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Med surg electrolyte
NRTC
| Question | Answer |
|---|---|
| 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
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