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Nursing F/E

Nsg F/E

Normal Sodium Level 135 - 145 mEq/L
Normal Potassium Level 3.5 - 5 mEq/L
Normal Calcium Level 8.5 - 10.5 mg/dL
Normal Magnesium Level 1.8 - 2.7 mEq/L
Normal Chloride Level 96 - 108 mEq/L
Normal Phosphorus Level 2.5 - 4.5 mg/dL
Normal Serum Osmolality 280 - 300 mOsm/kg
Normal Urine Specific Gravity 1.010 - 1.025
Normal Glucose (Particle to Water Ratio) 70 - 110 mg/dL
Increased Blood Sugar s/s Increased thirst, increased hunger & increased urination.
Approximately _______ of typical adult weight is water & electrolytes 60%
Factors affecting body fluid balance include: age - younger > older, gender - males > females & Fat - thin > fat
Approximately ______ of body fluids are located in the ICF 2/3
The ECF is further divided into three "compartments" which are: Intravascular holding 6L of fluid, Interstitial holding 11-12L of fluid and the Transcellular holding 1L of fluid
Body fluid moves between the ICF and the ECF to maintain _____________ between spaces equillibrium
Define: Third spacing The result of fluid shifting out of intravascular spaces but not into intracellular spaces.
Cations are Positively charged ions
Anions are Negatively charged ions
Electrolytes are Substances capable of breaking into electrically charged ions when dissolved in a solution
mEq Milliequivalents - a measure of the combining power of the ion
The primary ECF electrolytes Sodium (Na+) and Chloride (Cl-)
The primary ICF electrolytes Potassium (K+) and Phosphate (HPO4-)
Colloid Osmotic Pressure Pulling force exerted by protein in plasma
Hydrostatic Pressure Pushing force exerted on walls of blood vessels
Movements not requiring ATP (energy) Tonicity, Osmotic, Oncotic, and Diffusion
The number of dissolved particles contained in a fluid (concentration) determines the osmolality
Tonicity The ability of all solutes to cause an osmotic driving force that promotes water movement from one compartment to another.
Osmosis Diffusion through a membrane from and area of lower concentration to an area of higher concentration
Osmotic Pressure The amount of hydrostatic pressure required to stop the flow of water by osmosis
Oncotic Pressure The osmotic pressure exerted by proteins (albumin)
Osmotic Diuresis or Particle Induced Diuresis The increase in urine output caused by excretion of substances such as glucose, mannitol, and contrast agents in the urine
Diffusion The tendency of solutes to move freely (spread) throughout a solvent from an area of high concentration to an area of low concentration. OR The random movement of particles in all directions.
Movments which require energy Filtration and Reabsorbtion
Sodium Potassium Pump requires energy and facilitates movement of molecules across the cell membrane against the concentration gradient (from a lower concentration to a higher concentration)
Desireable fluid intake and loss in adults is approximately ____________ 2600mL/d
Sources of fluids Drink- 1300mL/d, Eat - 1000mL/d, Metabolize 300mL/d
Metabolism is the end product of protein, carbs and fat processing by the body
Areas of sensible (measureable) fluid loss: Kidneys - 1500mL/d, Intestinal Tract 200mL/d, and Skin - sweating - 0-1000mL/d
Areas of insensible fluid loss: Skin - evaporation 600mL/d; lungs - exhalation 300mL/d
Normal BUN level 10 - 20 mg/dL
Normal creatinine level 0.7 - 1.4 md/dL (doesn't vary with diet)
Normal Hematocrit level males 42% - 52%; females 35% - 47% Remember: with increased fluid volume you have decreased Hct and with decreased fluid volume you have increased Hct.
The __________ are the primary organs of homeostastis Kidneys; filtering 180L plasma/d and excreting 1-2L urine/d
The ______ and _______ vessels circulate blood through the kidneys under sufficient pressure to allow for urine formation heart; blood
MAP mean arterial pressure: the difference between the systolic and diastolic blood pressures
Should be >70: MAP
_____ will increase coughing and respirations which will assist in increased fluid loss. Lungs
These organs are crucial in maintaining acid-base balance Lungs
Pituitary Gland - hypothalamus manufactures _____ which is stored in the Posterior Pituitary Gland and released as needed to conserve water Antidiuretic Hormone (ADH)
Adrenal Glands helps the body conserve sodium, save water and chloride and excrete potassium.
Cortisol can cause sodium and water retention in large doses or amounts.
Parathyroiid Glands Four tiny glands embedded in the thyroid gland which secrete parathyroid hormone (PTH) which regulates calcium and phosphate balance
Baroreceptor influences Sodium and Water reabsorbtion as needed
Systolic Pressure consists of ventricular contraction
Diastolic Pressure consists of Ventricular relaxation
The Renin-Angiotensin-Aldosterone System Decreaased BP...renin...angiotensin...angiotensin I...angiotensin II...Aldosterone...Increased BP
Before administering these meds always check the BUN, Creatinine, Pulse and BP Ace Inhibitors (meds ending in PRIL) and ARB Inhibitors (meds ending in SARTIN)
Aldactone is a Potassium sparing Diuretic (always check the K+ level before administration)
The presence or absence of ______ is the most significant factor in determining whether urine is concentrated or dilute ADH
Albumin is a protein which helps pull water into the intravascular space
Increased _______ levels may be caused by overhydration Albumin
Decreased glomerular filtration rate is a special consideration for the elderly. The GFR should be >60
The average percentage of body weight in infants which is water: 70% - 80%
The infant is at very high risk for __________ because the ECF is easier to lose than ICF Fluid Volume Deficit
Dehydration is The loss of water by the body
Hypovolemia is The loss of fluid and electrolytes by the body
Causes of Hypovolemia Vomiting, Diarrhea, GI suctioning, Sweating, and Third Space Fluid shifts
S/S of Hypovolemia Acute weight loss, Decreased skin turgor, Oliguria, Concentrated urine, Orthostatic Hypotension, Weak pulses, Tachycardia, Thirst, Delayed capillary refill, Cool clammy pale skin, anorexia, Nausea, Weakness, Cramps, Dry tounge.
___________ Shock is the most common kind of shock, characterized by a reduction in intravascular volume by 15% - 30% Hypovolemic
Heart Failure, Kidney Failure, Cirrhosis of the liver, Endocrine conditions that affect ADH and aldosterone, Excessive intake of sodium containing fluids, drugs which cause sodium retention and the administration of sodium containing IVF are causes of Hypervolemia
Interstitial Edema, Elevated BP, Tachycardia, Bounding Peripheral Pulses, Increased Respiratory Rate, Dyspnea/Orthopnea, Crackles/Wheezes, Distended neck veins, Weight gain, dependent edema in lower extremities in ambulatory clients. Hypervolemia
Fluid losses due to vomiting diarrhea, sweating, diuretics. Causes of Hyponatremia
Poor skin turgor, hypotension, anorexia, n/v, h/a, exhaustion, muscle cramps/twitching, edema/weight gain, altered mental status. S/S of Hyponatremia
A common cause is fluid deprivaton in an unconscious patient who cannot perceive or respond to or communicate thirst, hypertonic interal feeding without water supplements, diarrhea, hyperventilation r/t fever and burns. Causes of Hypernatremia
Thirst,restlessness or weakness, disorientation or confusion, delusions or hallucinations S/S Hypernatremia
Caused by gastric suction, v/d, fistulas, laxative abuse, Medications, alteration in acid-base balance, Hyperaldosteronism, Poor Dietary intake. Hypokalemia
fatigue, anorexia, n/v, dysrythmias, muscle weakness/cramps, paresthesias, glucose intolerance, decreased muscle strength, decreased DTR's Hypokalemia
Hypokalemia will causes changes to the T wave on an EKG. Will the T wave be extraordinarily high or flat? Flat
Hypokalemia will also create an unsual _____ wave on the EKG U wave
Untreated renal failure, rapid administration of potassium, Hypoaldosteronism (Addison's Disease) and Medications will cause Hyperkalemia
Medications causing hyperkalemia include KCL, Heparin, ACE Inhibitors, _______, beta blockers, and potassium sparing diuretics NSAIDS
___ of the body's calcium is located in the bones and teeth. 99%
Calcium is controlled by PTH and calcitonin
Hypocalcemia causes include hypoparathyroidism, malabsorbtion, pancreatitis, massive transfusion of citrated blood, renal failure medications which include: Aluminium containing antacids, corticosteroids, loop diuretics, and caffeine
Trousseau's sign and Chvotsky's sign are both signs of: Hypocalcemia
Malignant tumors, hyperparathyroidism, bone loss related immobilization are all causes of Hypercalcemia
Muscle weakness, incoordination, dehydration, anorexia, n/v, constipation, abdominal distention, bone pain, polyuria, nad thirst are all s/s of Hypercalcemia
Dysrhythmias, confusion, impaired memory, slurred speech, lethargy, acute psychotic behavior, coma and cardic arrest Diagnotic findings of Hypercalcemia
Hypomagnesemia is most common in: chronic alcoholics
What is the percentage of Mg found in bones? 60%
What is the second most abundant cation in the ICF after potassium? Magnesium
Magnesium is lost via the: GI tract
NG suction, Diarrhea, Fistulas, Enteral or parenteral feeding deficient in Mg, Rapid administration of citrated blood, diabetic ketoacidosis, sepsis, burns and hypothermia Causes of Hypomagnesemia
Muscle weakness and hyperexcitability, alteraion in mood and changes in LOC s/s Hypomagnesemia
Caused by renal failure, Diabetic Ketoacidosis, Result of catabolism, Excessive administration of Mg, Antacids, and Laxatives causes of Hypermagnesemia
Created by: tstarrett08