Fluid And Electrolyte Common Alterations Across The Life Span

Front 1

Certain disorders are associated with hyponatremia, hypomagnesemia, and hypokalemia, including what 2?

Back 1

Diabetes mellitus

Hypertension.

Front 2

Certain medications are also associated with electrolyte imbalances, including what 2 classifications?..

Back 2

Diuretics

Benzodiazepines.

Front 3

Many modifiable risk factors affect fluid and electrolyte balance. Regular weight-bearing exercise helps maintain_________ balance.

Back 3

calcium

Front 4

How does stress affect fluids and electrolytes?

Back 4

Can increase cellular metabolism, blood glucose levels, and catecholamine levels, leading to fluid and electrolyte imbalancesCan increase production of ADH, which decreases urine production.

Front 5

Diuretics increase?

Back 5

increase urine production.

Front 6

Antipsychotic agents affect fluids how?

Back 6

fluid intake because they can increase thirst.

Front 7

Vasoconstrictors, beta-blockers, and certain stimulants increase the risk of _____________________because they can interfere with the body's ability to regulate temperature.

Back 7

fluid imbalance from heat stroke

Front 8

heat related illness symptoms

Back 8

Symptoms include fatigue, weakness, headache, loss of appetite, and vomiting.

Front 9

If water is not replaced, risk of _________ & ___________increases.

Back 9

heat exhaustion or stroke

Front 10

To prevent heat-related illness, nurses can teach clients to:5

Back 10

Limit outdoor activity during the hottest part of the dayTake frequent rest and water breaksDrink water before beginning to feel thirstyWear lightweight clothesWork or exercise with others when performing outdoor activities.

Front 11

The physical assessment for fluid and electrolyte status focuses on the following:

Back 11

skin, oral cavity and mucous membranes, eyes, cardiovascular and respiratory systems, and neurological and muscular status. The nurse will also note any unusual findings in the client's physical appearance.

Front 12

View general appearance ofskin. Explain normal and abnormal skin texture, temp, etc. concerning fluid & electrolyte imbalance.

Back 12

Normal: Skin is appropriate color for ethnicity, is dry. Skin is firm, warm, and moist.

Abnormal: Flushed, warm, very dry Very moist or diaphoretic or cool and pale

Front 13

Mucous membranes: Assessfor dryness and cracking.

Back 13

Norm: Moist in appearance.

Abnorm:Dry or cracking

Front 14

Edema: How do you assess for edema?

NOrm and Abnorm??

Back 14

Assess for pitting by depressing skin over tibia or on top of foot.

NOrm No swelling noted. Depressed skin rebounds immediately.

Abnormal: Depression remains when tissue is depressed (“pitting”).

Front 15

Eyes: Yes, you actually check the eyes! How do you check eyes for fluid and electrolyte imbalances?

Back 15

Gently palpate eyeball with lid closed.

Normal:Eyeball is soft.

Abnormal: Eyeball is firm to touch.

Front 16

Assess rate and rhythm, lungsounds.

Back 16

Normal: Rate is normal for age, lungs clear to auscultation.

Abnormal: Tachypnea, rales, wheezing, frothy sputum Cyanosis is a late sign.

Front 17

Assess level of consciousness(LOC),

Back 17

Norm:orientation, cognition. Awake and arousable Alert and oriented to person, place, and time

Abnorm: Decreased LOC, lethargy, stupor, or coma Disoriented, confused; difficulty concentrating

Front 18

The nurse can use three simple clinical measurements to assess a client's fluid and electrolyte status without a primary care provider's orders.

Back 18

Daily Weight

Vital Signs

Fluid intake and output (I&O):

Front 19

Daily Weight (just read over)

Back 19

Daily weights:Provides information about fluid volume statusSignificant changes over a short time (such as more than 5 lb in a week or less) indicate acute fluid changes in total body fluid volumeEach kilogram of weight is equivalent to 1 L of water gained or lostModerate to severe fluid volume deficits or excesses occur when client loses or gains 5–8% of total body weightParticularly important when measuring intake and output is not practical.

Front 20

Vital signs: (just read over)

Back 20

Changes may indicate or precede fluid, electrolyte, and acid–base imbalancesElevated temperature may be a result of dehydration or be a cause of increased fluid lossTachycardia is an early sign of hypovolemiaIrregular pulse may occur with electrolyte imbalancesPulse volume decreases with fluid volume deficit (FVD) and increases with fluid volume excess (FVE)Blood pressure decreases with FVD and increases with FVEPostural (orthostatic) hypotension may also occur with FVD.

Front 21

Fluid intake and output (I&O): Measure for how long for an assessment?

Back 21

Measurement of all fluid I&O over a 24-hour period is important for assessing a client's fluid and electrolyte balance

Front 22

Fluid input sources that must be recorded are:

Back 22

Oral fluids

Ice chips

Foods that are at room temperature (e.g., ice cream)

Tube feedings

Parenteral fluids

Intravenous medications

Catheter or tube irrigants

Front 23

Fluid output sources that must be recorded are:

Back 23

Urinary output:

Vomitus

and liquid feces

Tube drainage

Wound drainage

draining fistulas

Front 24

Chvostek sign:

Back 24

Tap over facial nerve about 2 cm anterior to tragus of ear.

Normal:No response

Abnormal: Facial muscle twitching including eyelids and lips on side of stimulus

Front 25

Trousseau sign:

Back 25

Inflate a blood pressure cuff on the upper arm to 20 mmHg greater than the systolic pressure, leave in place for 2–5 minutes.

Normal:No response

Abnormal: Carpal spasm: contraction of hand and fingers on affected side

Front 26

In addition to standard fluid input and output sources above, the nurse must consider sources specific to clients with health alterations such as those sweating profusely or with rapid respirations.

Back 26

just review

Front 27

Diagnostic tests used to determine fluid and electrolyte status include the following common tests:

Back 27

Serum electrolytes:

Complete blood count (CBC): Includes information about thehematocrit (Hct) (which is the percentage by volume of blood made up of RBCs.)

Front 28

Normal Hct values are

Back 28

40–54% in men and 36–46% in women.

Front 29

Serum osmolality measures solute concentration of blood and includes sodium ions, glucose, and urea. Normal values

Back 29

are 280–300 mOsm/kg H2O in children and adults. Increased values indicate FVD, while decreased values indicate FVE.

Front 30

Urine osmolality measures solute concentration of urine and includes nitrogenous wastes (creatinine, urea, and uric acid). Normal values are

Back 30

200–800 mOsm/kg H2O in children and adults. Increased values indicate FVD, while decreased values indicate FVE.

Front 31

Urine specific gravity: An indicator of urine concentration. Normal values are

Back 31

1.005–1.030, usually between 1.015 and 1.024.

Front 32

High urine specific gravity indicates a ______ urine osmolality; low values indicate a _____urine osmolality.

Back 32

1.high

2.Low