Nursing Sem.1 Fluid And Electrolytes

Front 1

What is HYPOVOLEMIA
and who is at risk?

Back 1

Decrease of fluid volume,
dehydration. Less solvent (H2O)
and more solutes. Patients at
risk include those who have
n/v/d.

Front 2

List signs and symptoms
of HYPOVOLEMIA
(fluid volume deficit)

Back 2

Pts are confused, change in
LOC, HA, dizzy, increased HR,
decreased BP, neck veins flat,
abd sunken, decrease urine
output, poor skin turgor,
diarrhea, mucous membranes dry

Front 3

What are some
lab values affected
by HYPOVOLEMIA?

Back 3

Labs will show increase in Na+,
K+, BUN, Urine spec. gravity,
Hgb, Hct (hemoconcentration of
increase in RBC's because of
decrease if fluid volume.

Front 4

What is HYPERVOLEMIA
and who is at risk?

Back 4

Increase of fluid volume,
overhydration. More solvent
(H2O) less solutes. Patients
at risk include ones who have
CHF, renal failure, IV at a
rapid rate, overhydration.

Front 5

List signs and
symptoms of
HYPERVOLEMIA
(fluid overload)

Back 5

blurry vision, wt gain, edema
(periorbital, faical, pedal,
peripheral), HA, increased BP
and RR, crackles, abd
distended, bounding pulse,
neck veins bulging, S3 sound
due to extra volume.

Front 6

What are some lab
values affected
by HYPERVOLEMIA?

Back 6

Decrease in Na+, K+, BUN,
Creatinine, Hgb, Hct, Urine
spec. gravity.

Front 7

Edema is the
result of_______?

Back 7

Increase of fluids

Front 8

The primary organ
responsible for
regulation of body
fluids is the _______?

Back 8

Kidney

Front 9

A person with NG suction
with prolonged vomiting
may have a deficit of
______, _______,
and _______.

Back 9

H2O, Na+, and K+

Front 10

When fluid volume
decreases what happens
to the electrolyte
concentration?

Back 10

It increases concentration of
Na+ and other electrolytes.

Front 11

A fluid volume deficit will do
what to the H and H?

Back 11

Increase the
Hgb and Hct.

Front 12

Normal lab value
for Na+:

Back 12

Na+ = 135-145

Front 13

What is HYPONATREMIA
and s + s?

Back 13

Decrease of Na+. Can be due
to too much H2O in system
which decrease Na+ level. S +
S are apprehension, change in
LOC, n/v/d, fever (sweating),
neuro and brain changes, risk
for seizures, decreased
appetite.

Front 14

What is HYPERNATREMIA
and s + s?

Back 14

Increase in Na+. S + S are
dehydration, impaired thirst
response, polydipsia, irritable,
restless, dry skin, dry
sticky tongue.

Front 15

Normal lab value
for K+:

Back 15

K+ = 3.5-5.3

Front 16

What is HYPOKALEMIA
and s + s?

Back 16

Decrease in K+. Leads to
dysrhythmias, heart blocks,
death. Pts with renal
failure= kidneys unable to
excrete K+. S + S include
weakness, fatigue, decreased
b.s., abd cramping, ECG
changes.

Front 17

What is HYPERKALEMIA
and s + s?

Back 17

Increase in K+. S + S include
weakness, anxiety, ECG changes,
heart blocks, abd cramps.

Front 18

Normal lab value
for Ca++:

Back 18

Ca++ = 8.5-10.5

Front 19

What is HYPOCALCEMIA
and s + s?

Back 19

Decrease in Ca+. S + S
include muscles twitch
involuntarily. + Chvostec
sign (contraction of muscle),
+ Trousseau (facial muscle
twitch), depression,
numbness, tingling fingers,
ECG changes

Front 20

What is HYPERCALCEMIA
and s + s?

Back 20

Increase in Ca+. S + S include
lethargy, deep tendon reflexes
slow and delayed, cardiac
arrest, decreased LOC, n/v

Front 21

Normal lab value
for Mg++:

Back 21

Mg++ = 1.5-2.5

Front 22

What is HYPOMAGNESIA
and s + s?

Back 22

Decrease of Mg++. S + S include
muscle tremors, + Chvostec
sign, + Trousseau, drowsy,
weak.

Front 23

What is HYPERMAGNESIA
and s + s?

Back 23

Increase of Mg++. S + S
include decreased depth and
rate of respirations.

Front 24

Lungs and Kidnys
work together
to achieve
__________.

Back 24

Homeostasis

Front 25

CO2 + H2O
---H2CO3---
H+ + HCO3

Back 25

carbon dioxide + water
--- carbonic acid ---
hydrogen ion +
bicarbonate

Front 26

List the buffer
systems:
(3 lines of
defense for
maintaing pH)

Back 26

Chemical: occurs in seconds,
in tissues and blood. H2CO3
(carbonic acid) most
important.
Biological: takes 2-4 hrs, K+
and H- ionic shift
Physiological: takes days,
systems come into effect

Front 27

The lungs and kidneys
play what role in the
buffer system?

Back 27

Lungs are sensitive to pH
changes and are quick
responders. The kidneys work
within hours to days.

Front 28

When H+ concentrations
in ECF increase,
RR will _______?

Back 28

RR will increase
to get rid of CO2

Front 29

List the types of
compenstion:

Back 29

Abnormal amounts of CO2 and/or
HCO3 will cause the opposite
system to compensate.
Metabolic
disturbance=respiratory
Repiratory
disturbance=metabolic
Complete: pH is back to norm
7.35-7.45
Partial: buffers are in
process
Decompenstion: worsening

Front 30

Normal lab values
for pH:
PCO2:
HCO3:

Back 30

pH: 7.35-7.45
PCO2: 35-45
HCO3: 22-26

Front 31

If there is a change
in PaCO = partial pressure
carbon dioxide, this
indicates ______.

Back 31

respiratory problem. Normal
35-45. Increase in CO2 leads
to increase in H+ cause
acidosis.
>45 acidosis
<35 alkalosis decrease in CO2
which means there is a
decrease in H+

Front 32

A change in
HCO3 = bicarbonate
indicates ________.

Back 32

Metabolic problem. Norm 22-26.
Decrease in HCO3 leads to
increase H+ cause acidosis.
<22 acidosis
>26 alkalosis

Front 33

RESPIRATORY ACIDOSIS
and who is at risk?
pH<7.35
CO2>45
HCO3<22 if compensating

Back 33

retaining CO2. Kidneys excrete H+ and
retain HCO3 (compensation)
Decrease in RR.
Hypoventilation.
Pts at risk: sedated pts,
post op, pna, COPD, emphysema.
Labs=hyperkalemia, hypercalcemia,
urine pH<6

Front 34

S+S of resp acidosis
and interventions:

Back 34

S+S: drowsiness,
disorientation, dizzy, HA,
hypotension, hypoxia, warm,
flushed skin. Interventions:
sit pt up, cough, deep
breaths, monitor electrolytes,
hydration,
limit/decrease/stop pain meds
(sedatives)

Front 35

RESPIRATORY ALKALOSIS
and who is at risk?
pH>7.45
CO2<35
HCO3>26 if compensating

Back 35

blowing off too much CO2.
Kidneys conserve H+ and
excrete HCO3 (compensation)
Increase in RR.
Hyperventilation. Pts at
risk: anxiety, fear, brain
inj, vent pts. Labs=urine
pH>6, hypokalemia,
hypocalcemia

Front 36

S+S of resp alkalosis
and interventions:

Back 36

S+S light-headed, dizzy,
dyspnea, tetany, tachycardic,
n/v. Interventions: brown bag,
focus on breathing (lower RR),
sedation.

Front 37

METABOLIC ACIDOSIS
and who is at risk?
pH<7.35
CO2<35 if compensating
HCO3<22

Back 37

Decrease in HCO3. Loosing
alkalinic fluid from intestines.
Pts with diarrhea, anal
fistula, dka, renal failure

Front 38

S+S of met acidosis
and interventions:

Back 38

S+S drowsiness, confusion, HA,
hypotension, n/v/d ...
hyperventilation (when
compensating)
Labs=hyperkalemia, urine pH<6.
Interventions: electrolyte
replacement, symptom control

Front 39

METABOLIC ALKALOSIS
and who is at risk?
pH>7.45
CO2>45 if compensating
HCO3>26

Back 39

Increase in bicarb.
loosing acidic fluid from
stomach. Pts at risk are
vomiting, NG tube, excessive
HCO3.

Front 40

S+S of met alkalosis
and interventiosn:

Back 40

S+S dizzy, irritable, nervous,
confused, tachy, n/v,
tremors. Labs=hypo kalemia,
calcemia, natremia, chloremia,
urine pH>6. Interventions:
treat underlying cause, take
antacid

Front 41

Common self care
requisites for maintaing
F+E balance:

Back 41

Control environment
Balance nutrition
Hydration
Decrease stress
Prevent illness
Seek health care early

Front 42

Risk factors for
imbalance:

Back 42

Age, chronic disease, trauma,
therapies (meds), GI losses

Front 43

Changes in
aging:

Back 43

Decline in kidney and lung
function, size. Decrease in
body water - norm 60% decreases
to 50-40%. Poor response to
early warning signs.

Front 44

an anxious client would have which lab values

Back 44

pH>7.45
CO2<35
increase RR
hyperventilation
at risk for resp.
alkalosis
HCO3>26 if compensating

Front 45

1. pH 7.19
CO2 42.5
HCO3 15.6

Back 45

pH acidic
CO2 norm
HCO3 acidic
METABOLIC ACIDOSIS

Front 46

2. pH 7.16
CO2 70
HCO3 25

Back 46

pH acidic
CO2 acidic
HCO3 norm
RESPIRATORY ACIDOSIS

Front 47

Describe how body
mechanisms regulate
F+E balance:

Back 47

FLUID INTAKE -
hypothalamus controls
thirst, influenses
intake

Front 48

Name the fluid
compartments in
the body:

Back 48

Intracellular (inside cell)
Extracellular -
Inerstitial
(fluids between cells) Intravascular (blood plasma)
Transcellular (urine, CSF)

Front 49

What are
electrolytes?

Back 49

Element or compound that when
melted dissolved and
separated into ions. Charge
particles. Either cations (+)
or anions (-). responsible for
acid-base balance, conduct
electrical current

Front 50

Major intracellular ion?
Major extracellular ion?

Back 50

Intracellular - K+
Extracellular - Na+

Front 51

Describe diffusion:

Back 51

solutes move from concentration
of high to low across a
semi-permeable membrane in an
attempt to equalize.

Front 52

Describe
filtration:

Back 52

process by which H2O and other
diffusible substances move
together in response to fluid
pressure

Front 53

Describe active
transport:

Back 53

Na+ K+ pump. As Na+ moves into
the cell, K+ is pumped out of
the cell. To equalize this the
Na+ K+ pump send Na+ back out of
cell and K+ back into cell

Front 54

Describe
osmosis:

Back 54

water molecules move through
semi-permeable membrane from are
of low concentration to high.

Front 55

1. Osmolality:
2. Osmolarity:
3. Osmotic pressure:

Back 55

1. amount of pressure
per L of H20
2. amount of any fluid
3. drawing power for H20.
depends on # molecules in a
solution

Front 56

1. Isotonic:
2. Hypertonic:
3. Hypotonic:

Back 56

1. equal pressure, cell does
not change
2. less solvent (h20) more
solutes: cells shrink
3. more solvent (h20) less
solutes: cells swell

Front 57

Describe body
fluid composition:

Back 57

60% H20=total body weight,
solvent, transports
minerals/eletrolytes,
exchanges O2 and CO2
Chemical compounds=solutes,
electrolytes, minerals, cells,
plasma

Front 58

Describe how body
mechanisms regulate
F+E balance

Back 58

Hormonal control -
Aldosterone-released by
adrenal cortex causes Na+
retention
Renin - angio 1-2 which
causes vasoconstriction
leads to blood flow to
kidneys and renal perfusion

Front 59

Describe how body
mechanisms regulate
F+E balance

Back 59

Fluid output
Kidneys 1500mL
Lungs 400 mL
Skin 500 mL
GI 100-200 mL