Fluid Balance unit
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| What is homeostasis | The bodies state of equilibrium
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| What are solutes | Particles.. or electrolytes and non-electrolytes
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| What is the most important nutrient? | WATER
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| What maintains blood volume? | WATER
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| What aids in digestion? | WATER
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| What regulates our body temperature | WATER
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| Which solutes have an electrical charge to them? | Electrolytes
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| 1 Kg of body weight equals.... | 2.2 pounds
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| What type of patients do you need to monitor weight for a potential increase? | Cardiac and Renal patients as it indicates fluid gain
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| What does the lab value of a BUN indicate? | The hydration status of the body
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| Concentration, tonicity, and osmolarity basically have the same meaning. What is the definition? | It is determined by the number of particles dissolved in a solution. It is an indicator of body hydration.
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| What is the osmolarity of ICF and ECF? | 300
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| What is passive transport? Give one example. | No energy is needed to transport particles between the semipermeable membranes. Examples are Osmosis, Diffusion, and filtration.
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| What is the definition of Osmosis? | This is the movement of FLUID from an area of lesser solute concentration to an area of greater solute concentration.
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| What is the definition of Diffusion? | This is the movement of SOLUTES from an area of greater concentration to an area of lesser concentration.
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| What is Isotonic | A solution with the same osmolarity/tonicity as the interior of the cell
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| What will a hypotonic solution do? | It will increase the cell's volume because this solution has a lesser concentration of solutes than the cell's interior. This is because with osmosis the fluid goes from less to more.
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| What will a hypertonic solution do? | It will decrease the cell's volume because the solution has a greater concentration of solutes than the cell's interior. Again, because with osmosis the fluid goes from less to more.
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| What does the Adrenal gland regulate? | It regulates the secretion of aldosterone and this regulates the sodium and potassium balance
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| What are sensible losses? | These are fluid losses that can be measured. Examples: urine, secretion of drainage tubes, emesis.
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| What are insensible losses? | These are fluid losses that CAN NOT be measured. Examples: fluid loss in feces, fever, respirations, perspiration.
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| What are some signs and symptoms of Extracellular fluid volume excess (circulatory overload)? | ACute weight gain, increased edema, increased JVD, S.O.B., tachypnea, crackles, increased B/P, bounding pulse, decreased oxygen saturations.
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| What are some TREATMENTS/INTERVENTIONS for Extracellular fluid volume excess (circulatory overload)? | Monitor VS, Monitor Lung sounds, Strict I&O, fluid restrictions, hourly foley outputs, oxygen, diuretics, daily weights,
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| What are some signs are symptoms of hypovolemia? (Extracellular deficit) | Change in mental status, Anxiety, restlessness, THIRST, tachycardia, delayed capillary refill, orthostatic B/P, decreased urinary output, WEAK or thready pulses, INCREASED HCT, BUN, and Urine specific gravity.
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| What are some TREATMENTS/INTERVENTIONS for hypovolemia? | Watch VS and mental status for improvement, oxygen, Isotonic IV solutions, monitor I&O, hourly urine outputs, daily weights, assess peripheral pulses, change positions slowly
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| Changes in which of the major intracellular cations will affect cardiac function? | Potassium (K+)
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| What is the normal serum value for K+? | 3.5-5.0 mEq/L
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| What assessment is vital to do when your patient has an abnormal K+ level? | Cardiac assessment (specifically for dysrhythmias)
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| What is the normal serum value for Ca+? | 8.4-10.5 mg/dl
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| What is necessary for Ca+ absorption from the GI tract? | Vitamin D
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| Describe Chvosek's sign | Tapping of the facial nerve which would elicit twitching of the face/mouth area when calcium levels are LOW.
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| Describe Trousseau's sign | Inflating of B/P cuff for a minute or two which will elicit a spasm of the fingers and hand when calcium levels are LOW.
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| How does AGE affect our Fluid and Electrolyte balance? | Elderly take longer to corect F&E imbalances due to decrease in kidney perfusion/function. They also have a lower consumption of food, dietary restrictions and decrease thirst or water intake.
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| During your assessment, what is the best indicator for fluid balance? | Weight! :)
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| What are some signs of F&E imbalances with your assessment? | Edema, JVD, dry mucous membranes, increase in abdominal girth, urine output less than 30ml/hr
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| What does poor skin turgor indicate and how do you complete this assessment? | Pinch the skin up, and if it tents up the patient is probably dehydrated.
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| List DESIRABLE outcomes for fluid balance. | Balanced I&O, Urine output greater than 30/hr, moist mucous membranes, no tenting or edema, electrolytes WDL, 2+ peripheral pulses, B/P WDL, no weight gain or loss, no elevation in temperature.
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