Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
EXAM 5 - MED SURG
Fluid & Electrolytes
| Question | Answer |
|---|---|
| Causes of Fluid Volume Loss | Vomiting, diarrhea, fistulas, fever, excess sweating, burns, blood loss, GI suction, third-space shifts, and decreased intake as in anorexia, nausea, and inability to gain access to fluid. Diabetes insipidus and uncontrolled diabetes can contribute |
| Causes of Fluid Volume Excess | Compromised regulatory mechanisms such as kidney injury, heart failure, and cirrhosis. Overzealous administration of sodium-containing fluids, and fluid shifts (treatment of burns). Prolonged corticosteroid therapy, severe stress, and hyperaldosteronism |
| Hypovolemia | Occurs when loss of ECF volume exceeds the intake of fluid. Occurs when water and electrolytes are lost in the same proportion as they normally exist |
| Hypervolemia | An expansion of the ECF caused by abnormal retention of water and sodium in approximately the same proportions in which they normally exist |
| Lab Values that Correlate with Fluid Volume Excess | Decreased hemoglobin and hematocrit. Decreased serum and urine osmolality. Decreased urine sodium and specific gravity |
| Lab Values that Correlate with Fluid Volume Deficiency | Increased hemoglobin and hematocrit. Increase serum and urine osmolality and specific gravity. Increased BUN and creatinine. Decreased urine sodium |
| Assessment Findings that Correlate with Fluid Excess | Acute Weight Gain, peripheral edema and ascites. Distended Jugular Veins. Crackles, SOB, Elevated CVP. Increased BP, pulse and cough. Increased respiratory rate. Increased urine output |
| Assessment Findings that Correlate with Fluid Deficiency | Acute weight loss. Decreased skin turgor, oliguria, concentrated urine. Prolonged capillary refill time, Low CVP. Decreased BP, flattened neck veins. Dizziness, Weakness, thirst & confusion. Increased pulse, muscle cramps, sunken eyes. Nausea, increased temp, cool, clammy, pale skin |
| Hypovolemia Treatment | Fluid Replacement either PO or IV. Monitor for fluid overload in IV. Safety precautions as they are at risk for falls with orthostatic hypotension, daily intake and output, and daily weight. Watch for hypovolemic shock. |
| Hypernatremia | Results from increased insensible losses and diabetes insipidus |
| Hypokalemia | Occurs with GI and renal Lossses |
| Hyponatremia | Occurs with increased thirst, and ADH release |
| Hyperkalemia | Occurs with adrenal insufficiency |
| Hypotonic Solutions | Out of the Vessel and into the Cell - Cell Expansion. Examples include 0.45% Normal Saline, 2.5% Dextrose, 0.33% Normal Saline |
| Hypotonic Solutions are used in | Intracellular dehydration such as diabetic keto acidosis, helps kidneys excrete excess fluids. NEVER given in burns or liver disease |
| Normotonic Solutions | Equal Water & Particle Ratio. Examples include 0.9% Normal Saline, Lactated Ringers. 5% Dextrose (D5W) |
| Normotonic Solutions are used in | Blood products, hypovolemia, burns, hemorrhage, surgery, dehydration, fluid maintenance |
| Hypertonic Solutions | More concentrated & increased Osmolality. Examples include 5% Dextrose in 0.9% NS (D5NS), 5% Dextrose in 0.45% Saline, 5% Dextrose in Lactated Ringers |
| Hypertonic Solutions are Used in | Cerebral Edema, Hyponatremia, Metabolic Alkalosis, Maintenance Fluid, and Hypovolemia |
| Air Embolism | Symptoms include palpitations, dyspnea, continued coughing. JVD, wheezing, cyanosis, hypotension, weak, rapid pulse, altered mental status, chest, shoulder, and low back pain. - Immediately clamp cannula and replace the leaking system, and place patient in a Trendelenburg Position. |
| IV Infection | Symptoms include backache, headache, increased pulse, increased respiratory rate, nausea and vomiting, diarrhea, chills and shaking, and general malaise. Additional symptoms include erythema, edema, and induration, or drainage at the insertion site. In sepsis vascular collapse and septic shock may occur. |
| Phlebitis | Inflammation of a vein, can be from irritating medication, long periods of cannulation, large catheter gauges, poorly secured catheters. Characterized by reddened, warm area around the insertion site or along the path of the vein, pain or tenderness at the site or along the vein, and swelling |
| Infiltration | Can occur from the IV cannula dislodging, or perforation of the vein wall. Characterized by edema around insertion site, leakage of IV fluid from the insertion site, discomfort and coolness in the affected area, and significant decrease in flow rate. Sloughing can occur when solution is really irritating. |
| Extravasation | Often caused by vasopressors, K+, and calcium preparations or chemotherapeutic agents. Characterized by pain, burning, redness, blistering, inflammation, and necrosis. |
| Thrombophlebitis | The presence of clot plus inflammation in the vein. Evidenced by localized swelling around insertion site or along the path of a vein. Immobility of the extremity may occur because of swelling, discomfort, and sluggish flow rate, fever, malaise, and leukocytosis |
| Hematoma | Blood leaks into tissues surrounding the IV insertion site. Results if the vein wall is perforated during venipuncture, the needle slips out of the vein, or the cannula is too large. Symptoms include ecchymosis, immediate swelling at the site, and leakage of blood at the insertion site. |
| Respiratory Buffer Systems | Hyperventilation. The increase RR helps blow out excessive hydrogen ions (decreases hydrogen ions). Hypoventilation occurs to increase hydrogen ions. |
| Kidney Buffer Systems | Produce more bicarbonate if needed. If there are high hydrogen ions, bicarbonate reabsorption and production occurs. If there is low hydrogen ions, bicarbonate excretion occurs |
| pH Level | The measurement of how acidic or alkalotic your blood is. It is regulated by both the lungs and kidneys. -- 7.35-7.45 (Lower = Acidosis, Higher = Alkalosis) |
| HCO3 Level | Measurement of the bicarbonate in the blood. It is regulated by the kidneys -- 22-26 |
| PaCO2 Level | Measurement of the Carbon Dioxide in the blood. It is regulated by the Lungs. -- 35-45 |
| Respiratory Acidosis Symptoms | Decreased BP & RR, increased HR (tachycardia), dysrhythmias, ventricular fibrillation, anxiety, restless, confusion, headache, sleepy/coma, pale/cyanotic |
| Respiratory Alkalosis Symptoms | Increased RR (tachypnea) over 20 breaths/min, increased HR (tachycardia), confused and tired, tetany, EKG changes, and Chvostek's Sign (twitching of the facial muscles when tapping the facial nerve) |
| Metabolic Acidosis Symptoms | Increased RR- Kussmaul breathing (deep, rapid breathing greater than 20 per minute), hyperkalemia (muscle twitching, weakness, arrythmias), decreased BP, confusion, skin warm, dry, pink. |
| Metabolic Alkalosis Symptoms | Decreased RR (hypoventilation less than 12 per minute), decrease potassium (dysrhythmias, muscle cramps/weakness), vomiting, tetany, tremors, EKG changes, hyper-reflexes, convulsions |
| Causes of Metabolic Acidosis | Ketoacidosis, lactic acid accumulation (shock), severe diarrhea, kidney diseases |
| Causes of Respiratory Acidosis | Hypoventilation, respiratory failure, respiratory depression, airway obstruction |
| Causes of Respiratory Alkalosis | Hyperventilation, hypoxemia from asphyxiation, high altitudes, shock, or early stage asthma/pneumonia |
| Causes of Metabolic Alkalosis | Prolonged vomiting or gastric suction |
Created by:
Nursing.Student.Help
Popular Nursing sets