NRTC
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| What percentage of water in body weight. What percentage of water in body weight in older person | 55-60%
50-55%
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| what is the pulling of water into and out of the cells by osmotic pressure | osmosis
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| what requires ATP to move electrolytes against the concentration gradient into the cell membrane | active transport
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| this is the movement of fluids across the capillaries | filtration
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| balance is maintained through what | input and output
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| fluid output occurs in what | kidneys skin lungs and gastrointestinal tract
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| are the major Regulators of fluid output | the kidneys
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| where is interstitial fluid located | between the cells and outside of the blood vessels
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| where is transcellular body fluids located | secreted by epithelial cells cerebrospinal pleural peritoneal and synovial fluids
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| intravascular fluid is | the liquid part of blood or plasma
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| 2/3 of fluid within the cells is called | intracellular
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| in an adult average fluid intake is what and ranges from what milliliters per day | 2500 ml per day (range 1800 to 3600 ml per day)
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| osmosis is | movement of water through a semi-permeable membrane draw water toward an area of Greater concentration is osmotic pressure
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| substance requires assistance from a carrier molecule to pass through a semi-permeable membrane | passive and facilitated diffusion
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| promotes movement of fluid and chemicals according to pressure differences | filtration
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| osmoreceptors are | neurons that sends blood concentration regulates fluid volume by triggering thirst when blood concentration is high triggers pituitary to make ADH reabsorption of water
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| what does osmoreceptors help you | restores normal serum osmolarity increased circulatory blood volume improves cardiac output and maintains blood pressure
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| what happens when aldosterone is released in the renin-angiotensin one Angiotensin 2 aldosterone system | kidneys reabsorb sodium and increase blood pressure and blood volume
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| hypovolemia what are some causes | low volume of extracellular fluid caused by vomiting, diarrhea, wounds ,profuse urination, altered intake,diuretic therapy
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| when a person is hypovolemic they are usually | dehydrated
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| assessment findings of hypovolemia include | thirst, furrowed tongue, concentrated urine, poor skin turgor, thready pulse, hypotension, tachycardia
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| some diagnostic findings for hypovolemia would be | elevated hematocrit and blood cell count, elevated urine specific gravity, elevated serum sodium
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| people with hypovolemia or at more risk for | kidney stones and blood clots
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| treating ideology first is treating | the problem first
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| with hypovolemia teach to | drink 8 glasses of water per day respond to thirst avoid alcohol and caffeine ,monitor vital signs ,slow position change for safety and, at least 30 ml per hour i&o
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| what is hypervolemia | high volume of water in intravascular fluid compartment caused by excessive oral intake IV fluids heart failure kidney disease or adrenal gland dysfunction
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| hypervolemia can lead to a fluid volume that exceeds what is normal for intravascular space and can compromise cardio pulmonary function which is called | circulatory overload
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| hypervolemia diagnostic findings would be | low in blood count low urine specific gravity and hemo dilation or decreased sodium
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| what would be some medical management for hypervolemia | restrict oral or peritoneal fluid, diuretics, limit sodium
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| what are some assessment findings with hypervolemia | with hypervolemia weight gain of 2 lbs in 24 hours crackles with lung sounds, BP HR and resp increase, skin edematous cracks and break down
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| planning and interventions for hypervolemia | monitor I and O, daily weight, administer diuretics, monitor potassium level, Elevate head of bed, prevent skin breakdown, sodium restrictions patient education
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| what is third spacing | translocation of fluid from intravascular to tissue compartments
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| causes for third spacing would consist of | hypoalbuminemia, burns, severe allergic reaction
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| what are some diagnostic findings for third spacing | blood count borderline and hemoconcentration which would be hypovolemic, dry mouth, dizziness
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| what to do for third spacing | albumin infusion helps pull trap fluid back into intravascular space and IV diuretic which reduces potential for overload
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| this occurs as deficits and or excess accompanied by fluid changes | electrolyte imbalance
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| what would be a cause for electrolyte imbalance | deficits, excess
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| priority electrolyte imbalances | sodium, potassium, calcium, magnesium
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| what is the major electrolyte found outside the cell extracellularly | sodium
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| what electrolyte regulates and distributes fluid volume, maintains normal nerve and muscular activity, regulates osomatic pressure, preserves acid base balance | sodium
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| what are some causes for hyponatremia | profuse diaphoresis, diuresis, loss of GI secretions, Burns, Addison's disease, low sodium intake
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| what are some assessment findings for hyponatremia | seizure precautions low CNS crave salt, hypothermia, tachycardia, hyperactive bowel sounds, abdominal cramping, muscular weakness, lethargy and mental confusion
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| what are some causes for hypernatremia | diarrhea excessive salt intake, high fever, excessive water loss, decreased water intake
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| what are some assessment findings for hypernatremia | thirst, dry sticky membranes, decreased urine output, fever, edema, irritability
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| what is Semana medical management for hypernatremia | water intake IV solution of .45% NaCl or 5% dextrose and I&o, VS, dietary restrictions
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| what are some functions for potassium | vital role in cell metabolism, transmission of nerve impulses, function cardiac muscle tissues, acid-base balance
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| causes of hypokalemia | potassium wasting diuretics, GI tract fluid loss, corticosteroids, IV insulin and glucose
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| why would insulin and glucose contribute to hyperkalemia | insulin pushes glucose as well as potassium in to cell
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| what are some assessment findings for hypokalemia | mental confusion fatigue weakness nausea cardiac dysrhythmias.
decreased GI Mobility, constipation and leg cramps
Labs decrease serum potassium
changes an electrocardiogram
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| what is the medical management for hypokalemia | potassium sparing diuretics like spironolactone, k+ rich foods, supplements, , (never bolus) 5 to 10 meq per hour IV
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| what kind of foods does furosemide need | avocados and fruit
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| what are some causes of hyperkalemia | renal failure, potassium sparing diuretics, supplements, crushing injuries, Addison's disease, salt substitutes
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| assessment findings for hyperkalemia | increased GI Mobility, nausea, restlessness irritability, cardiac dysrhythmias, lab increased serum potassium above 5 meq per liter
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| what medications do you hold when testing potassium level | Loop diuretics
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| Loop Diuretics excrete | potassium
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| medical management for hyperkalemia | decrease k+ intake, administrate insulin and glucose, Loop diuretics, kayexalate works as laxative or peritoneal dialysis/ hemodialysis
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| What is another name for sodium polystyrene sulfanate? | kayexalate, binds to k+ in Blood and poops it out profusely
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| calcium function | blood clotting transmission of nerve impulses and regulated by parathyroid gland
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| assessment findings for hypocalcemia | circumoral paresthesia, tetany and cramps with muscle twitches, +chevostek's sign Voz-stek, Trousseau's sign (Tru-so),decreased myocardial contractility
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| what is circumoral paresthesia | tingling of extremities and areas around the mouth
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| what is tetany | muscle twitches
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| what is positive Chevostek's sign (Voz-Stek) | tapping on the facial nerve triggering facial twitching
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| what is trousseaus sign | hand finger spasms with sustained blood pressure cuff inflation, excited nerves
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| causes of hypercalcemia | parathyroid tumors, multiple fractures, prolonged immobilization
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| hypercalcemia what happens to the calcium | goes out of the bone and into the blood
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| assessment findings for hypercalcemia | deep bone pain, constipation, mental changes, decrease memory and attention span
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| medical management for hypercalcemia | IV sodium chloride and Furosemide to excrete CA in urine, calcitonin, corticosteroids
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| functions of magnesium | transmission of nerve impulses, activate enzyme systems including functions of vitamin B
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| normal range for magnesium | 1.3 to 2.1
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| hypomagnesemia can result from | alcoholism, diabetic ketoacidosis, renal disease, Loop diuretics, Burns, malnutrition
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| assessment findings for hypomagnesemia | tachycardia, Harris thesis, neuromuscular irritability, hypertension, mental changes
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| medical management for hypomagnesemia | oral or IV magnesium (calcium gluconate antidote for magnesium sulfate), diet supplements that may cause (diarrhea or worsen mag depletion), foods rich in magnesium, discontinue Loop diuretics
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| foods that are rich in magnesium | green leafy veggies, whole grains, nuts, cocoa, chocolate, soybeans, Seafood, dried beans
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| assessment findings for hypermagnesemia | vasodilation , Flushing, lethargy, bradycardia, coma
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| causes for hypermagnesemia | renal failure, Addison's disease, excessive anti-acid or laxative use, hyperparathyroidism
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| medical management for hypermagnesemia | decrease oral magnesium, mechanical ventilation if resp failure occurs, hemodialysis if severe
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| quickly if pH is outside of the range of | 6.8 to 7.8
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| normal pH is | normal pH is 7.35 to 7.45
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| the more hydrogen ions in a solution the more | acidic it is
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| the body maintains normal pH by two mechanisms | chemical and organ
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| regular carbon dioxide or paco2 levels are between | 35-45
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| carbonate levels or hco3 is | 21 to 28
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| the lungs put off CO2 which is a | acid
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| kidneys put off hco3 which is a | base and alkaline
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| chemical mechanism to maintain normal pH | add or remove hydrogen ions first line of defense responds quickly to change in pH
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| either bind or release H+ ions | bicarbonate carbonic acid buffer system
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| carbonic acid formula | H2CO3 acid
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| bicarbonate formula | hco3 Base neutralizes acid
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| what is the second line of defense | lungs regulate carbonic acid levels by releasing or conserving CO2 increases decreases resp rate
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| decreases H+ ions | hyperventilation
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| increases H+ ions opioids COPD | hypoventilation
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| what is the third line of defense | kidneys regulate bicarbonate levels much slower takes 24 to 48 hours to kick in this is a metabolic system
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| during the third line of defense with bicarbonate levels High H+ ions indicate | bicarbonate reabsorption and production
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| during the third line of defense bicarbonate levels low H+ ions indicate | bicarbonate excretion
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| where do you draw blood for arterial blood gases ABG s | from the artery is a main tool for measuring blood pH CO2 content and bicarbonate
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| CO2 content equals | paco2
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| acidosis occurs with excessive accumulation of CO2 or excessive loss of hco3 in body fluids too much acid or too little Bass | alkalosis occurs with excessive accumulation of face or loss of acid and body fluids
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| CO2 levels out of range is | respiratory
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| hco3 levels out of range is | metabolic
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| metabolic acidosis is when | normal CO2 decreased hco3 and pH lower than 7.35
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| causes for metabolic acidosis | shock/cardiac arrest= lactic acid
starvation of fatty acid, DKA, (renal failure - no bicarb),ASAoverdose,loss of GI fluid, wound drainage, hyperkalemia - bs and K+high causing kidney malfunction
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| assessment findings for metabolic acidosis | KUSSMAUL'S breathing, nausea headache flushing abdominal pain muscle weakness
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| What is Kassmaul's breathing | fast and deep breathing from diabetic ketoacidosis
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| medical treatment for metabolic acidosis | replace fluid and electrolytes IV bicarbonate for kidney patient not making enough bicarb
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| metabolic alkalosis results in | PH above 7 .45 normal CO2 and increased hco3
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| causes for metabolic alkalosis | excessive bicarbonate, anti acid drugs, diuretic therapy, vomiting gastric suctioning
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| assessment findings for metabolic alkalosis | tachycardia dysrhythmias numbness tingling confusion ineffective breathing due to muscle weakness
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| medical treatment for metabolic alkalosis | fluid electrolyte replacement and antiemetics
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| respiratory acidosis | PH lower than 35, increased CO2, normal hco3
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| causes of respiratory acidosis | hypoventilation
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| assessment findings for respiratory acidosis | tachypnea cardiac dysrhythmias irritability confusion, slow rapid breathing, warm and flush skin
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| medical management for respiratory acidosis | provide oxygen repositioning Airway suctioning bronchodilators
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| respiratory alkalosis values | pH above 7 .45, decreased CO2, normal hco3
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| causes for Respiratory alkalosis | hyperventilation
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| assessment findings for Respiratory alkalosis | anxiety tingling numbness, chest pain palpitations, rapid deep breathing
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| medical treatment for Respiratory alkalosis | rebreathe expelled air through bag, anxiety reduction techniques
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| the concentration of substances in the blood | hemoconcentration
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| when would a nurse anticipate administering salt tablets | during mild deficits of serum sodium
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| if a client's parathyroid glands were accidentally removed during a procedure which condition should the nurse prepare for | hypocalcemia
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| when someone has hypovolemia they should avoid | they should avoid consuming alcohol and caffeine
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| what medication should the nurse monitor a client for lowered serum sodium and potassium levels | diuretics
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| ignition might cause respiratory alkalosis | rapid breathing
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