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365 Exam 1
365 CH Fluid and Electrolytes
| Term | Definition |
|---|---|
| hypovolemia | low volume manifested by thirst, dry mucous membranes, decreased skin turgor, changes in LOC |
| hypovolemia manifestations | postural hypertension, weak and thready pulse, tachypnea and tachycardia, oliguria |
| hypovolemia lab findings | elevated BUN, hemoconcentration |
| normal BUN | 7 to 20 |
| normal Creatinine | 0.9 to 1.3 |
| normal urine output | 30 to 60 mL per hour |
| hypovolemia risk | nausea and vomiting, dehydration, trauma |
| hypovolemia treatment | isotonic IVF - 0.9%NaCl or Lactated Ringers |
| hypervolemia | fluid excess; heart failure patients |
| hypervolemia manifestations | peripheral edema, JVD, crackles, increased BP, SOB and wheezing; bounding pulse |
| hypervolemia lab findings | low BUN, hemodilution |
| hypervolemia treatment | sodium restricted diet, fluid restriction, diuretics |
| hyponatremia causes | fluid loss, fasting diets and wound drainage, fluid excess |
| treatments avoiding over correction due to neurologic complications | hyponatremia |
| seizure precautions | bed in lowest position, padded side rails, suction and O2 at bedside |
| hypernatremia causes | decreased fluid intake, excess salt intake; dehydration, diarrhea, vomiting |
| hypernatremia manifestations | thirst, dry mucous membranes, concentrated urine, decreased reflexes, agitation, headache, restlessness |
| hypernatremia treatment | hypotonic solution; 5% dextrose in water or .45% saline; decreased Na level slowly |
| cerebral edema | lethargy, headache, N/V, increased BP |
| hypokalemia causes | decreased intake, GI loss through emesis, stool and urine; excess renal secretion, alkalosis |
| hypokalemia manifestations | muscle cramps, weakness and tenderness, postural hypertension, PVCs |
| administering IV potassium | potent vesicant; irritating to the veis |
| hyperkalemia cause | decreased urinary excretion, increased intake, tissue injury, renal disease (dialysis patients) |
| hyperkalemia manifestations | muscle weakness and paresthesia, muscle cramps, diarrhea, irregular pulse, lower extremity weakness, peaked T waves, bradycardia, tumor lysis syndrome |
| hyperkalemia treatment | regular insulin paired with 5% dextrose, albuterol nebs, sodium bicarbonate |
| potassium restriction | leafy greens, bananas, oranges, potatoes |
| fluid intake | water, ice, juice, coffee, jello, popsicles, broth |
| crystalloids | solutions with small solute particles that can pass through membranes |
| isotonic | tonicity is the same as blood plasma, does not change serum osmolality; increases vascular without affecting intracellular fluid |
| isotonic solution uses | hypovolemia, dilute medications, a control flush to keep veins open |
| isotonic solutions | 5% dextrose water, .9% NaCl, lactated ringers |
| hypotonic | solutions contain more water and less electrolytes; causes a fluid shift from bloodstream into cells |
| hypotonic uses | hypernatremia, severe cellular dehydration |
| hypotonic solutions | 0.45% NaCl, 0.33% NaCl |
| hypotonic caution | monitor for intravascular fluid loss, intracellular sweating; edema, hypotension, LOC changes |
| hypertonic | contains less water and more solute, tonicity is higher than blood plasma; causes a fluid shift out of cells and into the bloodstream |
| hypertonic uses | hypovolemia, intracellular swelling (water intoxication), hyponatremia |
| hypertonic solutions | dextrose 5% in .45% NaCl; dextrose 5% in .9% NaCl, dextrose 5% in LR |
| colloids | solutions with larger particles (proteins or starch) that do not fully dissolve and are too large to pass through vascular walls and into the cells |
| common colloids used | albumin, dextran, blood products |
| positive i&O | fluid excess, what went in is more than what came out |
| negative I&O | fluid deficit, what went in is less than what came out |
| hypercalcemia causes | cancer, hyperparathyroidism, immobilization, vitamin D overdose, use of diuretics |
| hypercalcemia manifestations | flank pain, kidney stones, decreased muscle tone and coordination, CNS depression (stones, groans, moans, bones) |
| hypercalcemia treatment | low calcium diet, isotonic fluids, .9% NaCl; stop ant acids, thiazide diuretics, vitamin D |
| hypercalcemia | hypophosphatemia |
| hypocalcemia causes | laxative abuse, lack of calcium and vitamin D, hypoparathyroidism, excessive IV fluids and blood transfusions, alkalosis |
| hypocalcemia manifestations | positive chvostek and trousseau, hyporeflexia, tetany |
| hyperphosphatemia causes | renal failure, tumor lysis syndrome, thyrotoxicosis, hypoparathyroidism, rhabdomyolysis, sickle cell anemia |
| rhabdomyolysis | fall damage to muscle and tissue, increased cardiac enzymes, damage to heart and kidneys |
| hyperphosphatemia manifestations | hypocalcemia, paresthesia, tetany, hyperreflexia, muscle cramps |
| hyperphosphatemia treatment | oral phosphate binding agent - calcium acetate (phoslo) |
| hypophosphatemia causes | diarrhea, malabsorption, malnutrition, parenteral nutrition, alcoholism, hyperparathyroidism |
| hypophosphatemia manifestations | hypercalcemia, ataxia, muscle weakness, bone pain, CNS depression (stones, moans, bones, groans) |
| hypermagnesemia | everything slow; muscle, BP, HR |
| hypermagnesemia causes | renal failure, tumor lysis syndrome, diabetic ketoacidosis |
| hypermagnesemia manifestations | lethargy, drowsiness, flushed, warm skin, muscle weakness, hyporeflexia, bradycardia, hypotension |
| hypermagnesemia treatment | limit green vegetables, nuts, bananas, seeds, legumes, oranges, grains, PB, chocolate |
| hypomagnesemia causes | GI loss; vomit, diarrhea, NG suction; chronic alcoholism, PPI therapy, increased urine output |
| hypomagnesemia manifestations | muscle cramps, tetany, positive chvostek and troussea signs, hyperactive reflexes |
| hypomagnesemia complications | torsade's de point |
| vomit risk | low potassium and magnesium |
| hypokalemia | muscle cramps |
| hyperkalemia | T waves |
| treating with diuretics | potassium wasting |
Created by:
ahommel
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