Fluid And Electrolytes

Front 1

Pt. at risk for F&E imbalence: Addison's Disease

Back 1

too little aldosterone which causes loss in sodium and retention of potassium..

Front 2

Pt. at risk for F&E imbalence:
Peristalsis

Back 2

No peristalisis so water is pushed into 3rd space (where it is not supposed to be)

Front 3

Pt. at risk for F&E imbalence:
Cushing's Disease

Back 3

too much aldosterone which causes retention of sodium (pt. becomes poofy and swollen)

Front 4

Tubules of the Kidneys:
If opened ______
if closed _______

Back 4

If opened you pee out and if closed you retain and do not pee.

Front 5

Glomerular Filtration Rate
Increased - Decreased

Back 5

Incleased you pee more (fluid loss) if decreased you don't pee (fluid retention)

Front 6

Where is ADH made and where is ADH stored?

Back 6

ADH is made in the hypothalamus and stored in the posterior pituitary.

Front 7

When ADH increases___
When ADH decreases ___

Back 7

increases = water retention
decreases = water loss

Front 8

Where is aldosterone stored and what is resposible for the secretion of aldosterone?

Back 8

Stored in the Adrenal gland and secreted by the adrenal cortex

Front 9

Increased sodium=__ aldosterone
Decreased sodium= ___ aldosterone

Back 9

Decreased aldosterone
increased aldosterone

Front 10

Parathyroid is responsible for what?

Back 10

Monitor calcium levels in our blood vessels

Front 11

Calcitonin does what?

Back 11

Pulls calcium from the blood back into the bone

Front 12

What takes calcium from the bone into the blood?

Back 12

Parathryoid

Front 13

Extracellular fluid is what % of total body weight and what does it consist of?

Back 13

20% and consists of the interstital which accounts for 75% of the total extracelluar total (fluid between plasma and cells) and intravascular which accounts for 25% of the total extracellular (plasma)

Front 14

What accounts for 40% of the total body weight?

Back 14

Intracellular

Front 15

Osmosis is what?

Back 15

movement of water from low to high concentration. dilute to less dilute

Front 16

Diffusion is what?

Back 16

particles move from high to low - no energy is required

Front 17

Facilitated diffusion is what?

Back 17

particles move from high to low - require a carrier molecule (glucose)

Front 18

Filtration is what?

Back 18

Hydrostatic pressure - movement of fluid from high to low pressure. higher pressure on arterial end (moves out) and lower pressure on venous end (moves in - absorption)

Front 19

Active Transport is what?

Back 19

movement from low to high- requires energy (sodium potassium pump)

Front 20

Cations

Back 20

Positivly charged electrolytes
Sodium Na+ , Potassium K+, Calcium Ca++ and magnesium Ma+

Front 21

Anions

Back 21

Negativly charged electrolytes
Chloride Cl-, Bicarbonate HC03- and Phosphate P04-

Front 22

Major intracellular

Back 22

Potassium and phosphate

Front 23

Major extracellular

Back 23

Sodium and chloride

Front 24

Isotonic

Back 24

same osmolarity as blood. No fluid shifts, stays in the intravascular space. Normal saline and lactated ringers

Front 25

Hypotonic

Back 25

Lower osmolarity than blood. fluid shifts out of vascular space to hydrate the cells. D5W, 1/2 NS and water we drink. used for dehydrated pts.

Front 26

Hypertonic

Back 26

osmolarity greater than blood. fluid shifts from cells into the vascualr space (cells strink). D10W, D50W , .3%NaCl

Front 27

Isotonic Dehydration

Back 27

Water and electrolytes are lost in the same amount..

Front 28

What caused Isotonic dehydration?

Back 28

GI losses, Hemorrhage, Loop diuretics and profuse sweating

Front 29

S&S of Isotonic dehydration

Back 29

Decreased BP, Increased Pulse, Flat neck veins, decreased urine output and weight loss

Front 30

Treatment for Isotonic dehydration

Back 30

Give fluids and sodium diet (salty broths) if can not tolerate give isotonic solution (NS & LR)

Front 31

Hypertonic Dehydration

Back 31

Loses more water than electrolytes. Fluid shifts from ICF to ECF (cells strink)

Front 32

Causes of hypertonic Dehydration

Back 32

Renal failure, kidney failure, diabetic isipidus and diarrhea

Front 33

S&S of hypertonic dehydration

Back 33

Thirst, Deep tendon reflexes, and furrow coating on tounge

Front 34

Treatment for hypertonic dehydration

Back 34

hypotonic orally (water) if need and IV(1/2 NS and D5W) for diabetes give insulin

Front 35

Hypotonic dehydration

Back 35

Lose more electrolytes than water. fluid shifts from ECf to ICF (cells swell)

Front 36

Hypotonic dehydration causes

Back 36

Renal failure, pt. on low sodium diet that is taking diuretics and malnutrition.

Front 37

Hypotonic dehydration S&S

Back 37

decrease urine output, non pitting edema, decreased BP and increased pulse and mental status changes

Front 38

Hypotonic dehydration treatment

Back 38

hypertonic solutions (.3%NaCl but slowly because potent to veint)

Front 39

Isotonic Fluid Volume Excess

Back 39

No fluid shift fluids and electrolyes are gained in equal amounts

Front 40

Isotonic Fluid Volume Excess causes

Back 40

Renal, Heart and liver failure

Front 41

Isotonic Fluid Volume Excess S&S

Back 41

Rapid weight gain, increased BP, pitting edema and 3rd spacing.

Front 42

Isotonic Fluid Volume Excess treatment

Back 42

Fluid restriction and sodium restriction. administer diuretics (heart OK kidney NOT OK) daily weights and strict I&O

Front 43

Hypotonic Fluid Volume Excess

Back 43

Lose more electrolytes than fluids. fluid shifts from ECF to ICF (cells swell)

Front 44

Hypotonic Fluid Volume Excess Causes

Back 44

SIADH, repeated tap water enemas and rapid infusions

Front 45

Hypotonic Fluid Volume Excess S&S

Back 45

Incease BP, convulsions if servere, mental status changes and warm moist skin.

Front 46

Hypotonic Fluid Volume Excess Treatment

Back 46

Water Restriction, weigh daily or use hypertonic solution .3%NaCl

Front 47

Hypertonic Fluid Volume Excess

Back 47

VERY RARE. Excessive ingestion of sodium!

Front 48

SIADH

Back 48

Increase ADH = retain water

Front 49

Diabetes insipidus

Back 49

Descrease ADH = lose water (pee alot)

Front 50

Sodium Normal Values

Back 50

135-145

Front 51

Hypernatremia

Back 51

Skin flushed, Aggitated, Low grade fever and Thirst. Causes include water loss(diuretic and diabetes insipidus) and sodium gains (Cushings) Treatment= water replacement, restrict sodium in diet and diuretics to promote sodium excretion

Front 52

Hyponatremia

Back 52

Nausea & vomiting, Abdominal distention, Altered LOC, Achy head, Anorexia and Positive Muscle Twitching. Causes= SIADH, addisons disease. treatment= fluid restriction replace oral with salty broths IV with .3% NaCl, assess mental status and seizure precautions

Front 53

Potassium Normal Values

Back 53

3.5-5.0

Front 54

Hypokalemia

Back 54

SUCTIONING.Skeletal muscle weakness, U wave(EKG changes), Constipation, toxicity of digoxin, irregular weak pulse, orthostatic hypotension and numbness. Causes= cushings, gastric suction, N&V and loop diuretics. Treatment= potassium supplements or foods high in potassium (bananas, avacodaos and cantalopes) and monitor dig level.

Front 55

Hyperkalemia

Back 55

MOST DEANGEROUS. Danger of V- fib, Abdominal cramping, Nausea, tingling and numbness, EKG changes, Rate irragular, Cardiac output decreases, unable to move- flaccid paralysis and slow heartrate- bradycardia. causes= excessive K+ intake, use of postassium sparing diuretics, massive cell destruction, acidosis and addisons disease. treatment= give insulin, sodium bicarb, calcium gluconate, kayexalate.

Front 56

Phosphate Normal Values

Back 56

2.7-4.5

Front 57

Calcium Normal Values

Back 57

8.5-10.5

Front 58

Calcium is decreased and ____ is increased

Back 58

Phosphate

Front 59

Phosphorus is eliminated from ___

Back 59

Bowel movements

Front 60

Main cause of hyperphosphateemia =

Back 60

alcoholisim

Front 61

Treat deficiency of phosphate with

Back 61

oral replacement of phosphates and Vitamin D

Front 62

Treat excess of phosphate with

Back 62

albumin hdroxide with meals to bind to phosphrous