Fluid & Electrolyte Balance

Front 1

S & S of fluid infiltration

Back 1

edema & pain
pallor and coolness

Front 2

what are the order for IV insertion

Back 2

ensure the 6 rights of medication admin
assess client experience with IV therapy
assess for risk factors, such as age or platelet count
perform hand hygiend
open & prepare infusion set
select appropriate vein and insert cannula

Front 3

what are the extracellular electrolytes

Back 3

sodium (Na) 135 - 145mEq/L
potassium (K) 3.5 - 5.0 mEq/L
ionized calcium (Ca) 4.5 - 5.5 mEq/L
chloride (Cl) 95 - 105 mEq/L
magnesium (Mg) 1.5 - 2.5 mEq/L

Front 4

the movement of a pure solvent across a semipermeable membrane from a lower to a higher concentration is known as what

Back 4

osmosis; equalizes the concentration of molecules

Front 5

diffusion

Back 5

random movement of a solute in a solution across a semipermeable membrane from high to low concentration

Front 6

what is the process of fluids passing through permeable membrane from high to low pressure

Back 6

filtration

Front 7

actuve transport

Back 7

ions move against osmotic pressure to an area of higher pressure

Front 8

what regulates body fluids

Back 8

fluid intake and output
hormones

Front 9

how much urine do the kidneys produce in 24 hrs

Back 9

1200 - 1500 ml

Front 10

what is insensible loss

Back 10

continuous loss through skin, lungs, GI tract

Front 11

what is sensible loss

Back 11

excess perspiration and is perceived by patient
insensible + sensible = 500 - 600 ml/day

Front 12

what is ADH and where is it found

Back 12

a hormone released from the posterior pituitary that is released to changes in the blood osmolarity, with pain, stress; prevents diuresis

Front 13

what do the adrenal glands do

Back 13

conserve Na+, Cl-, H2O
excrete K+

Front 14

hypotonic solution

Back 14

hydrates cells

Front 15

isotonic solution

Back 15

keeps balance
NS 0. 9%

Front 16

hypertonic solution

Back 16

brings or hydrates vessels resulting in increased blood pressure

Front 17

what are some results for fluid volume excess

Back 17

hypervolemia
edema
overhydration
interstitial-to-plasma shift

Front 18

causes of edema

Back 18

increased capillary filtration-bilat edema (HTN, artherosclerosis)
decreased capillary oncotic pressure-unilateral edema (burn pts, alcoholics; low albumin level)
increased capillary permeability-unilateral edema (MRSA, infection); will cause decrease BP, increase HR
lymph obstruction-unilateral edema (masectomy, hip surgery)

Front 19

what is third spacing

Back 19

accumulated fluid in the pericardial sac, peritoneal cavity, and the pleural cavity

Front 20

what does sodium do and where is it regulated

Back 20

regulates extracellular/body fluid
kidneys regulate it; monitor arterial pressure

Front 21

what are the signs of hypernatremia (sodium imbalance)

Back 21

extreme thirst, dry flushed skin, dry sticky tongue and mucous membranes, postural hypotension, fever agitation, convulsions, restlessness and irritability, apprehension, coma
serum Na+ abovr 145

Front 22

S & S of hyponatremia

Back 22

apprehension, personality change, postural hypotension, postural dizziness, abdominal cramping, nausea & vomiting, diarrhea, tachycardia, dry mucous membranes convulsions & coma, neck vein distention, orthostasis, tachycardia
serrum Na+ below 135

Front 23

s & s of hypokalemia (potassium)

Back 23

weakness and fatigue, nausea & vomiting, mm weakness, intestinal distention, decreased bowel sounds, decreased deep tendon reflexes, ventricular dysrhythmias, irregular pulse, paresthesias & weak,
serum K+ below 3.5

Front 24

s & s of hyperkalemia

Back 24

anxiety, dysrhythmias, paresthesia, weakness, abdominal cramps, diarrhea, bradycardia
serum K+ above 5.0

Front 25

s & s of hypcalcemia

Back 25

numbness & tingling of fingers and mouth area, hyperactive reflexes,, mm cramps, tetany, Trousseau's & Chvostek's sign
serum calcium below 8.5 or ionized calcium below 4.5

Front 26

s & s of hypercalcemia

Back 26

anorexia, nausea & vomiting, weakness, hypoactive reflexes, lethargy, flank pain, decreased LOC, cardiac arrest, personality change
serum ionizedcalcium above 5.5

Front 27

how much of our body weight is water

Back 27

infants - 70 - 80 %
toddlers & preschoolers 60 - 70 %
adolescents & adults 50 - 60 %

Front 28

how much fluid loss is a problem

Back 28

15 - 20% loss = death

Front 29

S & S of fluid volume deficit

Back 29

loss of 2.2 lbs/day
loss of turgor, flat neck veins, sunken eyes, sticky dry mucous, dry cracked lips, longitudinal tongue furrows, decreased capillary filling, low BP, distended abdomen, oliguria or anuria, increase urine specific gravity, decreased skin temperature

Front 30

s & s of fluid volume excess

Back 30

gain of 2.2 lb/day, blurred vision, papilla or periorbital edema, distended neck veins, edema in dependant body parts, bounding pulse

Front 31

what happens to a cell that gets a hypotonic solution

Back 31

since the solute is lower on the outside,water will move from low to high(inside) causing the cell to swell and eventually burst

Front 32

what happens to a cell that gets a hypertonic solution

Back 32

since the solute is higher outside, water will move from low to high (outside) causing the cell to shrink

Front 33

what results in thirst sensation and cellular shrinkage

Back 33

loss of body water increases serum osmolaty

Front 34

what is oncotic pressure

Back 34

pressure exerted by plasma protein

Front 35

who is at a higher risk for fluid volume excess?
1. 88 yr old with a fractured femur scheduled for surgery
2. 65 yr old recently diagnosed with CHF
3. 50 yr old with 2nd degree burns on ankles & feet
4. 20 yr olf with a 5 yr history of type 1 diabetes

Back 35

the 65 yr old recently diagnosed with CHF

Front 36

who would be more at risk for developing hypocalcemia
1. 56 yr old with acute renal failure
2. 28 yr old after total thyroidectomy
3. 65 yr old taking beta-adrenergic blockers for HTN
4. 40 yr old with systemic lupus

Back 36

56 yr old with acute renal failure

Front 37

if your patient has a low blood volume d/t hemorrhage, what would you expect to see

Back 37

increased heart rate

Front 38

if a patient can't ask for or obtain fluids what should you look for

Back 38

hypovolemia

Front 39

what does third space refer to

Back 39

interstitial area

Front 40

where is the majority of body fluids located

Back 40

intracellular

Front 41

what would you find if a patient had lost vascular volume

Back 41

increased heart rate
decreased urine output

Front 42

if a patient had very high blood sugar & sugar in the urine you would find

Back 42

increased urine output and decreased blood volume

Front 43

how does aldosterone contribute to fluid and electrolyte balance

Back 43

promotes sodium retention and potassium loss

Front 44

What IV solution would you administer if a client is admitted to the emergency department with hypovolemia

Back 44

Ringer's solution because it is isotonic and a balanced electrolyte solution that can expand plasma volume and restore electrolyte balance

Front 45

what would you expect to find on a client with fluid volume deficit

Back 45

orthostatic hypotension and flat neck veins because there is less volume in the vascular system which decreases venous return and cardiac output. Heart rate increases and BP falls

Front 46

A nursing care plan for a patient with hyponatremia should include what

Back 46

frequent neurological checks because heypernatremia draws water out of brain cells causing them to shrink resulting in tension on cerebral vessels that will tear and bleed, orienting client to person, place, time because of altered mental status and brain function, and maintain IV access to administer fluids and possible emergency meds

Front 47

If labs values show a low level of serum potassium what is the highest priority nursing action to be taken

Back 47

initiate cardiac monitoring

Front 48

a client who is known to be an alcoholic presents with confusion, hallucinations, and a positive Chvostek's sign what med(s) should be admininstered

Back 48

magnesium sulfate as it helps restore magnesium balance and neuromuscular function

Front 49

What is it if the ABG shows a pH 7.21, PaO2 98 mmHg, PaCO2 32 mmHg, and HCO3 17 mEq/L

Back 49

metabolic acidosis

Front 50

what assessment data would you anticipate if a client is admitted witha suspected heroin overdose with a respiratory rate of 5 to 6 per minute

Back 50

pH level below normal, PaCO2 above normal and warm, flushed skin because excess carbon dioxide causes vasodilation

Front 51

what acid-base imbalance would somebody be at risk for after having several days of gastric decompression

Back 51

metabolic acidosis because gastric suctioning removes highly acidic gstric secretions increasing the alkalinity of body fluids and the loss of chloride causes the kidneys to retain bicarbonate to restore the balance between positive and negative ions

Front 52

a client is undergoing mechanical ventilation following a severe chest wall injury and flail chest complains of chest tightness, anxiety and feeling as htugh she can't get enough air. She is afraid she is having a heart attack. what should the nurse do

Back 52

obtain ABGs as these are symptoms of respiratory alkalosis which is a potential complication of mechanical ventilation when the rate or volume of ventilations are too high