Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
45 Cards in this Set
- Front
- Back
|
sodium normal range |
135-145mEq/L |
|
|
Calcium normal range |
9-11mg/L |
|
|
Potassium normal range |
3.5-5.3mEq/L
|
|
|
Magnesium normal range |
1.5-2.5mEq/L
|
|
|
Phosphate normal range |
2.5-4.5mg/L
|
|
|
Serum osmolality |
280-300mOsm/kg
|
|
|
Fluid volume deficit: definition |
occurs when the body loses water and electrolytes in the same proportion as in the normal body fluids (isotonically)
serum electrolyte levels remain normal
state in which the body loses water and serum sodium levels increase (Dehydration) |
|
|
Fluid volume deficit: causes |
vomiting diarrhea GI suctioning sweating inadequate fluid intake massive edema burns acites elderly-forget to drink |
|
|
Fluid volume deficit: symptoms |
weight loss-1kg=1L decrease skin turgor oliguria concentrated urine dry/sticky mucus membranes postural hypotension weak/rapid pulse
|
|
|
Fluid volume deficit: lab findings |
elevated BUN and possibly creatine increase serum osmolality elevated Hgb and HCT possibly elevated electrolytes if hemo is concentrated |
|
|
Fluid volume deficit: Treatment |
strict I/O replace fluids isotonically (oral prefered) remember water is hypotonic iv hydration with isotonic fluids daily weight |
|
|
Fluid volume excess: description |
occurs when the body retains water and electrolytes isotonically
state in which the body retains water and serum sodium levels decrease |
|
|
Fluid volume excess: causes |
congestive heart failure renal and liver failure excessive salt ingestion over hydration with sodium fluids poor control of IV therapy (young and elderly)
|
|
|
Fluid volume excess: symptoms |
peripheral edema increased pulse bounding pulse elevated B/P distended neck veins dyspnea moist lungs-crackles attention loss confusion aphasia change in LOC |
|
|
Fluid volume excess: lab findings |
decreased BUN, HGB, HCT, serum osmolality, urine osmolality, urine specific gravity
electrolytes may be low due to dilutional effects |
|
|
Fluid volume excess: treatment and nursing care |
diuretics fluid restriction strict I/O sodium restricted diet daily weight monitor serum K+ |
|
|
isotonic solutions: description |
have an osmolality close to extracellular fluids do not cause RBC to swell or shrink indicated for intravascular hydration no fluid movement |
|
|
Isotonic solutions: solution examples |
Normal saline (0.9% ns) Lactated ringers (LR) D5W |
|
|
Isotonic solutions: treatment |
intravascular dehydration- fever sweating bleed vomiting diarrhea
avoid D5W in clients at risk for increased intracranial pressure |
|
|
isotonic solutions: comments |
once sugar is metabolized, the water makes the solution hypotonic (D5W only) |
|
|
Hypotonic solutions: description |
have an osmolality lower than extracellular fluid (<275)
causes fluid to move from extracellular space to intracellular space
indicated for cellular dehydration |
|
|
Hypotonic solutions: solution examples |
0.45% Normal saline (1/2 NS) 0.33% Normal saline 2.5% dextrose in 0.45% saline |
|
|
hypotonic solutions: Treatment |
treat intracellular dehydration: -prolonged dehydration -prolonged TPN use
*not common *not for use in clients with a risk for increased intracranial pressure |
|
|
Hypertonic solutions: description |
hve an osmolality higher than the extracellular fluid (>295) indicated for intravascular dehydration with interstitial or cellular over hydration high concentrations of dextrose are given for caloric replacement (TPN, PPN) |
|
|
Hypertonic solutions: solution examples |
5% dextrose in lactated ringers (D5LR) 5% dextrose in 0.45% saline (D5 1/2 NS) 5% dextrose in 0.9% saline (D5NS) |
|
|
Respiratory acidosis signs and symptoms |
dyspnea tachycardia confusion depression weakness flushed/warm skin |
|
|
respiratory acidosis causes |
drugs-narcotics, anesthetics pneumonia, pulmonary edema, Guillian-Barre, chest injuries, COPD-asthma, emphysema, chronic bronchitis *holds in CO2, slowed Respiratory rate |
|
|
respiratory acidosis ABG's |
pH < 7.35 CO2 > 45mm/Hg |
|
|
respiratory acidosis treatment |
removal of cause, deep breathing exercises, airway management, ventilator
|
|
|
respiratory acidosis compensation |
Respiratory: cant compensate Renal: excrete H+, retain HCO3-, acidic urine Cellular: H+ into cell, K+ out of cell *possible problem: hyperkalemia |
|
|
respiratory alkalosis signs/symptoms |
lightheadedness, dizziness, confusion, numbness in hands and feet |
|
|
respiratory alkalosis causes |
anxiety, fever, hyperventilation, hyperthyroidism, brain tumors, excessive exercise -loss of CO2 |
|
|
respiratory alkalosis ABG's |
pH > 7.45 CO2< 35mm/Hg |
|
|
respiratory alkalosis treatment |
removal of cause, rebreath expired air, antianxiety drugs |
|
|
respiratory alkalosis compensation |
Respiratory: cant Renal: Retain H+, excrete HCO3-, alkine urine Cellular: K+ into cell, H+ out of cell *potential problem: hypokalemia |
|
|
Metabolic acidosis signs and symptoms |
chest pain, palpatations, kussmal respirations, headache, visual problems, confusion, N&V, abdominal pain, muscle weakness |
|
|
metabolic acidosis causes |
renal failure, lactic acidosis, intake of salicyalates, diarrhea, severe infection, pancreatic, biliary or intestinal fistulas, ketoacidosis, DM, ETOH, starvation. *increase in H+ in the system |
|
|
metabolic acidosis ABG's |
pH < 7.35 HCO3- < 24 mEq/L |
|
|
Metabolic acidosis treatment |
remove cause, administer sodium bicarb, restore water, electrolytes, and nutrients |
|
|
Metabolic compensation |
Respiratory: increase respirations Renal: excrete H+, retain HCO3-, acidic urine Cellular: H+ into cell, K+ out of cell *potential problem: hyperkalemia |
|
|
Metabolic alkalosis signs/symptoms |
irritability, confusion, tetany, shallow breathing, vomiting |
|
|
Metabolic alkalosis causes |
Loss of H+: kidneys or GI tract shift of H+ to cell: alkali administration drugs: diuretics, glucocorticoids loss of water in extracellular space
|
|
|
Metabolic alkalosis ABG's |
pH > 7.45 HCO3- > 28 mEq/L |
|
|
metabolic alkalosis treatment |
remove cause, administer and IV solution of sodium chloride, replace potassium deficit if needed. |
|
|
Metabolic alkalosis compensation |
Respiratory: decreased respirations Renal: Retain H+, excrete HCO3-, alkaline urine Cellular: K+ into cell H+ out of cell *potential problem: hypokalemia |
