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DES F&E
Fluids & Electrolytes Saunders NCLEX-RN #4
| Question | Answer |
|---|---|
| Intravascular Compartment | fluid inside a blood vessel |
| Intracellular Compartment | Fluid inside the cell (most body fluids) |
| Hypotonic Solution | contains lower concentration of salt or solute than another solution |
| Hypertonic Solution | contains higher concentration of solutes than another solution |
| Osmotic Pressure | solutions on each side of a selectively permeable membrane want to balance tonicity - not volume |
| Insensible Loss | water lost through the skin & lungs - about 400 mL/day - average by sweating 100 mL/day - average by lungs 350 mL/day |
| GI water loss | In feces 150 mL/day - diarrhea increases loss |
| Fluid Volume Deficit Isotonic dehydration | Hypovolemia- Water and dissolved electrolytes are lost in equal proportions Most common type of dehydration results in decreased circulating blood volume and inadequate tissue perfusion |
| Fluid Volume Deficit Hypertonic dehydration | Water loss > Electrolyte loss fluid moves from intracellular compartment into plasma and interstitial fluid spaces = cell dehydration and shrinkage. Assessment: hyperactive deep tendon reflexes, pitting edema |
| Fluid Volume Deficit Hypotonic dehydration | Electrolyte loss > water loss Decrease in plasma volume fluid from plasma and IF into cell = cells swell and plasma volume deficit. Assessment: skeletal muscle weakness |
| Fluid Volume Deficit Lab Findings | Increased serum osmolality Increased hematocrit Increased BUN Increased serum sodium level |
| Fluid Volume Excess | Overhydration / Fluid Overload |
| Fluid Volume Excess Isotonic Overhydration | Hypervolemia - excessive fluid in the extracellular fluid compartment. Causes circulatory overload and interstitial edema - in pt with poor cardiac function, CHF and pulmonary edema can result. Causes: poorly controlled IV therapy, RF, LT corticosteroids |
| Fluid Volume Excess Lab Findings | Decreased serum osmolality Decreased hematocrit Decreased BUN Decreased serum sodium Decreased urine specific gravity |
| Sodium | 135 - 145 mEq/L |
| Hyponatremia & Causes | < 135 mEq/L - excessive diaphoresis, diuretics, vomiting, diarrhea, wound drainage esp GI, renal disease, decreased secretion of aldosterone, NPO, hyupotonic fluid ingestions, RF, freshwater drowning, SIADH, hyperglycemia, CHF |
| Hypernatremia & Causes | >145 mEq/L - corticosteroids, Chushing's syndrome, RF, hyperaldosteronism, increase in sodium, decrease water intake, increased water loss |
| Potassium | 3.5 - 5.0 mEq/L |
| Hypokalemia & Causes | < 3.5 diuretics or corticosteroids, increased secretion of aldosterone, vomiting, diarrhea, wound drainage esp GI, long NG suction, excessive diaphoresis, renal disease impairing K+ reabsorption, inadequate intake (NPO), alkalosis, hyperinsulinism |
| Hyperkalemia & Causes | > 5.1 excess K+ intake, K+ sparing diuretics, rapid infusion of K+, K+ movement from intra to extracellular, |
| Calcium | 8.6 - 10.0 mg/dL |
| Hypocalcemia & Causes | < 8.6 low intake, lactose intolerance, malabsorption syndromes, low vit D intake, ESRD, RF, diarrhea, steatorrhea, wound drainage esp GI, hyperproteinemia, alkalosis, CA chelator or binder meds, acute pancreatitis, hyperphosphatemia, immobility |
| Hypercalcemia & Causes | > 10.0 inc intake, inc vit D intake, RF, thiazide diuretics, hyperparathyroidism, hyperthyroidism, malignancy, immobility, glucocorticoids, dehydration, lithium use, adrenal insufficiency |
| Magnesium | 1.6 - 2.6 mg/dL |
| Hypomagnesemia & Causes | < 1.6 malnutrition and starvation, vomiting or diarrhea, malabsorption syndrome, Celiac disease, Crohn's disease, diuretics, chronic alcoholism, hyperglycemia, insulin amdin, sepsis |
| Hypermagnesemia & Causes | > 2.6 mag-containing antacids an laxatives, excess IV admin, renal insufficiency / excretion |
| Phosphorus | 2.7 - 4.5 mg/dL Phosphorus and Calcium are opposites |
| Hypophosphatemia & Causes | < 2.7 (hypercalcemia) - insufficient intake, malnutrition and starvation, increased excretionhyperparathyroidism, malignancy, antacids mag-based or aluminum hydroxide-based, hyperglycemia, resp alkalosis |
| Hyperphosphatemia & Causes | > 4.5 (hypocalcemia) - decreased renal excretion (RI), Tumor lysis syndrome, inc intake, laxative and enemas containing phosphate, hypoparathyroidism |
Created by:
dstrobel1230
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