Fluids And Electrolytes Hacc N205 Leonard

Front 1

Extracellular fluids:
anything outside vascular space---
blood flowing through the body--
left over fluid in extracellular compartment---

Back 1

interstitial
intervascular
transcellular

Front 2

factors that influence fluid content

Back 2

age (less fluid when older), muscle mass (holds more fluid than fat), fat content, sex

Front 3

the movement of fluid from an area of less solute to an area of more solutes

Back 3

osmosis

Front 4

the movement of solutes from an area of higher concentration to an areaof lower concentration

Back 4

diffusion

Front 5

the movement from lower to higher concentration of solutes
requires energy (Na outside K inside)

Back 5

active transport

Front 6

what are the normal hydrostatic pressures?
When pressure is higher, fluid seeps out of veins and can go into lungs

Back 6

capillary- 35 on arteriole side, 20 on venicle side

Front 7

when dehydrated, what labs are affected

Back 7

HBG, BUN, Sa are all increased
more solutes in vascular space- this pulls water from interstitial space and then intercellular

Front 8

what is the largest amount of protein in body

Back 8

albumin- 70%- created by liver- when liver fails, can't synthesis albumin and also causes ascities (albumin in abdominal cavity)

Front 9

the process where albumin is magnet that pulls fluid back into vascular space (filtration, absorption)

Back 9

plasma colloid osmotic pressure

Front 10

total concentration of solute particles in a solution (what is the normal range?)

Back 10

osmolarity (275-295)

Front 11

what types of isotonic solutions are there? (most similar to plasma)

Back 11

NS (almost same Sa as in blood) D5W(glucose metabolizes quickly in blood) and LR

Front 12

What type of hypotonic solutions are there

Back 12

NSS < .9% (lower concentration than blood, pulls fluid into cell)

Front 13

what type of hypertonic solutions are there?

Back 13

D5NSS, D10 D5LR higher concentration - anything with glucose in it is hypertonic on the shelf. pulls fluid out of cells

Front 14

What is the first area to assess in an emergency situation?

Back 14

Lungs first

Front 15

Ways to regulate fluid in body

Back 15

thirst, RAS, ADH, ANP

Front 16

what fluid function does the kidneys do?

Back 16

capillaries filter, tubules exchange water and electrolytes, and secrete renin

Front 17

What is the process of RAS (renin angiotensin system)

Back 17

Renin triggers angiotensin in the lungs, and pituitary secretes anti diaretic horomone to control fluid. Holds onto water

Front 18

what does the pituitary secrete that causes vasoconstriction and renal fluid reabsorption (increases BP)

Back 18

vasopressin

Front 19

what is the process of ANP- atrial natiuretic peptide

Back 19

blood volume increases, BP increases, atrai or heart stretch, ATRIA releases ANP, inhibits sodium reabsorption and aldosterone secretion, BP and volume decrease

Front 20

what problems trigger secretion of ADH?

Back 20

dehydration, diabetic keto acidosid, CHF, etc

Front 21

when should be a plan be made in advance concerning I&O

Back 21

when patient is on fluid restriction

Front 22

how much fluid = 1kg?

Back 22

1 liter

Front 23

what levels are increased with dehydration?

Back 23

Sa HCB HCT BUN

Front 24

3 types of fluid loss and what causes them-

Back 24

isotonic-loosing =fluid/solutes (hemorrhage, GI loss)
hypertonic- fluid>solutes (inappropriate ADH),
hypotonic- solutes > fluid

Front 25

what assessment complications show with dehydration?

Back 25

increased HR (tready) decreased BP (flat neck veins), deep RR increased, decreased renal output, poor turgor, confusion, agitation, decreased peristalsis

Front 26

what are the two types of fluid volume excess

Back 26

intravascular- in blood stream
extravascular- commonly interstitial or intracellular (water intoxication)

Front 27

where are third space fluids located?

Back 27

abdomen, pleural, joints, skin, eyes, heart, brain

Front 28

hard edema that is discolored - caused by proteins and usually linked to cellulitits

Back 28

brawny edema

Front 29

edema caused by airplane travel

Back 29

refractory edema

Front 30

outward force exerted by fluid in vessel, increased capillary pressure forces fluid into surrounding tissue (filtration)

Back 30

hydrostatic pressure

Front 31

What are 2 big reasons to have 3rd space fluid?

Back 31

CHF and renal failure! Also colloid osmotic pressure and lymphatic damage

Front 32

What conditions lead to a decreased colloid osmotic pressure?

Back 32

Liver failure, low protein intake. Nephrotic syndrome

Front 33

Normal albumin

Back 33

3.5-5

Front 34

What are come causes of capillary damage that causes fluid to leak out?

Back 34

Caused by burns (blisters), tissue trauma (sprain), bowel obstruction (tissue stretches and fluid seeps out)

Front 35

What problems are caused by third space fluids?

Back 35

Airway issues, heart perfusion, ascetics, tissue perfusion, crackles, impaired gas exchange

Front 36

How is third space fluids problems treated?

Back 36

Treated with diuretics , pericentisis, thoracentisis, fluid restrictions

Front 37

How is third space fluid prevented?

Back 37

Diuretics, extremities elevated

Front 38

Pituitary produces too much ADH or other body parts produce something that acts like ADH (like lung cancer)

Back 38

Siadh
Syndrome of inappropriate anti diuretic hormone

Front 39

What are some causes of SIADH

Back 39

Pituitary tumor, brain surgery, cell lung cancer

Front 40

What are some signs and symptoms of SIADH?

Back 40

Waighht gain (swelling), neuro changes (confused, lethargic, irritable, HA, slow down), cerebral edema

Front 41

If SIADH is not treated it can lead to....

Back 41

Seizures and cerebral edema

Front 42

What are some treatments for SIADH?

Back 42

Fluid restriction(1500>), diuretics (LASIK, loop), hypertonic fluid replacement (3%ns used cautiously), meds for chronic

Front 43

What types of mEdicatiins are used for chronic SIADH?

Back 43

Mannitol (for cerebral edema), meds that block ADH in kidney-lithium (type of salt), declomycin (antibiotic ; it has less side effects)

Front 44

What type of nursing care is used for SIADH?

Back 44

Monitor I&O , neuro checks, daily weights, seizure precautions if low sodium

Front 45

Deficit in the synthesis of ADH. Absolute deficiency. Surgery, trauma, idiopathic, drugs (Dilantin and alcohol)

Back 45

Diabetes insipidus central - majority caused by head trauma or tumors

Front 46

Condition where ADH produced but kidneys don't respond, genetic kidney disease

Back 46

Nephrogenic

Front 47

Signs and symptoms of diabetes insipidus

Back 47

Polyuria, polydypsia but not polyphagia
Dehydration, weakness, dehydration, weight loss

Front 48

What are treatments for diabetes insipidus? Central

Back 48

Replacement of vasopressin (can diagnose wi a test dose), fluid replacement, ddavp- desmopressin similar to vasopressin given as a nasal spray

Front 49

Diabetes insipidus nephrogenic treatment

Back 49

Thiazide diuretic - slow down glomerular filtration rate and pulls water back in.
I&o , weight, HTN

Front 50

Why are patients placed on iv fluids post op?

Back 50

ADH and aldosterone kick in after surgery but they are blunted by anesthesia

Front 51

What do you assess post op first 24 hrs

Back 51

Risk for FVD, assess urine output, monitor iv infusion, third space fluid shifts, check lung sounds, need to check fluid toxicity

Front 52

What is assessed post op after 48 hours?

Back 52

Fluid volume excess, monitor iv fluids, assess for signs of fluid overload

Front 53

Why is potassium replacement needed ?

Back 53

Prevent cardiac arrythmias ,mnot eating, cutting into skin