactone, k+ rich foods, supplements, , (never bolus) 5 to 10 meq per hour IV
what kind of foods does furosemide need avocados and fruit
what are some causes of hyperkalemia renal failure, potassium sparing diuretics, supplements, crushing injuries, Addison's disease, salt substitutes
assessment findings for hyperkalemia increased GI Mobility, nausea, restlessness irritability, cardiac dysrhythmias, lab increased serum potassium above 5 meq per liter
what medications do you hold when testing potassium level Loop diuretics
Loop Diuretics excrete potassium
medical management for hyperkalemia decrease k+ intake, administrate insulin and glucose, Loop diuretics, kayexalate works as laxative or peritoneal dialysis/ hemodialysis
What is another name for sodium polystyrene sulfanate? kayexalate, binds to k+ in Blood and poops it out profusely
calcium function blood clotting transmission of nerve impulses and regulated by parathyroid gland
assessment findings for hypocalcemia circumoral paresthesia, tetany and cramps with muscle twitches, +chevostek's sign Voz-stek, Trousseau's sign (Tru-so),decreased myocardial contractility
what is circumoral paresthesia tingling of extremities and areas around the mouth
what is tetany muscle twitches
what is positive Chevostek's sign (Voz-Stek) tapping on the facial nerve triggering facial twitching
what is trousseaus sign hand finger spasms with sustained blood pressure cuff inflation, excited nerves
causes of hypercalcemia parathyroid tumors, multiple fractures, prolonged immobilization
hypercalcemia what happens to the calcium goes out of the bone and into the blood
assessment findings for hypercalcemia deep bone pain, constipation, mental changes, decrease memory and attention span
medical management for hypercalcemia IV sodium chloride and Furosemide to excrete CA in urine, calcitonin, corticosteroids
functions of magnesium transmission of nerve impulses, activate enzyme systems including functions of vitamin B
normal range for magnesium 1.3 to 2.1
hypomagnesemia can result from alcoholism, diabetic ketoacidosis, renal disease, Loop diuretics, Burns, malnutrition
assessment findings for hypomagnesemia tachycardia, Harris thesis, neuromuscular irritability, hypertension, mental changes
medical management for hypomagnesemia oral or IV magnesium (calcium gluconate antidote for magnesium sulfate), diet supplements that may cause (diarrhea or worsen mag depletion), foods rich in magnesium, discontinue Loop diuretics
foods that are rich in magnesium green leafy veggies, whole grains, nuts, cocoa, chocolate, soybeans, Seafood, dried beans
assessment findings for hypermagnesemia vasodilation , Flushing, lethargy, bradycardia, coma
causes for hypermagnesemia renal failure, Addison's disease, excessive anti-acid or laxative use, hyperparathyroidism
medical management for hypermagnesemia decrease oral magnesium, mechanical ventilation if resp failure occurs, hemodialysis if severe
quickly if pH is outside of the range of 6.8 to 7.8
normal pH is normal pH is 7.35 to 7.45
the more hydrogen ions in a solution the more acidic it is
the body maintains normal pH by two mechanisms chemical and organ
regular carbon dioxide or paco2 levels are between 35-45
carbonate levels or hco3 is 21 to 28
the lungs put off CO2 which is a acid
kidneys put off hco3 which is a base and alkaline
chemical mechanism to maintain normal pH add or remove hydrogen ions first line of defense responds quickly to change in pH
either bind or release H+ ions bicarbonate carbonic acid buffer system
carbonic acid formula H2CO3 acid
bicarbonate formula hco3 Base neutralizes acid
what is the second line of defense lungs regulate carbonic acid levels by releasing or conserving CO2 increases decreases resp rate
decreases H+ ions hyperventilation
increases H+ ions opioids COPD hypoventilation
what is the third line of defense kidneys regulate bicarbonate levels much slower takes 24 to 48 hours to kick in this is a metabolic system
during the third line of defense with bicarbonate levels High H+ ions indicate bicarbonate reabsorption and production
during the third line of defense bicarbonate levels low H+ ions indicate bicarbonate excretion
where do you draw blood for arterial blood gases ABG s from the artery is a main tool for measuring blood pH CO2 content and bicarbonate
CO2 content equals paco2
acidosis occurs with excessive accumulation of CO2 or excessive loss of hco3 in body fluids too much acid or too little Bass alkalosis occurs with excessive accumulation of face or loss of acid and body fluids
CO2 levels out of range is respiratory
hco3 levels out of range is metabolic
metabolic acidosis is when normal CO2 decreased hco3 and pH lower than 7.35
causes for metabolic acidosis shock/cardiac arrest= lactic acid starvation of fatty acid, DKA, (renal failure - no bicarb),ASAoverdose,loss of GI fluid, wound drainage, hyperkalemia - bs and K+high causing kidney malfunction
assessment findings for metabolic acidosis KUSSMAUL'S breathing, nausea headache flushing abdominal pain muscle weakness
What is Kassmaul's breathing fast and deep breathing from diabetic ketoacidosis
medical treatment for metabolic acidosis replace fluid and electrolytes IV bicarbonate for kidney patient not making enough bicarb
metabolic alkalosis results in PH above 7 .45 normal CO2 and increased hco3
causes for metabolic alkalosis excessive bicarbonate, anti acid drugs, diuretic therapy, vomiting gastric suctioning
assessment findings for metabolic alkalosis tachycardia dysrhythmias numbness tingling confusion ineffective breathing due to muscle weakness
medical treatment for metabolic alkalosis fluid electrolyte replacement and antiemetics
respiratory acidosis PH lower than 35, increased CO2, normal hco3
causes of respiratory acidosis hypoventilation
assessment findings for respiratory acidosis tachypnea cardiac dysrhythmias irritability confusion, slow rapid breathing, warm and flush skin
medical management for respiratory acidosis provide oxygen repositioning Airway suctioning bronchodilators
respiratory alkalosis values pH above 7 .45, decreased CO2, normal hco3
causes for Respiratory alkalosis hyperventilation
assessment findings for Respiratory alkalosis anxiety tingling numbness, chest pain palpitations, rapid deep breathing
medical treatment for Respiratory alkalosis rebreathe expelled air through bag, anxiety reduction techniques
the concentration of substances in the blood hemoconcentration
when would a nurse anticipate administering salt tablets during mild deficits of serum sodium
if a client's parathyroid glands were accidentally removed during a procedure which condition should the nurse prepare for hypocalcemia
when someone has hypovolemia they should avoid they should avoid consuming alcohol and caffeine
what medication should the nurse monitor a client for lowered serum sodium and potassium levels diuretics
ignition might cause respiratory alkalosis rapid breathing
Created by: KesleyNRTC