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49 Cards in this Set
- Front
- Back
Where is two third of our fluid contained? What is the main electrolyte?
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Intracellular. Potassium.
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Where is extracellular fluid held? What is the main electrolyte?
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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 |
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What happens when fluid begins to leave the capillaries?
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It brings with it water, hormones, nutrients, and all the things it needs to nourish the cells
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What is the input for the average person?
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Fluid: 1300 mL
Food: 1100 mL Oxidation (water produced within the body): 200 mL Total: 2600 mL |
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What is the output for the average person?
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Urine: 1500 mL (should be over 60mL an hour)
Feces: 200 mL Insensible losses: -Lungs 300 mL -Skin 600 mL Total: 2600 mL |
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What is hydrostatic pressure?
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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 |
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What is osmotic pressure?
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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 |
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Explain the fluid shift and reasons for giving a hypotonic solution?
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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 |
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Explain isotonic solution
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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
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Explain hypertonic solution
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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 |
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With fluid volume excess where is most of the fluid being held onto?
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In the extracellular space. Either in the blood vessels or in the interstitial space
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How many mLs in an ounce?
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30
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What's the most effective intervention for FVE?
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If caught early enough put them on a low sodium diet and decrease their water intake. For most patients this is just fine.
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How much does a liter of water weigh?
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1 kg or 2.2 pounds
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What is the normal sodium range?
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135-145
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Who's at risk for FVD?
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Immobilized, depressed, sedated, can't talk. Best way is to try and prevent it
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What is a good indicator of FVD?
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Orthostatic or postural hypotension
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What are normal serum potassium levels?
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3.5-5.2
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What are normal chloride levels?
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96-106
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What are normal CO2 levels?
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24-30
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What are normal BUN levels?
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10-20
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What are normal creatinine levels?
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0.7-1.5
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What are normal glucose levels?
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70-100
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What is the normal pH of urine?
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4.5-8.0
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What is normal specific gravity of urine?
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1.010-1.020
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What are some of the most common causes of hyponatremia?
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-Diuretics such as Lasix and loss of GI fluids(loss of sodium)
-Excess electrolyte-poor IV fluids (Gain of water) |
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What are some of the most common causes of hypernatremia?
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-Excessive fluid loss or decrease in fluid intake (water loss)
-Diabetes Insipidus (sodium excess) |
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What is hypernatremia normally linked to?
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Fluid volume deficit
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What do you treat in hypernatremia?
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The cause!!
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Where is potassium mainly found?
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Intracellularly. But we measure it in the blood not in the cell
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Is potassium stored by the body?
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No, so we need to ingest it daily?
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What hormone helps to excrete potassium?
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Aldosterone
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What foods are high in potassium?
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Orange juice, cooked winter squash,banana, skim milk,
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What can cause Digtoxicity?
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Low potassium
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What EKG change is associated with low potassium?
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Low T wave and a prominent U wave. May feel arrythimias as well
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What EKG change is associated with high potassium?
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High and peaked T wave
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What are you never supposed to give as a bolus?
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Potassium chloride. It has to be mixed in an IV solution. Never give it IV push
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What is the most common cause of hyperkalemia?
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Kidney failure since the kidneys excrete potassium
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What can a crush injury cause?
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Hyperkalemia since when the cells are crushed potassium will like into the ECF.
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What is the biggest issue with hyperkalemia?
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Arrythimias and cardiac problems
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What does calcium gluconate do in a patient who is hyperkalemic?
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Helps to protect the myocardium while we try to lower potassium
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What does the combination of insulin and glucose do?
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Drive excess potassium intracellular
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What are normal calcium levels?
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8.5-10.5
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Where is most calcium stored?
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99% in the bones
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What are some of the uses of calcium?
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-Needed for muscle contraction
-Essential for blood clotting -Necessary for electrical conduction in the heart |
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What does a decrease in reflexes mean?
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Hypercalcemia
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What are some causes of hypercalcemia?
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Increased bone reabsorption
Cancer Immobility |
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What are some symptoms of hypocalcemia?
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Muscle cramping or twitching
Tetany which can lead to convulsions Cardiac arrhythmia Trousseau's Sign Chvostek's sign |
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What is an emergency interventions for hypocalcemia?
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Calcium chloride or calcium gluconate IV
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