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187 Cards in this Set

  • Front
  • Back
% of body weight = H2O

full term newborn
70-80%
% of body weight = H2O

1 year
52-60%
% of body weight = H20

puberty to 39
52-60%
% of body weight = H2O

40-60 years
47-55%
% of body weight = H2O

over 60
46-52%
Average Daily Fluid Requirements:

3 days 3.0kg
250-300 mL/24hr
Average Daily Fluid Requirements:

1 yr 9.5kg
1150-1300 mL/24hr
Average Daily Fluid Requirements:

2 yr 11.8kg
1800-2000 mL/24hr
Average Daily Fluid Requirements:

6 yr 20.0kg
1800-2000 mL/24hr
Average Daily Fluid Requirements:

10 yrs 28.7kg
2000-2500 mL/24hr
Average Daily Fluid Requirements:

14 yrs 45.0 kg
2200 - 2700 mL/24hr
Average Daily Fluid Requirements:

18 yrs 45.o kg
2200-2700 mL/24hr
Assess skin (color, temp, moisture, turgor, edema), mucous membranes (color, moisture), eyes (firmness)*ck[]=SIADH
SIADH
Dehydration in children:

Weight Loss:
Mild dehydration:
Moderate dehydration:
Severe dehydration:
fluid and electrolyte imbalance
Skin: grey, cold to touch, poor skin turgor
Mucous membranes: dry oral buccal mucosa, salivation absent
Eyes: sunken eyeballs, absence of tearing when crying
Anterior fontanel (infant): sunken
Shock: increase pulse, increase respirations, decrease BP
Urine: oliguria, increase specific gravity, ammonia odor
Alterations in consciousness:irritability, lethargy, stupor, coma poss., seizures, metabolic acidosis or alkalosis
Mild: 5%
Moderate; 5-9%
Severe: 10-15%
Extracellular most abundant cation; controls and regulates water balance:
S/S dehydration in children
Intracellular major cation in intracelluar fluids; vital electrolyte for skeletal, cardiac and smooth muscle activity, also acid base balance:
sodium Na+
Cation mostly found in skeletal system:
potassium K+
Cation found mostly in skeleton, intracellular fluid, neuromuscular, cardiac function:
Ca2+
calcium
Carried nutrients to and from the the cells; fluid found outside the cells accounts for 1/3 of total body fluid:
magnesium
Mg2+
Intravascular extracellular fluid
extracellular fluid
interstitial extracellular fluid
plasma
transcellular fluid
lymph
Average fluid output:
cerebrospinal, pleural peritoneal, synovial fluids
Average fluid output/hr
1400-1500ml
The movement of the bone away from the midline of the body:
Abduction
Evaluates pts. acid-base balance and oxygenation; composed of pH, PaO2, PaCO2, OCO3, base excess, O2 sat:
ABG's
Substances combine with a carrier on the outside surface of the cell membrane and they move to the inside surface of the cell membrane:
Active transport
The movement of bone toward the midline of the body:
adduction
Substance produced in the posterior pituitary gland and is a major controller of fluid balance:
ADH
System that promotes sodium and water retention in the distal nephron:
Aldosterone
Edema that is generalized throughout the body as a result of over loading of vascular fluid compartment; a generalized edema throughout the body:
anasarca
Ion that carries a charge; chloride, HCO3 (bicarbonate), HPO4 (phosphate), SO4 (sulfate):
anions
These can cause metabolic alkalosis with N/V and convulsions:
antacids
Regulates water excretion from the kidney, located in hypothalamus:
ADH
anti-diuretic hormone
Accumulation of fluid in the abdominal cavity:
ascites
Released from cells in the atrium of the heart in response to excess blood volume and stretching of atrial walls; acts as a diuretic; inhibits thirst, reducing fluid intake:
Atrial natriuretic factor (ANF)
Forms bones bones and teeth, transmitting nerve impulses, regulating muscle contractions, maintaining cardiac pacemaker, blood clotting activating enzymes:
calcium
-hypoparathyoidism
-acute pancreatitis
-hyperphosphatemia
-thyroid carcinoma
-inadequate Vit D intake
-malabsorption
-alkalosis
-sepsis
-alcohol abuse
S/S hypocalcemia
-Paget's disease
-malignancy of bone
S/S hypercalcemia
Ions that carry equal charges; NA+, K+, Ca2+, Mg2+
cations
Inserted for long term IV therapy, parenteral nutrition, for chemical damaging to the veins; assess for SOB, CP, cough, hypotension, tachycardia and anxiety:
central lines
Daily weights provide adequate assessment of
fluid status
-hyperosmolar imbalance
-water lost from body without significant loss of electrolytes occurs in older patients because of decreased thirst sensation
-prolonged fever
-diabetic ketoacidosis
-those receiving enteral feedings with insufficient water
S/S dehydration
Continual intermingling of molecules in liquids, gases or solids brought about by the random movement of molecules; movement of particles from an area of greater concentration to an area of lower concentration
diffusion
Do not administer hypotonic fluids to pts with _____________ or ____________disease and watch for hypovolemia.
kidney
heart disease
Fluid volume excess intravascular and interstitial spaces have an increased water and sodium content; when the body starts to utilize the stored protein due to poor nutritional intake:
edema
Have an altered thirst response which can alter the fluid and electrolyte balance
Elderly
Contain various amounts of cations and anions:
electrolyte solutions
Charged particles capable of conducting electricity:
electrolytes
Depends on the informational input from the labyrinth (inner ear), vision and from stretch receptors of muscles and tendons:
equilibrium
Fluid in the interstitial space; accounts for 1/3 total body fluid:
ECF
Process whereby fluid and solutes move together across a membrane from one compartment to another, moves from high pressure to low pressure:
filtration
Body retains both water and sodium (hypovolemia) caused by excessive sodium chloride intake, administering infusions too fast, disease process that alters the regulatory mechanisms (eg: CHF, renal failure, cirrhosis of liver, Cushing's syndrome):
fluid volume excess
1. body alignment (posture)
2. joint mobility
3. balance (stability)
4. coordinated movement
four basic elements of normal body movement
Body loses both water and electrolytes from the ECF
Fluid Volume Deficit (FVD)
Produced by the body in response to a specific antigen called an antibody:
globulin
Measures % of whole blood composed of RBCs; increase with severe dehydration; decrease with severe over hydration; norm in males 40-50% and females 37-47%:
hematrocrit
Major component of EBCs; increases with dehydration:
hemoglobin
Homeostatic mechanisms that regulate the body fluids:

1.
2.
3.
4.
5.
6.
1. kidneys
2. endocrine system
3. cardiovascular system
4. lungs,
5. GI
6. hormone
Body's measurement of acidity and alkalinity:
hydrogen ion concentration
The pressure exerted by fluid within a closed system of the walls of a container in which it is contained:
hydrostatic pressure
S/S include:
acidosis
weakness and lethagry
risk for dysrhythmias
coma
hypercholoremia
S/S include:
lethargy
weakness
anorexia
N/V
constipation
polyuria
dysrhythmias
hypercalcemia
S/S include:
GI hyperactivity
diarrhea
irritability
apathy
confusion
muscle weakness
hyperkalemia
S/S include:
N/V
muscle weakness
paralysis
decrease BP
bradycardia
hypermagnesium
S/S include:
thirst
tongue red, dry, swollen
weakness
fatigue
decrease in LOC
disorientation
convulsions
hypernatremia
S/S include:
tingling around the mouth, fingertips
muscle spasms
tetany
hyperphosphatemia
D5NS
D51/2NS
D5LR
hypertonic solutions
Higher osmolarity than bodyfluids eg: 3% sodium chloride
hypertonic solutions
TPN is what type of solution?
Hypertonic
Body retains both water and sodium:
hypervolemia
S/S include:
numbness and tingling in extremities
cramps
hypocalcemia
S/S include:
Excess loss of Ca2+ through the GI tract, kidneys or sweating
hypochloremia
S/S include:
muscle weakness
leg cramps
fatigue
lethargy
anorexia
N/V
decreased bowel sounds
cardiac dysrhythmia
ABs may show alkalosis
hypokalemia
S/S includes:
chronic alcoholism
renal failure
adrenal insufficiency
neuromuscular irritability
positive Chvostek and Trousseau's sign
hypomagnesium
S/S include:
lethargy
confusion
apprehension
muscle twitching
abdominal cramps
anorexia
vomiting
nausea
HA
hyponatremia
S/S include:
muscles weakness
pain
mental changes
possible seizures
hypophosphatemia
What type of solutions are
1/2NS
1/3NS
Hypotonic
Lower osmolarity than body fluids eg: 0.45% sodium chloride
hypotonic
Fluid lost from the intravascular compartment:
hypovolemia
Hypovolemia patients should be on what type of diet:
low sodium
Infants and growing children have a greater fluid turnover due to increase __________ rate which can affect fluid and electrolyte balance.
metabolic
_____________ is swelling, coolness, pallor and discomfort at the site.
infiltration
Perspiration looses 300-400 ml per day
Exhaled air looses 300-400 ml/day
Feces looses 100 ml
insensible losses
Fluid that surrounds cells and includes lymph:
interstitial
Fluid within all of body; 2/3 of total body fluid; contains O2, dissolved nutrients, excretory products of metabolism (such as carbon dioxide and charged particles called ions):
intracellular fluid
Contains solutes, O2, electrolytes and glucose; provides medium which metabolic process of cells takes place:
intracellular fluid
Largest fluid compartment in an adult:
intracellular
Found within vascular system; plasma
intravascular
Involves muscle contraction or tension against resistance:
isokinetic
Static or setting; there is a change in muscle tension but no change in muscle length and no muscle or joint movement (cast, traction):
isometric
Dynamic - muscle shortens to produce muscle contraction and active movement
isotonic
Same osmolarity as body fluids eg: NS
isotonic
Includes:
NS
LR (treats metabolic acidosis)
5% dextrose in water
D5W
isotonic solutions
Excessive loss from GI tract; can be caused from long term diuretic use, chronic alcohol abuse, pancreatitis, burns:
hypomagnesium
Can be caused from abnormal retention of this, renal failure, adrenal insufficient
hypermagnesium
Regulates cardiac functions, transmits nerve impulses, relaxes muscle contractions, intracellular metabolism:
magnesium
This acidosis can be caused by severe diarrhea:
metabolic
pH less than 7.35, PaCO2 less than 38, Kussmaul's respirations, lethargic, confusion, HA, weakness, N/V, monitor ABGs, I/O, LOC, administer IV sodium bicarb carefully, treat underlying problem:
metabolic acidosis
pH greater than 7.45, PACO2 greater than 45mmhg, decreased rate and depth, dizziness, hypertonic muscles, monitor I/O, LOC, V/S, IV fluids:
metabolic alkalosis
Water lost through respirations, skin and feces; approximately 1300ml
obligatory losses
Pulling force exerted by colloids:
oncotic pressure
Loss or gain of water only; osmolarlity of serum is altered:
osmolar
Movement of H2O across cell membranes from less concentrated solution to the more concentrated solution; important to maintain homeostasis:
osmolarity
The power of a solution to draw water across a semi-permeable membrane
osmotic pressure
Hyposmolar imbalance of water intoxication is gained in excess of electrolytes resulting in low serum osmolarity and low serum sodium levels;water drawn in cells makes them swell:
over-hydration
Warmth or redness over the vein; inflammation of the vein:
phebitis
Major anion of intracellular fluids, absorbed from intestines; involved in metabolism of fats, proteins, carbs:
phosphate
Causes:
- TPN can cause it to shift into the cells from ECF compartment
- ETOH withdrawl
- acid/base imbalance
hypophosphatemia
Shifts out of cells
Ex:
- tissue trauma
- chemo
- renal failure
- infants fed cow milk
hyperphosphatemia
Major cation in the intracellular fluid
potassium
-Maintains ICF osmolarity
-Transmits nerve and other electrical impulses
-Regulates cardiac impulses and muscle contraction
-Regulates acid base balance
potassium
Causes include:
- Vomiting
- Diarrhea
- Gastric suctioning
-Diarrhea
- Heavy perspiration
- Diuretics
- Hyperaldosteronism
- Hyper-renal failure
- Hypoaldosterone
- Excess or rapid infusions of K+
Hypokalemia
This may occur in pts who are newly diagnosed with diabetes or in the individual who either did not administer enough insulin or the body requirements exceeded the supply available:
Diabetic ketoacidosis (DKA)
The body will demand more insulin whenever faced with increased physical activity or serious illness. The excessive glucose and ketones within the blood cause the serum osmolarity to rise. Water will begin to exit the cells to dilute the blood and make it less hypertonic. The cells become dehydrated and the patient will develop neurological changes. Glucose and ketones will spill over into the urine causing an osmotic diuresis to occur within the kidneys. This compounds the original problem as now the cells must release more of their water and potassium, phosphate and magnesium. Acidosis promotes potassium moving out of cells to buffer the pH change (hydrogen moves into the cells, potassium moves out).
Diabeticketoacidosis
S/S include:
-polyuria
-hypotension
-weight loss
-tachycardia
-fatigue
-irritability, lethargy, coma
-N/V
-initially signs of hyperkalemia
-dry, flushed skin
- dry mucus membranes
- hypokalemia p insulin administration
Diabetic Ketoacidosis
Treatment:
- Rehydration usually with NS then D5W
- Rapid-acting insulin
- Restoration of electrolyte balance (Na with NS; K+ levels can shift from hyper to hypo p admin of insulin (causes K+ to shift back into the cells)
- IV bicarbonate: given if pH <7.1. It's use is controversial as insulin therapy will correct the low bicarbonate levels
- Treat Underlying cause: e.g. infection
diabetic ketoacidosis
Caused by most often by too little ADH produced by the pituitary gland or occasionally by the inability of the kidneys to respond to ADH. Patients will excrete large amounts (5 to 40 liters per day) of extremely dilute urine. They are at risk of serious complications as vascular volume quickly falls, serum osmolarity rises and hyponatremia results. Also as serum osmolarity rises, patients become prone to thromboemboli.

Most often caused by tumors or injury of the pituitary gland or cerebral death:
DiabeticInsipidus
S/S include:
- polyuria
- signs of dehydration such as dry mucous membranes, poor skin turgor, hypotension, tachycardia
- urine osmolarity decreased < 200
- urine specific gravity > 300
- serum sodium > 147 mEq/L

Risk Factors:
- head injury
- pituitary tumors
- brain death
- increased ICP
Diabetes Insipidus
Treatment:
- Rapid rehydration with hypotonic saline to correct fluid losses then replacement is tailored to urinary losses
- Exogenous vasopressin (DDAVP)
- Chlorpropamid (stimulates ADH release)
Diabetes Insipidus
Stimulated by:
- Increased plasma volume as sensed by stretch recptors located in the left atrium & pulmonary vasculature & decreased BP as sensed by pressure receptors located in the carotid arteries
- During these times increased ADH release occurs which causes the kidneys to conserve water. This extra water expands in the serum & decreased serum osmolarity & sodium levels. Decrased serum osmolarity causes water to move into first the extracellular space then the intracellular spaces, causing the brain to swell - causing increased ICP.
- The increase in ECF causes an increase in aldosterone secretion which further reduces serum Na levels. Without prompt treatment the pt. will experience increased ICP due to cerebral edema & severe hyponatremia which may be fatal.
- common in ICU settings
SIADH
Syndrome of inappropriate secretion of anti diuretic hormone
Risk Factors:

- Oat cell carcinoma of the lung; carcinoma of the pancreas, duodenum, prostate, or thymus, and some forms of leukemia
- fear, pain or stress
- head trauma, brain tumors, intercranial hemorrhage, meningitis
- positive pressure ventilation (stimulates pressure receptors in the carotid sinus & aortic arch)
- medications such as chlorpropramide, acetaminophen, morphine, amitriptyline, thiazide diuretics, CA, chemotherapy drugs
SIADH

Syndrome of Inappropriate Secretion of Anti Diuretic Hormone
Causes serum and cellular fluid overload but not interstitial overload. This can be seen by fingerprint edema (when a finger is pressed over the sternum a fingerprint will be left).
SIADH
Syndrome of Inappropriate Secretion of Anti Diuretic Hormone
- COPD
- CHF
- kidney disease
- CA
- ileostomy
- elderly
- young
- fever
- surgery
- homeless
Common Risk Factors for Fluid, Electrolyte, & Acid – Base Imbalances:
Rate of bone loss is slowed with regular exercise in __________ and _________.
menopausal women & older men
Receptors in juxtaglomerular cells in kidneys causing sodium and water retention:
Renin-angiotensin
-pH > 7.45
-PACO2 < 35mmhg
-C/O
- SOB
- CP
- chest tightness
- difficulty concentrating
- blurred vision

- Monitor
- V/S
- ABGs

- Assist client to
- Breath more slowly
- Breath in paper bag
- Apply NRB
Respiratory alkalosis
- pH < 7.35
- PaCO2 > 45mmhg
- S/S
- increase HR
- increase RR
- dizziness
- confusion
- decrease LOC
- convulsions
- warm flushed skin

- Assess
- Respiratory status
- lung sounds

- Monitor
- Airway
- I/O
- V/S
- ABGs
- Narc antagonists

- Maintain
- Adequate hydration
Respiratory acidosis
Major cation in the ECF:
sodium
- Renal absorption or excretion
- aldosterone increase it
- re-absorbed in collecting ducts of nephrons
- Regulates ECF volume and distribution
- Maintains blood volume
- Transmits nerve impulses and contracts muscles
sodium
Causes:
- GI fluid loss
- sweating
- diuretics
- hypotonic tube foods
- drinking water
- excess IV D5W
- head injury
- AIDS
- Malignant tumors
Hyponatremia
Causes
- Loss of fluids
- hyperventilation
- diarrhea
- water deprivation
- excess salt intake
- heat stroke
hypernatremia
________ increases cellular metabolism blood glucose concentration, catecholaminelevels.
Stress
_______ can increase ADH and decrease urine output.
Stress
Sudden weight gain, blurred vision, H/A, and decreased fluid output compared to intake is an early sign of
water excess
______________ can affect the body's ability to maintain fluid.
surgerygauge
The diameter of the lumen is the _______ of the needle.
gauge
The ___________ are the primary regulator of body fluids and electrolytes.
Kidneys
The ____________ is the organ that assumes the greatest responsibility for the __________________ balance.
kidneys
potassium
The normal fluid intake is _____________ ml. We need _______________ ml. We get an extra _______ ml from the food taken in during metabolic process.
1500 ml
2500 ml
1000 ml
The fluid shifts from the vascular space into an area where it is not readily accessible as ECF.
Thirst mechanism
_______________ is the primary regulator of fluid.
Third space syndrome
These are used to increase blood volume following severe loss of blood. Examples are Dextran, plasma and human serum albumin.
Volume expanders
You are at risk for dehydration if you have a decrease in
Anti-diuretic hormone
Risk factors include:
-alveolar gas exchange impairment (pneumonia, acute pulmonary edema, aspiration, near-drowning)
-chronic lung disease (asthma, CF, emphysema
-OD narcotics/sedatives that depress respiration
-brain injury

Manifested by:
-PaCO2 above 45 mmHg
-pH < 7.35
Respiratory acidosis
Risk Factors:
-Hyperventilation (anxiety, increased body temp, overventilation via mechanical vent, hypoxia, salicylate OD)

Manifested by:
-light-headedness
-pH >7.45
-PaCO2 35 mmHg
Respiratory alkalosis
Risk Factors include:
-Increased nonvolatile acids in the blood (renal impairment, diabetes mellitus, starvation)
-Decreased bicarbonate (prolonged diarrhea)
-Excess IV of NaCl

Manifested by:
-Kussmaul's respirations
-pH <7.35
-serum bicarbonate<22 mEq/L
Metabolic acidosis
Risk Factors include:
-Excess acid loss (vomiting, GI sx)
-Excess use of potassium-losing diuretic
-Excess adrenal corticoid hormones (Cushing's syndrome, hyperaldosteronism)
-Excess bicarbonate intake (antacids, parenteral NaHCO3)

Manifested by:

-tetany
-dizziness
-dizziness
-decreased RR and depth
-pH > 7.45
-serum bicarbonate > 26 mEq/L
Metabolic alkalosis
-Relationship is critical for homeostasis
-Significant variations from normal pH ranges are notwell tolerated and may be life threatening
-Balance is achieved by Respiratory and Renal systems
Acid base balance
There are two buffers and they work in pairs:

Associated with the respiratory and renal compensatory system
H2CO3 Carbonic acid

NaHCO3 Base bicarbonate
Approximately 98% normal metabolites are in the form of
CO2
Metabolic element of the acid base balance is a function of the
kidneys
Process of kidneys excreting ____ into the urine and reabsorbing ____ into the blood from the renal tubules
1) active exchange ______ for H+ between the tubular cells and glomerular filtrate
2) carbonic _________ is an enzyme that accelerates hydration/dehydration CO2 in renal epithelial cells
H+
Na+
anhydrase
Acid Base Relationship

H20+CO2 = ______ = HCO3 + H+
H2CO3
Normal ABGs:

pH:
PCO2:
PO2:
HCO3:
BE:
SaO2:
pH: 7.35-7.45
PCO2: 35-45 mmHg
PO2: 80-100 mmHg
HCO3: 22-26 mmol/L
BE:-2 - +2
SaO2:>95%
Acidosis:

pH:
PCO2:
HCO3:
pH: <7.35
PCO2: >45
HCO3:<22
Alkalosis:

pH:
PCO2:
HCO3:
pH: > 7.45
PCO2: < 35
HCO3:> 26
- emphysema
- drug OD
- narcosis
- respiratory arrest
- airway obstruction
causes of Respiratory acidosis
- think of CO2as an acid
- failure of the lungs to exhale adequate CO2
- pH <7.35
-PCO2 > 45
- CO2 + H2CO3 - decreased pH
Respiratory acidosis
-Failure of kidney function
-Decreased blood HCO3 which results in decreased availability of renal tubular HCO3 for H+ excretion
-pH < 7.35
-HCO3 <22
Metabolic Acidosis
-renal failure
-diabetic ketoacidosis
-lactic acidosis
-excessive diarrhea
-cardiac arrest
Causes of Metabolic Acidosis
-too much CO2 exhaled (hyperventilation)
-decreased PCO2, H2CO3 insufficiency = increased pH
-pH > 7.45
- PCO2 < 35
Respiratory Alkalosis
-hyperventilation
-panic d/o
-pain
-pregnancy
-acute anemia
-salicylate OD
Causes of Respiratory Alkalosis
-Increased plasma bicarbonate
-pH > 7.45
- HCO3> 35
Metabolic Alkalosis
-increased loss acid from stomach or kidney
-hypokalemia
-excessive alkali intake
Causes of Metabolic Alkalosis
Analyzing an ABG:

1. PO2: NL = ______
2. pH NL = ________
3. PCO2 NL = _________
4. HCO3 NL = ________
PO2 NL = 80-100 mmHg

pH NL = 7.34-7.45
acidotic <7.35
alkalotic>7.45

PCO2 NL = 35-45 mmHg

HCO3 NL = 22-26 mmol/L
acidotic <22
alkalotic >26
Analyzing an ABG:

Step 1:

1. Determine PaO2 & SaO2
2. Determine oxygen status
3. Low PaO2 (< ____mmHg) means hypoxia
4. NL/elevated oxygen means adequateoxygenation

Step 2:
pH acidosis < 7.35
alkalosis >7.45

Step 3:
Study PaCO2 & CHO3
Respiratory irregularity if PaCO2 _______ & HCO3 _____
Metaboic irregularity if HCO3 ______ & PaCO2 ____

Step 4:
Determine if there is a compensatory mechanism working to try to correct the _____. (ie: If have primary respiratory acidosis will have increased PaCO2 and decreased pH. Compensation occurs when the kidneys retain _______.
step 1: 80
step 3: abnormal & NL
abnormal & NL

step 4: pH
HCO3
Respiratory Acidosis:

pH =
PaCO2=
HCO3=
Respiratory Acidosis:
pH = 7.30
PaCO2= 60
HCO3= 26
Respiratory Alkalosis:

pH =
PaCO2=
HCO3=
Respiratory Alkalosis:

pH = 7.50
PaCO2= 30
HCO3= 22
Metabolic Acidosis:

pH =
PaCO2=
HCO3=
Metabolic Acidosis:

pH = 7.30
PaCO2= 40
HCO3= 15
Metabolic Alkalosis:

pH =
PaCO2=
HCO3=
Metabolic Alkalosis:

pH = 7.5
PaCO2= 40
HCO3= 30
Compensations:

Respiratory acidosis and metabolic _______________
alkalosis
Compensations:

Respiratory alkalosis and metabolic _______________
acidosis
In respiratory conditions, the _______ will attempt to compensate and visa versa.
kidneys
In chronic respiratory acidosis (COPD), the __________ increase the elimination of H+ and absorb more ________. The ABG will show NL pH, increase CO2 and increase HCO3.
kidneys
HCO3
Buffers kick in within________. Respiratory compensation is rapid and starts within minutes and complete within _____ hours. Kidney compensation takes hours and up to ______ days.
minutes
24 hours
5 days
Valuable information can be gained from an ABG as to the patients
physiologic condition
A diet high in ______, ______ and ______ should be encouraged for an immobile patient.
protein, calories, fiber
0.9% NaCl & Lactated Ringer’s -initially remain in the vascular compartment, expanding vascular
volume. 5% dextrose in water (D5W) -provides free water when metabolized, expanding ICF & ECF
volumes – avoid in ↑ intracranial pressure, can ↑ cerebral edema
Isotonic Solutions
5% Dextrose in NaCl (D5NS), 5% dextrose in 0.45% NaCl (d5 1/2NS), 5% Dext5rose in Lactated
Ringers (D5LR) – used to draw fluid out of the intracellular & interstitial compartments into the vascular compartment, expanding vascular volume. Avoid in Pts w kidney or heart disease or clients who are dehydrated.
Hypertonic Solutions
Dextran, Plasma & human Serum Albumin – used to increase blood volume following severe loss of
blood or plasma.
Volume Expanders
0.45% NaCl (1/2 NS) & 0.33% NaCl – used to provide free water & treat cellular dehydration. – promote
waste elimination by the kidneys.
Hypotonic Solutions
___________ infusion set drop factor is always 60 drops/mL
Microdrip
_____________ infusion sets commonly have drop factors of 10, 12, 15 or 20 gtt/mL √ labels.
Macrodrop
Equation for Milliliters per hour:
Total infusion volume ÷ total infusion time = mL/h
Equation for Drops per Minute
(Total infusion volume X drop factor) ÷ Total time of infusion in minutes
Example: 1000mL in 8 hours using a macrodrop 20 drops/mL
1000mL x 20 ÷ 480 min. = 41 gtt/min