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S353Test1
Nutrition&Fluids for Test 1 IUPUI S353
| Question | Answer |
|---|---|
| Dehydration means (H2O, Na) | Loss of water NOT sodium |
| Fluid volume deficit means (H2O, Na) | Loss of water AND sodium |
| What IV fluid should you use for rapid volume replacement? | 0.9% NaCl |
| ECF fluid volume deficit = | Hypovolemia |
| What is the primary use of hypertonic solutions? | TPN (total parenteral nutrition) |
| Administration of an isotonic fluid expands: | ECF only |
| When can enteral feedings be started? | When bowel sounds are present, usually 24 hrs after placemens |
| Assessments before enteral feeding | Abdomen soft, non-distended, when was last BM |
| Enteral feeding position | HOB 30-45 degrees, upright 30-60 minutes after feeding |
| When do you irrigate enteral feeding tube? | Before/after feeding, medications, residual check |
| Assessments for enteral nutrition | Daily weight (very important, same scale, same time AM) Bowel sounds before feeding I&O Glucose Change tubing every 24 hrs |
| Complications of enteral nutrition | Vomiting, diarrhea, constipation, dehydration (especially high protein content) |
| Gerontologic considerations of enteral nutrition | Fluid/electrolyte imbalance Glucose intolerance Increase risk of aspiration Decreased ability to handle large volumes |
| How much of body fluid is ICF? | 2/3 |
| Which fluid space is least stable? | Vascular space (part of ECF) |
| Which fluid space is the fluid reserve? | Interstitial (part of ECF) |
| Movement from high solute concentration to low solute concentration | Diffusion |
| Example of active transport | Na-K ATP pump |
| Movement of water from area of low concentration to high concentration | Osmosis |
| Osmolarity measures: | Osmotic force of solute per unit of total volume |
| Osmolality describes: | Fluids inside body |
| Osmolarity describes: | Fluids outside the body |
| Oncotic pressure deals with: | Colloidal osmotic pressure (proteins) |
| What does a hypertonic IV solution do to cells? | Sucks water out of them, into the vascular space |
| Name the two major solutes in plasma. | Na and protein |
| Define osmotic pressure | Amount of pressure required to stop the osmotic flow of water |
| What is filtration? | Movement of fluid through a cell or blood vessel |
| What is hydrostatic pressure? | The force within a fluid compartment |
| Define homeostasis | State of equilibrium in the body |
| Water content of adult in % | 50-60% |
| Water content of older adult in % | 45-55% |
| Water content of infant in % | 70-80% |
| Intravascular fluid is: | ECF within the blood vessels |
| Interstitial fluid is: | ECF fluid between the cells |
| Transcellular fluid is: | ECF fluid in specialized cavities |
| First space fluid is: | Normal, fluid is where it should be |
| Second space fluid is: | Abnormal accumulation of interstitial fluid, edema |
| Third space fluid is: | Abnormal accumulation of fluid in part of body where it is not easily exchanged with ECF (ascites) |
| Hypovolemia symptoms | ↑ HR, ↑ RR, ↓ BP |
| Hypovolemia labs: | ↑ most labs, due to concentration from fluid loss |
| What is the most accurate assessment for hypovolemia? | Daily weight |
| Hypervolemia symptoms | Moist crackles, ↑HR, ↑RR, ↑BP |
| Hypervolemia labs: | Decreased values (dilutional effect) |
| Hypotonic IV fluids move water from: | from ECF to ICF |
| Isotonic IV fluids move water from: | Nowhere. Isotonic fluids expand only the ECF. |
| Hypertonic IV fluids require frequent monitoring of : | BP, lung sounds, Na |
| Dextrose 5% in water is used to: | Move fluid to ICF, increase renal excretion of solutes, |
| what is the preferred fluid for immediate response? | 0.9% Na or NS |
| What tonicity is Lactated Ringers? | Isotonic |
| Lactated Ringers contains which electrolytes? | NaCl, K, Ca, Phosphate |
| What tonicity is D5 1/2NS? | Hypertonic |
| Functions of Na | Maintains BP, balances volume of water in body, transmits nerve impulses for muscle contraction |
| Symptoms of hypernatremia caused by sodium gain | Seizures, thirst, flushed skin, peripheral and pulmonary edema |
| Symptoms of hypernatremia caused by water loss | Seizures, thirst, weight loss, postural hypotension, weakness |
| Functions of potassium | Controls cardiac rate and rhythm, excitability of nerves and muscles, regulates glucose storage |
| Trauma can cause: | Hyperkalemia (cells are crushed and release potassium into ECF) |
| Hyperkalemia symptoms | Irregular pulse, cardiac arrest (cardiac changes), lower extremity muscle weakness, paresthesia |
| Insulin helps which electrolyte imbalance? | Hyperkalemia |
| How does insulin help hyperkalemia? | Moves potassium from ECF to ICF |
| Frequent cause of hypokalemia is: | Use of diuretics |
| Hypokalemia symptoms | Cardiac changes, muscle weakness, polyuria, hypoglycemia |
| What is rate of administration of KCl? | 10-20 mEq/L over an hour, never IV push |
| Foods high in potassium | Bananas, bacon, potatoes, peas, lima beans, fruit juices, pecans |
| How should you administer liquid K+ supplement? | Dilute in juice to conceal bad taste |
| Only give potassium if: | kidneys are functioning |
| Functions of calcium | Maintains muscle tone, cardiac contractility (blood pressure), nerve transmission and contraction of skeletal and cardiac muscle |
| Most common cause of hypocalcemia | Prolonged immobilization |
| Hypercalcemia symptoms | Weakness, depressed reflexes, hypertension, confusion, kidney stones (nephrolithiasis), cardiac changes |
| Hypercalcemia treatment | Calcitonin (promotes renal excretion of calcium); 0.9% Na IV fluid followed by loop diuretic (Na follows Ca) |
| Hypocalcemia symptoms | Tetany, Chvostek's & Trousseau's sign, hyper-reflexes, tingling lips and tongue, cardiac changes |
| Functions of phosphate | Muscle contraction, calcium homeostasis, proper function of red blood cells |
| Hyperphosphatemia symptoms | muscle problems (tetany, twitching), bone and joint pain, cardiac problems, deposits of calcium phosphate in soft tissues |
| which electrolyte moves with phosphate? | Calcium |
| What is a common cause of hypophosphatemia? | Alcohol withdrawal |
| Hypophosphatemia symptoms | Cardiac dysrhythmias, CNS dysfunction, respiratory muscle weakness, slurred speech, confusion |
| Functions of magnesium | Muscular irritability and contractions, vasodilation, strong bones, transporter for Na and K across cellular membranes |
| Hypermagnesemia symptoms | Loss of deep tendon reflexes, bradypnea, bradycardia, hypotension, decreased level of consciousness |
| Treatment for hypermagnesemia | Calcium gluconate |
| What electrolyte imbalance are pts who undergo bariatric surgery susceptible to? | Hypomagnesemia |
| Hypomagnesemia symptoms | Hyper active deep tendon reflexes, tremors, seizures, dysrhythmias |
| Which electrolyte imbalance may develop with hypomagnesemia? | Hypocalcemia |
| Cause of pitting edema | Fluid volume excess |
| Cause of flushed, dry skin | Na excess |
| Cause of cold, clammy skin | Na deficit, shift of plasma to interstitial fluid |
| Cause of poor skin turgor | Fluid volume deficit |
| Cause of bounding pulse | Fluid volume excess, shift of interstitial fluid to plasma |
| Cause of rapid, weak, thready pulse | Na deficit, fluid volume deficit, shift of plasma to interstitial fluid |
| Cause of weak, irregular, rapid pulse | Severe K deficit |
| Cause of weak, irregular, slow pulse | Severe K excess |
| Cause of hypotension | fluid volume deficit, Na deficit, shift of plasma to interstitial fluid |
| Cause of hypertension | Fluid volume excess, shift of interstitial fluid to plasma |
| Cause of shortness of breath | Fluid volume excess |
| Cause of moist crackles | fluid volume excess, shift of interstitial fluid to plasma |
| Cause of restricted airway | Ca deficit |
| Cause of cramping of exercised muscle | Ca deficit, Mg deficit |
| Cause of flabby muscles | K deficit |
| Cause of picking at bedclothes | K deficit, Mg deficit |
| Cause of indifference | Fluid volume deficit, Na deficit |
| Cause of apprehension | Shift of plasma to interstitial fluid |
| Cause of extreme restlessness | K excess, Na excess, fluid volume deficit |
| Cause of confusion and irritability | K deficit, Na deficit, Ca excess, Mg excess, H20 excess |
| Cause of decreased LOC | Na deficit, H2O excess |
Created by:
bjperkin
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