Ati: Fluid & Electrolyte Imbalances

Front 1

Where does body fluids distributed?

Back 1

Intracellular fluid & Extracellular fluid

Front 2

Fluid can move between compartments through?

Back 2

Selective permeable membranes

Front 3

There are varieties of methods of moving fluid through compartments what are theY? 4 ans

Back 3

DIFFUSION, ACTIVE TRANSPORT, FILTRATION, OSMOSIS

Front 4

This is minerals sometimes called salts that are present in all body fluids?

Back 4

ELECTROLYTES

Front 5

They help regulate fluid balance and hormone production, strengthen skeletal structures, and act as catalysts in nerve response, muscle contraction ,ad the metabolism of nutrients

Back 5

ELECTROLYTES

Front 6

When electrolytes dissolved in water or another solvent what happen? 2 ans

Back 6

It separate into ions: conduct either POSITIVE OR NEGATIVE electrical current

Front 7

Examples of Electrolytes that are cation or positive? 4 ans

Back 7

magnesium, potassium, sodium, and calcium

Front 8

Examples of Electrolytes that are anions or negative? 4 ans

Back 8

phosphate, sulfate, chloride, bicarbonate

Front 9

The lab test can reflect the electrolyte concentrations in?

Back 9

Plasma not within the cell

Front 10

The nurse should familiar the 2 fluid imbalances?

Back 10

Fluid Volume deficits and Fluid volume excess

Front 11

Fluid volume deficits(FVD's) include? 2 ans

Back 11

1. Hypovolemia-isotonic

Front 12

What happen of the water and electrolytes in Hypovolemia-isotonic

Back 12

Both loss water and electrolytes from ECF

Front 13

What happen of the water and electrolytes in Dehyration-osmolar?

Back 13

Loss of water, no loss of electrolytes

Front 14

It occurs with dehydration that result in increases in Hct, serum electrolytes and urine specific gravity.

Back 14

Hemoconcentration

Front 15

Compensatory mechanisms include sympathetic nervous system responses that also arise? 3 ans

Back 15

Increased thirst, antidiuretic horme (ADH) release, and aldosterone release

Front 16

Why is it that older adults have an increased risk of dehydration ?

Back 16

due to a decrease in TOTAL BODY MASS, w/c includes total body water content

Front 17

Assessment: Causes of HYPOVOLEMIA?

Back 17

1. ABNORMAL GI LOSES ( vomiting, diarrhea, nasogastric suctioning.
2. ABNORMAL SKIN LOSSES (Diaphoresis-excessive sweating)
3. ABNORMAL RENAL LOSSES ( diuretic therapy, diabetes insipidus, renal disease, adrenal insufficiency, osmotic diuresis)
4. THIRD SPACING- Peritonitis, Intestinal obstruction, ascites, burns
5. HEMORRHAGE
6. ALTERED INTAKE (NPO)

Front 18

IS Hct increase or dec in Hypovolemia?

Back 18

Increased Hct

Front 19

HCT:In dehydration is Hemoconcentration Inc. or dec.? what if dehydration casued by Hemorrhage?

Back 19

Inc. Hemoconcentration/ not present when caused by hemorrhage

Front 20

Serum osmolarity dehydration what happen to Hemoconcentration osmolarity?

Back 20

Increased hemoconcentration osmolarity( greater than 300 mOsm/L)=inc protein, BUN, electrolytes, glucose

Front 21

In Urine specific gravity and osmolarity dehydration what happen to concetration?

Back 21

Increased

Front 22

In Serum Na(sodium) dehydration what happen to hemoconcentration?

Back 22

Increased

Front 23

One of the Collaborative Care in Hypovolemia w/c is monitor I & O and urine output less than ml/hr

Back 23

30 ml/hr

Front 24

Fluid Volume EXcess (FVE) include? 2 ans

Back 24

1. Hypervolemia-isotonic
2. Overhydration-osmolar

Front 25

What happen to the water and Sodium in Hypervolemia-Isotonic?

Back 25

Water and sodium are abnormally high

Front 26

What happen to the water and electrolytes in overhydration-osmolar?

Back 26

water increase than electrolytes

Front 27

If severe Hypervolemia it can lead to ? 2 ans

Back 27

Pulmonary edema and heart failure

Front 28

Hemodilution occurs with overhydration, what happen to Hct, serum electrolytes and protein?

Back 28

All decreases

Front 29

In Fluid Volume excesses compensatory mechanism include an increased release of natriuretic peptides resulting Inc. or dec loss of sodium and water by the kidneys? and inc. or dec release of aldosterone?

Back 29

increase loss/decreased release of aldosterone

Front 30

What are the causes of Hypervolemia? 5 ans

Back 30

1. Chronic stimulus to the kidney to conserve sodium and water(heart failure, cirrhosis, increased glucocorticosteroids)
2. Abnormal renal function with reduced excretion of sodium and water (renal failure)
3. Interstitial to plasma fluid shifts (hypertonic fluids, burns)
4. Age-related changes in cardiovascular and renal function
5. Excessive sodium intake

Front 31

In hypervolemia the Hct is dec or inc?

Back 31

decrease

Front 32

in Overhydration the Hct is inc or dec?

Back 32

decrease

Front 33

Overhydration minus decreased Hct=

Back 33

Hemodilution

Front 34

In serum osmolarity the overhydration wil inc or decrease hemodilution (omolarity lessthan 270 mOsm/L)

Back 34

Decrease

Front 35

the Electrolytes, BUN, and creatinine ill increase or dec? in overhyration/hypervolemia

Back 35

Decrease all

Front 36

What is the result of x-rays as a diagnotic tool in the lungs having hypervolemia

Back 36

Pulmornay congestion

Front 37

What are the Major electrolytes in the body? 6 ans

Back 37

Na, K, Chloride, Mg, Phosphorus, and Calcium

Front 38

It is important to reconize the ________ of elctrolyte imbalance?

Back 38

sign & symtoms

Front 39

The clients that has greates risk for electrolyte imbalance are?

Back 39

Infants, children, older adults, clients w/ cognitive disorders, and w/ chronic illness

Front 40

What one of the jamfor electrolyte found in ECF?

Back 40

Sodium(Na+)

Front 41

It is essential for maintenace of acid-base balance, active and passive transport mechanisms, and irritability and conduction of nerve and muscle tissue

Back 41

Sodium

Front 42

What is the expected serum sodium levels?

Back 42

136-145 mEq/L

Front 43

serum sodium level less than 136 mEq/L

Back 43

Hyponatremia

Front 44

It is a net gain of water or loss of sodium-rich fluid

Back 44

Hyponatremia

Front 45

What happen to the depolarization of membranes on Hyponatremia?

Back 45

delay and slow

Front 46

In hyponatremia the water will move from the ECF to ICF or ICF to ECF?;w/c causes cells to swell(cerebral edema)

Back 46

ECG to ICF

Front 47

What are the serious complications of acute hyponatremia if untreated ?3 ans

Back 47

coma, seizures, respiratory arrest

Front 48

Cause of Hyponatremia(loss of sodium) deficient of ECF vol or ICF?

Back 48

ECF vol

Front 49

Abnormal GI losses is risk factors of hyponatremia what are the examples?

Back 49

vomiting, diarrhea, NG suctioning, tap water enemas

Front 50

Edema risk of hypnatremia include illness? 3 ans

Back 50

Heart failure, cirrhosis, nephrotic syndrome

Front 51

The client's riks factors of hyponatremia is __________ why?

Back 51

older adult clients( inc. incidence of chronic illnesses, use of diuretic medications and risk for insuff. sodium intake

Front 52

Serum Na Hyponatremia? less than ___meq/L

Back 52

136

Front 53

Serum osmolarity of Hyponatremia is dec less than --------------- mOsm/L

Back 53

280

Front 54

A serum sodium level that is greater than 145 mEq/L. It is a serious electrolyte imbalance. It can cause__________(3) ans?

Back 54

1. Hypernatremia.
2. neurological, endocrine, and cardiac disturbances

Front 55

Incr. Na causes hypertonicity of the serum. What happen to the water in our cell or body?

Back 55

water out of the cells making the cells dehydrated

Front 56

What are the risk factors of hypernatremia? (loss of Na)

Back 56

1. water deprivation(NPO)
2. escessive Na intake
3. Excessive sodium retention
4. Fluid losses
5. Age-related changes
6. compensatory mechanisms with inc thirst and inc. production of ADH

Front 57

One of the causes of hypernatremia is age-related changes in old age why?

Back 57

dec. total body water content and inadequate fluid intake related to an altred thirst mechanism

Front 58

Hypernatremia,The serum sodium will increase greater than ______mEq/L

Back 58

145

Front 59

Hypernatremia:Serum osmolarity in Hypernatremia will inc greater than _________mOsm/L

Back 59

300

Front 60

What is the major cation in ICF that plays vital role in Cell Metabolism;transmission of nerve impulses;functioning of cardiac, lung, and muscle tissues; and acid-base balance

Back 60

Potassium(K+)

Front 61

________ is the major cation in ICF that plays a vital role in cell metaboism; transmission of nerve impulses; functioning of cardiac, lung, and muscle tissues; and acid-base balance

Back 61

Potassium(K+)

Front 62

K has reciprocal action with ______

Back 62

Na

Front 63

Expected serum potassium levels

Back 63

3.5 to 5 mEq/L

Front 64

the result of an inc. loss of K from the body or movement of K into the cells. Levl below 3.5 mEq/L

Back 64

Hypokalemia

Front 65

Risk factors of hypokalemia(loss of potassium)

Back 65

1. Abnormal GI losses (vomiting, diarrhea, NG suctioning , inaappropriate laxative use)
2Renal losses=excessive use of diuretics =furosemide(lasix), corticosteroids
3. Skin Losses-diaphoresis, wound losses
4.Insuffiecient K
5. Inadequate dietary intake(rare)
6. Prolonged administration of non-electrolyte(IV sloutions such as 5% dextrose in water)
7. ICF-metabolic alkalosis,afer correction of acidosis, during periods of tissue repair(burns, trauma, starvation) total parenteral nutrition
8. Age-related factors

Front 66

The client that is risk for hypokalemia and why?

Back 66

older adult because due to increase use of diuretics, and laxatives

Front 67

laboratory findings of serum K hypokalemia dec and less than

Back 67

3.5 mEq/L

Front 68

laboratory finding so arterial blood gases metabolic alkalosis pH greater

Back 68

than 7.45

Front 69

Diagnostic procedures in hypokalemia is _________ what are the finding?

Back 69

will show findings of dysrhthmias, such as PVCs, ventricular tachycardia, inverted T waves, and St depression

Front 70

Collaborative nursing care of hypokalemia to replace potassium by

Back 70

1. encourage foods high in potassium (avocado, brocolli, dairy products, dried fruit, cantaloupe, bananas

Front 71

A serum potassium level greater than 5 mEq/L. It is the result of an increased intake of K, movement of K out of the cells, or inadequate renal excretion

Back 71

Hyperkalemia

Front 72

Risk factors of hyperkalemia? 5 ans

Back 72

1. Increased total body potassium-IV K administration, salt substitutes
2.ECF shif- dec. insulin, acidosis(diabetic ketoacidosis), tissue catabolism(sepsis, trauma, surgery, fever, myocardial infaction)

3.Hypertonic states-uncontrolled diabetes mellitus
4. Decrased excretion of potassium-Renal failure, severe dehydration, potassium sparing diuretic, ACE inhibitors, NSAIDs, adrenal insufficiency
7. Older adult clients

Front 73

What client is risk of hyperkalemia?why?

Back 73

older adult. Due to inc. use of salt substitues, angiotensin-converting enzyme inhibitors, and K-sparing diuretics

Front 74

if potassium levels are extremely high what will be required?

Back 74

dialysis

Front 75

_______ found in the bones and the teeth. Plentiful in the body. what its normal values?

Back 75

calcium. 9 to 10.5 mg/dl for ionized calcium

Front 76

it is essential for proper functioning of the cardiovascular, neuromuscular, and endocrine systems, as well as blood cotting and bone and teeth fomation

Back 76

calcium

Front 77

it is a serum calcium level less than 9 mg/dL

Back 77

hypocalcemia

Front 78

What are the risk of Hypocalcemia? 5 ans

Back 78

1.Malabsorption syndromes, such as Crohn's disease
2. End-stage renal disease
3. Post thyroidectomy
4. Hypoparathyroidism
5. Reapeated transfusion

Front 79

What happen to the Cardiovascular in hypocalcemia?

Back 79

dec. myocardial contractility(dec heart rate and hypotension)

Front 80

What exam of GI in hyocalcemia?

Back 80

Hyperactive bowel sounds, diarrhea, abdominal cramping

Front 81

what happen to the Central Nervous System in hypocalcemia

Back 81

seizures due to overstimulation of the CNS

Front 82

Lab finding is hypocalcemia, calcium level less

Back 82

than 9 mg/dL

Front 83

Lab findings of hypocalcemia?

Back 83

ECG. prolonged QT interva;

Front 84

examples of foods high in calcium?

Back 84

dairy products and dark green vegetables

Front 85

Where does most Magnesium found in our body. Which is found less in our body?least found

Back 85

1. mostly in the bones
2. smaller amounts in body cells.
3. least in ECF

Front 86

Most of the ____________ found in the bones. ___________ in smaller amounts found within body cells. Very small amount is found in ECF. What is this called?

Back 86

Magnesium

Front 87

What is the Normal values of Magnesium level?

Back 87

1.3 to 2.1 mEq/L

Front 88

A serum magnesium level less than 1.3 mg/dl

Back 88

Hypomagnesemia

Front 89

What are the risk factors of hypomagnesemia? 2 ans

Back 89

1. Malnutrition(insufficient magnesium intake)
2. Alcohol ingestion(magnesium excretion)

Front 90

In subjective and Objective data of Hypomagnesemia
1. Neuromuscular will? 3 ans
2. What happen of the GI? 4 ans

Back 90

1. Inc. nerve impulse transmission (hyperactive DTRs, Paresthesias, Muscle tetany, positive Chvostek's and TRousseau's sign
2. Hypoactive bowel sound, constipation, abdominal distention, paralytic ileus

Front 91

What are the Nursing Care for hypomagnesemia? 3 ans

Back 91

1. Discontinue medications that decrease Mg (exam=. loop diuretics
2. Administer oral or IV Mg sulfate following safety protocols. IV route is used because IM can cause pain and tissue damage. Oral Mg can cause diarrhea and Inc. Mg depletion. MONITOR CLOSELY
3.Encourage foods high in MG (dairy prod. and dark green Vegetables