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annie morel
F & E
| Question | Answer |
|---|---|
| What is considered a hypotonic state? | Less than body and less than 250 mEQ/L |
| What is considered an isotonic state? | Equal to body and equal to 310 mEQ/L |
| What is considered a hypertonic state? | More than body or greater than 375 mEq/L |
| What happens to a cell in a hyponic state? | It is dehydrated to start which means there is more water outside of the cell so water moves toward the cell. |
| What happens to a cell in an isotonic state? | Nothing...all is happy and balancedNo movement of water.. |
| What happens to a cell in a hypertonic state? | It is edematous and there is fluid volume excess so there is less sodium in the cell than water so water moves from cell to circulatory system |
| What is the daily volume of gastric juice? | 2500 ml |
| What is the daily volume of intestinal juices? | 3000 ml |
| What happens when there is sever vomiting or prolonged suctioning or diarrhea out of the stomach? | the losses are H, Na, K, and Mg. There is a deficit = hyponatremia and hypokalemia |
| What happens when there are losses of K, Na, and HCO3 out of the intestines? | there is a deficit = hypokalemia and hyponatremia |
| When there is dehydration in the 2nd degree in the ECF what happens? (cell) | Na increases with a H20 deficit and there is a Na deficit and Na decreases and there is an Isotonic deficit (the Na will be within normal limits |
| What happens when there is an expansion of the ECF in the 2nd degree? (cell) | Edema and there is H20 excess with Na decrease and Na excess with Na increase and Isotonic excess with Na within normal limits |
| What are the neuro symptoms of FVE or Hypovolemia--H20 gain and Na gain? | irritable, sluggish and anxiety |
| What are the CV symptoms of FVE H20 gain and Na gain? | JNVD, ^BP, ^HR, and wt. gain |
| What are the Resp. symptoms of FVE H20 gain and Na gain? | ^RR, dyspnea, crackles, pulmonary edema. |
| What are the GI symptoms of FVE H20 gain and Na gain? | Distended, sluggish gut, anorexia |
| What are the renal symptoms of FVE H20 gain and Na gain? | increase or decrease in acute renal failure or congestive heart failure. |
| What meds do you treat excess with? | Diuretic--LAsix, ACE inhibitors |
| In FVE and H20 gain and Na gain what do the labs show? | The serum labs appear normal |
| What causes FVE with Na and H20 gain? | steroids, CHF, excess, IV fluid, kidney failure |
| What should you check? | potassium and monitor Na, Cl, Mg, as well. Sodium can drop with K levels or ^k with aldosterone. |
| What happens to Hgb and Hct? | Both decrease |
| What happens to renal functions with urinary output with acute renal failure and Congestive heart failure? | There is a decrease in output |
| What happens to urinary output with chronic renal disease? | increase in output |
| Why should you check K? | b/c loops are not K sparing |
| What happens in Fluid Volume Deficit--Hypovolemia? | There is a loss of H20 and Na and there is an Isotonic loss |
| What causes FVD with H20 and Na loss? | vomiting, GI suction, sweating, diarrhea, 2nd and 3rd spacing, hemorrhage, decreased vascular volume, ^aldosterone, fever |
| What neuro symptoms do you have with FVD loss of H20 and Na loss? | decreased |
| What CV symptoms do you have with FVD loss and H20 and Na loss? | decreased BP with orthostatic changes, ^HR, JVD flat. |
| What are the GI symptoms of FVD loss and H20 and Na loss? | irritability |
| What are the renal symptoms of FVD and H20 loss and Na loss? | decreased output |
| How do you treat? | with IV fluids--isotonic NS or LR b/c isotonic loss is replaced with isotonic fluids. |
| What happens to the labs in FVD H20 loss and Na loss? | ^hgb, ^hct, ^BUN, ^spec. gravity |
| What else can you do to see if kidneys can output more urine by response? | Fluid challenge of 200-500 cc NS over 1-2 hours |
| What are some nursing actions? | IV fluids, BP, safety, ^falls risk, check orthostatic checks, urine output, check to make sure that there is 30 ml of urine per hour |
| What happens to the blood flow to the kidneys and aldosterone and urine output? | blood flow decreases, aldosterone increases, and urine decreases |
| What happens with hyponatremia with FV deficit with hypotonic imbalance? | More Na is lost than H20 and there is decreased Na |
| What causes Hyponatremia with FV deficit? | decreased Na 120 or less, steroids decreased and Na excreted, diarrhea, emesis |
| What are the neuro symptoms of Hyponatremia with FV deficit? | dizziness, headache, lethargy, weakness, confusion |
| What are the CV symptoms of hyponatremia with DV deficit? | ^HR, decreased BP, flat JVD |
| What are the Resp. symptoms of hyponatremia with FV deficit? | ^RR |
| What are the GI symptoms of hyponatremia with FV deficit? | irritability |
| What are the renal symptoms of hyponatremia with FV deficit? | decreased urinary output |
| What are the weight symptoms of hyponatremia with FV deficit? | decreased |
| How is this treated? | with IV of 3% NS or LR Encourage water PO and regular diet. Na will increase. |
| What happens to Hgb and Hct? | increases |
| What are some nursing actions to take? | check orthostatic changes, labs, I&O, monitor fluids |
| What happens with hyponatremia with FV excess? | There is more H20 gained than Na and Na levels appear low |
| What causes this? | renal or liver failure, CHF, decreased Hgb and Hct (dilution), steroids |
| What are the neuro symptoms of hyponatremia with FV excess? | cells swell, headache, lethargy, and confusion |
| What are the CV symptoms of hyponatremia with FV excess? | ^BP and ^HR |
| What are the resp. symptoms of hyponatremia with FV excess? | ^RR, SOB,crackles |
| What are the GI symptoms of hyponatremia with FV excess? | sluggish |
| What are the renal symptoms of hyponbatremia with FVE? | ^UO, wt. gain, spec gravity decreases |
| What are the skin and membrane symptoms of htponatremia with FVE? | moist--edema |
| What is the treatment for this? | Diuretics and diet and restrict fluids (3rd space edema) |
| What are some nursing actions? | monitor labs, ^safety risk, risk for skin integrity with moist areas (turn pt.), look at K supplementation or not, auscultate lungs, and monitor wt. and urinary output daily |
| What is considered a hypotonic state? | Less than body and less than 250 mEQ/L |
| What is considered an isotonic state? | Equal to body and equal to 310 mEQ/L |
| What is considered a hypertonic state? | More than body or greater than 375 mEq/L |
| What happens to a cell in a hyponic state? | It is dehydrated to start which means there is more water outside of the cell so water moves toward the cell. |
| What happens to a cell in an isotonic state? | Nothing...all is happy and balancedNo movement of water.. |
| What happens to a cell in a hypertonic state? | It is edematous and there is fluid volume excess so there is less sodium in the cell than water so water moves from cell to circulatory system |
| What is the daily volume of gastric juice? | 2500 ml |
| What is the daily volume of intestinal juices? | 3000 ml |
| What happens when there is sever vomiting or prolonged suctioning or diarrhea out of the stomach? | the losses are H, Na, K, and Mg. There is a deficit = hyponatremia and hypokalemia |
| What happens when there are losses of K, Na, and HCO3 out of the intestines? | there is a deficit = hypokalemia and hyponatremia |
| When there is dehydration in the 2nd degree in the ECF what happens? (cell) | Na increases with a H20 deficit and there is a Na deficit and Na decreases and there is an Isotonic deficit (the Na will be within normal limits |
| What happens when there is an expansion of the ECF in the 2nd degree? (cell) | Edema and there is H20 excess with Na decrease and Na excess with Na increase and Isotonic excess with Na within normal limits |
| What are the neuro symptoms of FVE or Hypovolemia--H20 gain and Na gain? | irritable, sluggish and anxiety |
| What are the CV symptoms of FVE H20 gain and Na gain? | JNVD, ^BP, ^HR, and wt. gain |
| What are the Resp. symptoms of FVE H20 gain and Na gain? | ^RR, dyspnea, crackles, pulmonary edema. |
| What are the GI symptoms of FVE H20 gain and Na gain? | Distended, sluggish gut, anorexia |
| What are the renal symptoms of FVE H20 gain and Na gain? | increase or decrease in acute renal failure or congestive heart failure. |
| What meds do you treat excess with? | Diuretic--LAsix, ACE inhibitors |
| In FVE and H20 gain and Na gain what do the labs show? | The serum labs appear normal |
| What causes FVE with Na and H20 gain? | steroids, CHF, excess, IV fluid, kidney failure |
| What should you check? | potassium and monitor Na, Cl, Mg, as well. Sodium can drop with K levels or ^k with aldosterone. |
| What happens to Hgb and Hct? | Both decrease |
| What happens to renal functions with urinary output with acute renal failure and Congestive heart failure? | There is a decrease in output |
| What happens to urinary output with chronic renal disease? | increase in output |
| Why should you check K? | b/c loops are not K sparing |
| What happens in Fluid Volume Deficit--Hypovolemia? | There is a loss of H20 and Na and there is an Isotonic loss |
| What causes FVD with H20 and Na loss? | vomiting, GI suction, sweating, diarrhea, 2nd and 3rd spacing, hemorrhage, decreased vascular volume, ^aldosterone, fever |
| What neuro symptoms do you have with FVD loss of H20 and Na loss? | decreased |
| What CV symptoms do you have with FVD loss and H20 and Na loss? | decreased BP with orthostatic changes, ^HR, JVD flat. |
| What are the GI symptoms of FVD loss and H20 and Na loss? | irritability |
| What are the renal symptoms of FVD and H20 loss and Na loss? | decreased output |
| How do you treat? | with IV fluids--isotonic NS or LR b/c isotonic loss is replaced with isotonic fluids. |
| What happens to the labs in FVD H20 loss and Na loss? | ^hgb, ^hct, ^BUN, ^spec. gravity |
| What else can you do to see if kidneys can output more urine by response? | Fluid challenge of 200-500 cc NS over 1-2 hours |
| What are some nursing actions? | IV fluids, BP, safety, ^falls risk, check orthostatic checks, urine output, check to make sure that there is 30 ml of urine per hour |
| What happens to the blood flow to the kidneys and aldosterone and urine output? | blood flow decreases, aldosterone increases, and urine decreases |
| What happens with hyponatremia with FV deficit with hypotonic imbalance? | More Na is lost than H20 and there is decreased Na |
| What causes Hyponatremia with FV deficit? | decreased Na 120 or less, steroids decreased and Na excreted, diarrhea, emesis |
| What are the neuro symptoms of Hyponatremia with FV deficit? | dizziness, headache, lethargy, weakness, confusion |
| What are the CV symptoms of hyponatremia with DV deficit? | ^HR, decreased BP, flat JVD |
| What are the Resp. symptoms of hyponatremia with FV deficit? | ^RR |
| What are the GI symptoms of hyponatremia with FV deficit? | irritability |
| What are the renal symptoms of hyponatremia with FV deficit? | decreased urinary output |
| What are the weight symptoms of hyponatremia with FV deficit? | decreased |
| How is this treated? | with IV of 3% NS or LR Encourage water PO and regular diet. Na will increase. |
| What happens to Hgb and Hct? | increases |
| What are some nursing actions to take? | check orthostatic changes, labs, I&O, monitor fluids |
| What happens with hyponatremia with FV excess? | There is more H20 gained than Na and Na levels appear low |
| What causes this? | renal or liver failure, CHF, decreased Hgb and Hct (dilution), steroids |
| What are the neuro symptoms of hyponatremia with FV excess? | cells swell, headache, lethargy, and confusion |
| What are the CV symptoms of hyponatremia with FV excess? | ^BP and ^HR |
| What are the resp. symptoms of hyponatremia with FV excess? | ^RR, SOB,crackles |
| What are the GI symptoms of hyponatremia with FV excess? | sluggish |
| What are the renal symptoms of hyponbatremia with FVE? | ^UO, wt. gain, spec gravity decreases |
| What are the skin and membrane symptoms of htponatremia with FVE? | moist--edema |
| What is the treatment for this? | Diuretics and diet and restrict fluids (3rd space edema) |
| What are some nursing actions? | monitor labs, ^safety risk, risk for skin integrity with moist areas (turn pt.), look at K supplementation or not, auscultate lungs, and monitor wt. and urinary output daily |
| What happens wth hypernatremia with FVD? | Hypertonic imbalance and Na appears high with deficits in ECF and ICF |
| What are the neuro symptoms of hypernatremia with FVD? | irritable, confused, lethargic, |
| What are the CV symptoms of hypernatremia with FVD? | ^HR, decreased BP with orthostatic changes, HTN |
| What are the resp. symptoms of hypernatremia with FVD? | ^RR |
| What are the GI symptoms of hypernatremia with FVD? | irritable |
| What are the renal symptoms of hypernatremia with FVD? | decreased urinary output and ^spec gravity |
| What is the treatment of this? | IV of 0.45 NS of 1/2 NS if decreased BP and PO water D5 1/2 with NS |
| What causes this? | H20 intake, BG, feeding tube (hyperglycemia), swweating, vomiting, diarrhea, diuresis, excessive diuretic therapy |
| What are some nursing actions? | othorstatic checks, Na, daily wt., intake of fluids, ice chips, mouth swabs, labs, BUN, Cr, spec. gravity, I&O |
| What happens with increased potassium? | early--irritabilitylate--weakness, flaccidity, exhaustion |
| What causes this? | Acidosis, bananas, OJ, salt substitute, meds, urinary output, GI loss, trauma and burns (cell damage), Addison's disease |
| What are the CV symptoms of ^K? | T- wave peaked, QRS wave peaked |
| What is the treatment of ^K? | Low K diet, IV- 50% dextrose and insulin, limit k foods, restrict k from diet completely |
| What are meds to help with ^K? | KLayexelate, furosemide, and dialysis, ACE inhibitors, K sparing drugs, beta blockers |
| What are the normal levels of K? | 3.5-4.5 |
| What are some nursing actions? | EKG, CR, BUN, I&O, GFR, Falls risk, |
| What causes hypokalemia? Low K? | ECG changes, diuretics, laxatives, renal loss, decreased k dietary intake, increased protein, NPO, TPN< Shift of ECF to ICF, GI loss |
| What are the neuro symptoms of hypokalemia? | Weakness, fatigue |
| What are the CV symptoms of hypokalemia? | decreased T wave, U wave, HR dysrrhythmias, dig toxicity |
| What are the GI symptoms of hypokalemia? | smooth muscle,decreased ileus, paralytic ileus, decreased muscle contraction |
| What is the treatment of hypokalemia? | Diet rich in K rich foods and drinks, IV serious 40 MEq over 4 hours (give slowly), PO KCL, daily bananas, and veggies. |
| What are some nursing actions? | EKG, monitor labs, falls risk, monitor BM's, RR, dig levels, monitor t wave and U wave. |
| What is very important to remember!!!! | dig+lasix=decreased K and = death!!!!! |
Created by:
anniemorel
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