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53 Cards in this Set
- Front
- Back
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Dehydration
(describe symptoms) |
Dry & sticky mucous membrane, flushed dry skin, thirst, increased body temperature, irritability, convulsions, coma, increased sodium > 145 mEq/L, increased osmolarity > 295 mosm/kg
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Sensible Water Loss
(Define) |
Occurs through excess perspiration and can be perceived by the client or through inspection (stimulation of sweat glands)
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Insensible Water Loss
(Define) |
continues and occurs through the skin and lungs
Increases with fever or burns |
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Aldosterone
(Describe) |
Released in response to increased plasma potassium levels, saving sodium, volume regulator
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Fluid Volumes
(Examples of) |
Overhydration, fluid excess, dehydration, fluid deficit
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Chloride Regulation
(Describe and give normal range) |
Major anion in ECF, follows sodium transport, regulated by dietary intake and the kidneys
Normal Range (90-110 mEq/L) |
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Hypokalemia
(Describe & Give Symptoms) |
Low potassium
Decreased weakness and fatigue, irregular pulse, muscle tone |
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Hyperkalemia
(Describe & Give symptoms) |
High Potassium
Anxiety, cardiac dysrhythmias, abnormal cramps |
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Hypernatremia
(Decribe & Give Symptoms) |
high sodium
Dry mucous membrane, agitation, convulsions |
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Potassium Regulation
(Describe & Give Normal Range) |
Major cation in intracellular compartment regulates many metabolic activities, regulated by dietary intake and renal excretion, body conserves K+ poorly
Normal Range Serum K+(3.5 - 5.0 mEq/L) |
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Sodium Regulation
(Describe & Give Normal Values) |
Most abundant cation (90%) in the ECF, major contributor to maintaining water balance regulated by dietary intake and aldosterone secretions
Normal Range (135 -145 mEq/L) |
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Hyponatremia
(Describe & give some symptoms) |
Low sodium
personality change, postural hypotension |
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Fluid Output Regulation
(Describe what it affects) |
kidneys, skin, lungs, GI tract
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Hypovolemia
(Describe) |
Hypothalamus stimulated when excess fluids are lost
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Osmoreceptors
(Describe) |
Monitor serum osmotic pressure when osmolarity increases and hypothalamus is stimulated
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Sodium Potassium Pump
(Describe) |
Sodium is pumped out and potassium is pumped in against concentration. Gradient allows for a higher concentration of K+ in the ICF and higher concentration of NA+ in the ECF
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Active Transport
(Describe) |
Requires metabolic activity and expenditure of energy to move materials across cell membranes
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Hydrostatic Pressure
(Describe) |
The force of the fluid pressure outward against a surface increases fluid pressure in the arterial portion of the circulation, forcing fluid through the capillary into the interstitial spaces and from glomerular capillaries into the collection tubules of kidneys.
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Filtration
(Describe) |
The process by which water and diffusable substances move together in reponse to fluid pressure
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Concentration Gradient
(Describe) |
The difference between the two concentrations
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Diffusion
(Describe) |
Movement of a solute (gas or substance) in a solution from an area of higher concentration to a lower concentration results in an even distribution of the solute in a solution
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Isotonic
(Describe) |
Expand the body's fluid volume without causing a shift from one compartment to another
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Colloid Osmotic (Oncotic Pressure)
(Describe) |
Tends to keep fluid in the intravascular compartment by pulling water from the interstitial space back in to the capillaries
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Hypertonic
(describe& what process is it) |
Solution with higher osmotic pressure pulls fluid from cells causing them to shrink. (passive process)
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Hypotonic
(Describe & what process is it) |
Solution with lower osmotic pressure moves fluid into the cells causing them to enlarge. (passive process)
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Osmotic Pressure
(Describe) |
"pull" created by a soltion of higher concentration across a semipermeable membrane
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Osmosis
(Describe) |
Involves movement of a pure solvent (water) through a semipermiable membrane from an area of lesser solute concentration. Equalize concentrations of ions on both sides of the membrane
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Anion
(Describe) |
Negatively charged electrolyte
Cl- HCO- SO4- |
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Cation
(describe) |
Positively charged electrolytes
Na+ K+ Ca2+ |
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mEq
(Describe & name) |
Milliquivalents per Liter
represents # of grams of the specific electrolyte (solute) dissolved in a liter of plasma (solution) |
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Electrolyte Distribution in Body Fluids
(Name them with ranges) |
Na+ : 135-145 mEq/L
K: 3.5-5.0mEq/L HCO3- : 22-26 mEq/L Cl- : 95-105 mEq/L Ca2+ : 4.5 - 5.5 mg/dl Mg2+ : 1.5-2.5 mEq/L |
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Electrolytes
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Substances whose molecules dissociate or split into IONS when placed into water electrically charged
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Steps to measure I&O
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Obtain I&O sheet
Instruct client & family record amount of liquid and type Total I&O at the end of each shift Total I&O at end of each 24 hours Calculate negative and positive balance |
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Negative Balance I&O
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More output than intake
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Positive Balance I&O
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Not urinating, can go into fluid overload (fluid in body still)
More intake than output |
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Average Adult Output
(Ranges) |
1200 - 1500 mL of urine
(Changes based on intake) Insensible 400 - 1000mL Intestines 100-200mL |
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1 kg of weight gained or lost = ?
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1 Liter
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Average Adult Intake
(Range of intake daily, and what does solid, oral, oxidative metabolism account for) |
2200 - 2700 mL per day
oral intake accounts for 110-1400 mL Solid foods account for 800-1000mL Oxidative metabolism accounts for 300mL |
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Output
(Name methods of output, and the major function of kidneys) |
Urine, diarrhea, vomitus, gastricsuction drainage, drainage from post surgery, drainage tubes
Kidneys- major regulartoy organ |
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All Factors influencing imbalances (fluid, electrolyte, acid-base imbalances)
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Age, gender, environment, chronic disease, trauma, therapies, gastrointestinal losses
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Acute Illness
(name factors that influence fluid & electrolyte imbalances) |
trauma, surgery, burns, head injury, respiratory disorders, chronic illnesses (pg 979)
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Factors Influencing Fluid Electrolyte Needs (AGE)
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Infant:
need greater than adult fluid content 80% of body weight H2O more outside cell H2O more easily lost Elderly: Need for H2O overlooked thirst mechanism diminishes conscious attention to adequate fluid intake |
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Intake
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All fluids taken by mouth through NG, feeding tubes, IV fluids
External - by mouth or feeding tubes Parenteral - IV therapy, only foods that change to liquid at room temperature (soup, gelatin, pudding, ice cream, popsicles) |
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Fluid Volume Deficit (FVD)
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body water loss is proportionately greater per kg of weight postural hypotension, tachycardia, dry mucous,membrane, poor skin turgor, thirst, rapid weight loss, slow vein filling, lethargy, weak pulse
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Fluid Volume Excess (FVE)
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Retain Fluids * resticted fluid intake requires frequent mouth care
rapid weight gain, edema, polyuria, increased blood and venous pressure, crackle in lungs, hypertension, and decreased hematocric <38%, decreased BUN <10mg/100mL |
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Overhydration
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Syndrome of inappropiate of antidiuretic hormone (SIADH)
Excess water intake, decreased conciousness, convulsions, coma, decreased sodium <135 mEq/L, decreased osmolarity <280 mosm/kg |
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Fluid Volume Deficit (FVD)
(lab findings) |
urine specific gravity >1.030, increased hematocrit >50%, increased BUN >25mg/100mL
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How to calculate intake and output?
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Add intake volumes and add outake volumes
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How many oz in a mL?
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1 oz = 30 mL
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Criteria for weighing Intake & Output
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same time
same scale same clothes after patient voids |
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Criteria for when you perform a Physical Assessment
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daily weighs
intake and output laboratory studies |
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Example problem to calculate intake
coffee 6oz =180mL OJ 4oz = 120 mL Tea 3 x 8 oz = 720 mL Water 4 x 8 oz = 960 mL IV 30 mL x 12 = 360 mL (note: convert oz to mL) |
coffee 6oz =180mL
OJ 4oz = 120 mL Tea 3 x 8 oz = 720 mL Water 4 x 8 oz = 960 mL IV 30 mL x 12 = 360 mL intake 12 hours = 2340 mL |
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Patient Recorded Output Voided
400cc at 7AM 100cc at 10AM 200cc at 12PM 150cc at 2PM 400cc at 6PM nurse emptied 300cc from JP tube vomited 100cc at 4PM total output for 12 hours? |
400cc at 7AM
100cc at 10AM 200cc at 12PM 150cc at 2PM 400cc at 6PM nurse emptied 300cc from JP tube vomited 100cc at 4PM HEM urine = 1250 mL drainage = 300mL Emesis = 100mL Total = 1650mL output for 12 hours |
