Med-Surg/fluid And Electrolyte Balance

Front 1

Where is two third of our fluid contained? What is the main electrolyte?

Back 1

Intracellular. Potassium.

Front 2

Where is extracellular fluid held? What is the main electrolyte?

Back 2

Anywhere that is outside of the cell
-Intravascular: In the blood vessels
-Interstitial: The fluid that surrounds the cells on the outside

Sodium is the primary electrolyte

Front 3

What happens when fluid begins to leave the capillaries?

Back 3

It brings with it water, hormones, nutrients, and all the things it needs to nourish the cells

Front 4

What is the input for the average person?

Back 4

Fluid: 1300 mL
Food: 1100 mL
Oxidation (water produced within the body): 200 mL
Total: 2600 mL

Front 5

What is the output for the average person?

Back 5

Urine: 1500 mL (should be over 60mL an hour)
Feces: 200 mL
Insensible losses:
-Lungs 300 mL
-Skin 600 mL
Total: 2600 mL

Front 6

What is hydrostatic pressure?

Back 6

Hydrostatic Pressure is a pushing pressure. The weight and the volume of water. The higher the volume, the higher the pressure. The more fluid that we pump intravascularly (example IV) the more it's going to increase the pressure. We use this to bring blood pressure up as well as to give fluids

The weight and the volume of water allows it to leave the intravascular area and this can cause edema

Front 7

What is osmotic pressure?

Back 7

This is a pulling pressure. It's the diffusion of water across a semi-permeable membrane from an area of high concentration of particles to an area of low concentration.

It is the number of particles in each compartment that keeps water where it is supposed to be

Front 8

Explain the fluid shift and reasons for giving a hypotonic solution?

Back 8

Solutes less than 250. It is given to shift fluid out of the vessel and into the cell. Complications include edema, may worse hypotension, and hyponatremia.
Examples include: .33% normal saline, .45% normal saline, and D5W

Front 9

Explain isotonic solution

Back 9

Has solutes greater than 250 and includes .9% normal saline and lactated ringers. Has the same concentration as blood plasma. There is no fluid shift and is used for vascular expansion and to replace electrolytes. May cause fluid volume excess, generalized edema and dilutes hemoglobin

Front 10

Explain hypertonic solution

Back 10

A solution greater than 375. Includes D5 .45% NS, D5,9% NS, Hypertonic saline at 3% or 5%
This is used to shift fluid intravascular and causes vascular expansion. It also is used to replace electrolytes. It may irritate veins, cause fluid volume excess, and may cause hypernatemia

Front 11

With fluid volume excess where is most of the fluid being held onto?

Back 11

In the extracellular space. Either in the blood vessels or in the interstitial space

Front 12

How many mLs in an ounce?

Back 12

30

Front 13

What's the most effective intervention for FVE?

Back 13

If caught early enough put them on a low sodium diet and decrease their water intake. For most patients this is just fine.

Front 14

How much does a liter of water weigh?

Back 14

1 kg or 2.2 pounds

Front 15

What is the normal sodium range?

Back 15

135-145

Front 16

Who's at risk for FVD?

Back 16

Immobilized, depressed, sedated, can't talk. Best way is to try and prevent it

Front 17

What is a good indicator of FVD?

Back 17

Orthostatic or postural hypotension

Front 18

What are normal serum potassium levels?

Back 18

3.5-5.2

Front 19

What are normal chloride levels?

Back 19

96-106

Front 20

What are normal CO2 levels?

Back 20

24-30

Front 21

What are normal BUN levels?

Back 21

10-20

Front 22

What are normal creatinine levels?

Back 22

0.7-1.5

Front 23

What are normal glucose levels?

Back 23

70-100

Front 24

What is the normal pH of urine?

Back 24

4.5-8.0

Front 25

What is normal specific gravity of urine?

Back 25

1.010-1.020

Front 26

What are some of the most common causes of hyponatremia?

Back 26

-Diuretics such as Lasix and loss of GI fluids(loss of sodium)
-Excess electrolyte-poor IV fluids (Gain of water)

Front 27

What are some of the most common causes of hypernatremia?

Back 27

-Excessive fluid loss or decrease in fluid intake (water loss)
-Diabetes Insipidus (sodium excess)

Front 28

What is hypernatremia normally linked to?

Back 28

Fluid volume deficit

Front 29

What do you treat in hypernatremia?

Back 29

The cause!!

Front 30

Where is potassium mainly found?

Back 30

Intracellularly. But we measure it in the blood not in the cell

Front 31

Is potassium stored by the body?

Back 31

No, so we need to ingest it daily?

Front 32

What hormone helps to excrete potassium?

Back 32

Aldosterone

Front 33

What foods are high in potassium?

Back 33

Orange juice, cooked winter squash,banana, skim milk,

Front 34

What can cause Digtoxicity?

Back 34

Low potassium

Front 35

What EKG change is associated with low potassium?

Back 35

Low T wave and a prominent U wave. May feel arrythimias as well

Front 36

What EKG change is associated with high potassium?

Back 36

High and peaked T wave

Front 37

What are you never supposed to give as a bolus?

Back 37

Potassium chloride. It has to be mixed in an IV solution. Never give it IV push

Front 38

What is the most common cause of hyperkalemia?

Back 38

Kidney failure since the kidneys excrete potassium

Front 39

What can a crush injury cause?

Back 39

Hyperkalemia since when the cells are crushed potassium will like into the ECF.

Front 40

What is the biggest issue with hyperkalemia?

Back 40

Arrythimias and cardiac problems

Front 41

What does calcium gluconate do in a patient who is hyperkalemic?

Back 41

Helps to protect the myocardium while we try to lower potassium

Front 42

What does the combination of insulin and glucose do?

Back 42

Drive excess potassium intracellular

Front 43

What are normal calcium levels?

Back 43

8.5-10.5

Front 44

Where is most calcium stored?

Back 44

99% in the bones

Front 45

What are some of the uses of calcium?

Back 45

-Needed for muscle contraction
-Essential for blood clotting
-Necessary for electrical conduction in the heart

Front 46

What does a decrease in reflexes mean?

Back 46

Hypercalcemia

Front 47

What are some causes of hypercalcemia?

Back 47

Increased bone reabsorption
Cancer
Immobility

Front 48

What are some symptoms of hypocalcemia?

Back 48

Muscle cramping or twitching
Tetany which can lead to convulsions
Cardiac arrhythmia
Trousseau's Sign
Chvostek's sign

Front 49

What is an emergency interventions for hypocalcemia?

Back 49

Calcium chloride or calcium gluconate IV