Acid-Base, Fluid, And Electrolyte Fundamentals

Front 1

solvents

Back 1

liquids that hold a substance in a solution

Front 2

solutes

Back 2

substances that are dissolved in a solution

Front 3

electrolytes

Back 3

substances capable of breaking into electrically charged ions when dissolved in a solution

Front 4

non-electrolyte

Back 4

substance that does not hold an electrical charge
(glucose, albumin)

Front 5

osmosis

Back 5

diffusion of water caused by fluid concentration gradient

Front 6

diffusion

Back 6

substance moves from an area of higher concentration to one of lower concentration

Front 7

active transport

Back 7

energy must be expended for movement to occur against a concentration gradient

Front 8

filtration

Back 8

movement of water and solutes occurs from an area of high hydrostatic pressure to an area of low hydrostatic presure

Front 9

kidneys

Back 9

selectively retain and excrete body fluids, electrolytes
excretes metabolic wastes and toxic substances
regulation of pH of extracellular fluid by retention of hydrogen ions

Front 10

aldosterone

Back 10

excreted from the adrenal gland
an increase causes sodium retention (water follows sodium) and potassium loss
it also causes vasoconstriction

Front 11

ADH

Back 11

increase level causes the renal tubules to retain water
a pure water gain

Front 12

parathyroid hormone

Back 12

increased levels cause an increase of blood calcium levels with decreased blood phosphorus levels

Front 13

thyroxin

Back 13

increased levels increase metabolism with slight increase in water

Front 14

GI

Back 14

absorption of minerals and water

Front 15

nervous system

Back 15

contols all hormonal and bodily functions

Front 16

sodium (135-145 mEq/L)

Back 16

maintains appropriate extracellular fluid osmolality
maintains extracellular volume (water follows sodium)
influences chloride levels (chloride follows sodium)
aids impulses transmission in nervew and muscles
helps regulate acid-base balance

Front 17

Potassium (3.5-5.0 mEq/L)

Back 17

maintains cell electro-neutrality and cell osmolality
directly affects cardiac muscle contraction and electrical conductivity
aids in neuromuscular transmission of nerve impulses
major role in acid-base balance

Front 18

Calcium (8.5-10.5 mEq/L)

Back 18

enhances bone strength and durability
*has a sedative affect on nerves (the higher the level)
helps maintain cell membrane structure, function, and membrane permeability
affects activation, excitation, and contraction of cardiac and skeletal muscle
participates in neurotransmitter release at synapses
helps activate specific steps in blood coagulation
activates serum complement, a major factor in immune system function

Front 19

Magnesium (1.3-2.1 mEq/L)

Back 19

important in metabolism of carbs and proteins
important for many vital reactions involvling enzymes
necessary for protein and DNA synthesis
maintains normal intracellular levels of potassium
helps maintain electric activity in nervous tissue membranes and muscle membranes
*affects peripheral vasodilation (increase will decrease BP)

Front 20

Phosphate (2.5-4.5 mEq/L)

Back 20

major component in bones and teeth
helps maintain cell membrane integrity
functions in cellular metabolism to promote energy transfer to cells (ATP)
involved in important chemical reactions in the body
plays a major role in acid-base balance through its actions as a urinary buffer
*has a reciprocal relationship with calcium (inversely related)

Front 21

Chloride (98-106 mEq/L)

Back 21

acts with sodium to maintain the osmotic pressure of the blood
plays a role in the body's acid-base balance
important buffering action when oxygen and carbon dioxide exchange in RBCs
essential for the production of hydrochloric acid in gastric juices

Front 22

Total WBCs

Back 22

<_ 10

Front 23

Total RBCs

Back 23

4.6-6.2

Front 24

hemoglobin

Back 24

13.5-18 g/dL

Front 25

hematocrit

Back 25

40-54%

Front 26

total platelets

Back 26

150,000-450,000

Front 27

fluid volume deficite
(hypovolemia)

Back 27

deficiency in both the amount of water and electrolyte in the extracellular fluid

Front 28

causes of fluid volume deficit

Back 28

vomiting, diarrhea, GI suctioning, sweating, decreased intake

Front 29

signs and symptoms
of fluid volume deficit

Back 29

acute weight loss, decreased skin tugor, oliguria, concentrated urine, postural hypotension, weak rapid heart rate, falttened neck veins, thirst, anorexia, nausea, lassitude (not with it), muscle weakness

Front 30

nursing interventions of
fluid volume deficit

Back 30

treat underlying cause, replace fluids, monitor I& O, daily weight, vital signs

Front 31

fluid volume excess
(hypervolemia)

Back 31

overload of fluids in extracellular fluid
(usually due to heart or renal failure)

Front 32

causes of fluid volume excess

Back 32

heart failure, kidney failure, excess salt intake, excess infusion of IV fluids

Front 33

signs and symptoms of
fluid volume excess

Back 33

edema, distended neck veins, crackles in lungs, tachycardia, increased blood pressure, increased pulse pressure, increased weight, increased urine output, shortness of breath, wheezing

Front 34

nursing interventions for
fluid volume excess

Back 34

treat the underlying cause, discontinue IV fluids if needed, administer diurectics as ordered, restrict fluid and sodium, monitor respiratory status, monitor I&O, monitor daily weights

Front 35

hyponatremia

Back 35

serum sodium <135 mEq/L

Front 36

causes of hyponatremia

Back 36

* Loss of sodium-diuretics, loss of GI fluids, renal disease
* Dilutional hyponatremia- SIADH (too much ADH), hyperglycemia (water follows glucose), irrigating NG tube with water, excess use of tap-water enemas, administering electrolyte poor IV fluids

Front 37

signs and symptoms of hyponatremia

Back 37

*pure sodium loss- lethargy, confusion, apprehension, depressed reflexes, seizures, coma
*isotonic sodium loss- hypotension, tachycardia, decreased urine output
*dilutional sodium loss- weight gain, edema, jugular vein distention, ascites

Front 38

nursing intervetions for hyponatremia

Back 38

treat underlying cause, carefully administer sodium, restrict fluids

Front 39

water in the body functions primarily to:

Back 39

Provide a medium for transporting nutrients, facilitate cellular metabolism, act as a solvent, help maintain normal body temp, facilitate digestion and promote elimination, act as a tissue lubricant.

Front 40

total-body water or fluid

Back 40

is approximately 50%-60% of body weight in a healthy person

Front 41

variations in fluid content

Back 41

body'sweight, age, lean body mass, sex, amount of fat cells

Front 42

electrolytes

Back 42

substances capable of breaking into electrically charged ions when dissolved in a solution.

Front 43

cations

Back 43

positively charged ions

Front 44

anions

Back 44

negatively charged ions

Front 45

Sodium

Back 45

cheif electrolyte of ECF that moves easily between intravascular and interstitial spaces and moves across cell membranes by active transport

Front 46

Potassium

Back 46

major cation of ICF working in reciprocal fashion with sodium

Front 47

Calcium

Back 47

most abundant electrolyte in the body, with up to 99% of the totaly amount of calcium in the body found in bones and teeth in ionized forms

Front 48

Magnesium

Back 48

most of cation magnesium found within body cells---heart, bone, nerve, and muscle tissues: second most important cation in the ICF

Front 49

Chloride

Back 49

cheif extracellular anion found in the blood, interstitial fluid and lymph and in minute amounts in ICF

Front 50

Bicarbonate

Back 50

an anion that is the major chemical base buffer within the body: found in both ECF and ICF

Front 51

Phosphate

Back 51

the major anion in the body cells a buffer anion in both ICF and ECF

Front 52

Buffer System

Back 52

bicarb = blood
phosphate = kidney
protein = in cells

Front 53

Hypermagnesemia

Back 53

Renal failure
Diabetic ketoacidosis
too much milk of magnesemia

Front 54

Hypomagnesemia

Back 54

NG tube suction
Diarrhea, alcohol withdrawal,
Muscle Weakness, tremor
tetany, chvostek, truseau's sign
Nursing intervention:
Increase magnesium

Front 55

Hypercalcemia

Back 55

Hyperparathyroidism, bone malignancy, immobility
Incoordination, anorexia, kidney sotne.
Treatment: give phospate

Front 56

Hypernatremia

Back 56

Decrease fluid, hypertonic, watery diarrhea, burns
Increase temperature, swollen tongue
Disoriented, irriatable, hallucinate
Treatment: Sodium, give water

Front 57

Hyponatremia
Isotonic sodium loss

Back 57

Fluid volume deficit
Hypotension
Tachycardia
Dercreased urine output

Front 58

Hypornatremia
(Dilutional)

Back 58

Hyperglycemia, SIADH, excess tapwater, poor IV fluids
S/S
Weight gain, edema, jugular distenstion ascities

Front 59

Hyponaremia
Loss of sodium

Back 59

Diuretics, GI, fluid loss, renal disease, confusion, decreased reflex, seizure coma

Front 60

(fluid lost)
gastric juice

Back 60

(imbalance likely to occur)
extracellular fluid volume deficit, metabolic alkalosis, sodium deficit, potassium deficit, tetany, magnesium deficit

Front 61

(fluid lost)
intestinal juice

Back 61

(imbalance likely to occur)
extracellular fluid volume deficit, metabolic acidosis, sodium deficit, potassium deficit

Front 62

(fluid lost)
bile

Back 62

(imbalance likely to occur)
sodium deficit
metabolic acidosis

Front 63

(fluid lost)
pancreatic juice

Back 63

(imbalance likely to occur)
metabolic acidosis, sodium deficit, calcium deficit, ECF deficit

Front 64

(fluid lost)
sensible perspiration

Back 64

(imbalance likely to occur)
ECF deficit, sodium deficit

Front 65

(fluid lost)
insensible water loss

Back 65

(imbalance likely to occur)
water deficit (dehydration), sodium excess

Front 66

(fluid lost)
wound exudate

Back 66

(imbalance likely to occur)
protein deficit, sodium deficit, ECF volume deficit

Front 67

(fluid lost)
ascites

Back 67

(imbalance likely to occur)
protein deficit, sodium deficit, plasma to interstitial fluid shift, ECF volume deficit

Front 68

respiratroy acidosis

causes (pulmonary edema, aspiration of a foreign body, atelectasis, overdose of sedative, emphysema, brochial asthma, cystic fibrosis, inadequate ventilation, CNS depression, neuromuscular diseas)

Back 68

mental cloudiness, dizziness, muscular twitching, unconsciousness, weakness, dull headache

Front 69

respiratory alkalosis

causes (hyperventilation, extreme anxiety, hypoxemia, high fever, early sepsis, excessive ventilation, CNS lesion, thyrotoxicosis)

Back 69

lightheadedness, inabliity to concentrate, tinnitus, palpitations, sweating, dry mouth, tremors, convulsions, and LOC

Front 70

metabolic acidosis

causes (diarrhea, intestinal fistulas, any ostomies, excess acids, diabtic ketoacidosis, renal failure, starvational ketoacidosis)

Back 70

headache, confusion, drowsiness, increased repiratory rate and depth, N/V, peripheral vasodilation, hyperkalemia is usually present

Front 71

metabolic alkalosis

causes (vomiting, GI suctioning, hypokalemia, K+ diuretics, alkali ingestion (antacids), renal loss of H+

Back 71

dizziness, tingling of fingers and toes, hypertonic muscles, depressed respirations (if compensatory), hypokalemia may be present