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42 Cards in this Set
- Front
- Back
Describe the distribution of body fluids?
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ICF (Intracellular) inside cell
ECF (extracellular) Outside cell. |
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What are the composition of body fluids?
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water, electrolytes, nonelectrolytes, minerals, and cells.
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Identify the purpose water serves in the body?
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universal solvent, transports nutrients and carries waste products from the cell. Medium for chemical reactions, participates in chemical reactions. Maintains stable body temp. Absorbs heat in the body.
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Describe the variation in the amount of body fluid according to age?
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Decreases with age. Infants 80%H2O, Men 50-60% H2O. Women 45-50% H2O
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Name the body fluid compartments?
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Intravascular, interstitial, transcellular
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Identify major constituents of intracellular and extracellular fluid compartments and body secretions?
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1) plasma found within vascular system ARTERIES and VEINS
2) surrounds cell, includes lympth fluid and fluid tissue (EDEMA) 3) cerebrospinal, pleural, peritoneal, and synovial fluids |
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Describe the ways in which fluids and electrolytes move through the body?
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osmosis, diffusion, filtration, active transport.
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Describe the ways in which osmotic and hydrostatic pressure influence movement of fluids through membrane?
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osmotic-movement from lower concentration to higher solute concentration.
hydrostatic- when venous pressure is greater than or equal to arterial pressure fluid is forced out (BP) |
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Describe how body mechanism regulate fluid and electrolyte balance?
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balanced by the water loss through the feces, skin, and the respiratory process. Fluid intake, ingested H2O, ingested food, metabolic oxidation.
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Identify sources of fluid output?
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Kidneys, skin, insensible (something that cannot be seen), Sensible ( you can see this stool, mucous), lungs, GI
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Identify the role of the kidneys and lungs in regulating acid-base balance
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regulate hydrogen ions. They are part of buffer system. controll PH. Respiratory system short term PH balance. Kidneys long term PH balance.
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Describe the main functions of the major and minor electrolytes.
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Read pg 1674-1676
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The major electrolytes are?
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Na,K, Ca, Mag
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Describe how acid-balance is maintained in the body?
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Buffer system, respiratory mechanisms, renal regulation
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Identify the factors that affect body fluid, electrolytes and acid-balance?
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age, gender and size, environmental temp, lifestyle.
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Identify different types of fluid imbalances?
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fluid volume deficit (hypotonic), fluid volume excess.(Hypertonic)
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Identify causes of water deficits and excesses?
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Fluid deficit-vomiting, diaherra, gastric suction, elevated body temp, hemorrage, profound urine loss.
Fluid vol excess- kidney and circulatory impairments, liver impairments |
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Describe the typical clinical signs of a dehydrated person?
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dry skin, mucous membrane, oliguria, weight loss, VS, decreased BP, high resp, increased heart rate, increased hemocrit, Na-normal
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Compare effects of extracellular fluid deficits and excesses?
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Hypovolemia-fluid loss (fluid deficit)
Hypervolemia-excess of fluid. (fluid excess) EDEMA |
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Hyponatremia(Sodium Deficit)
Serum Na+ <125mEq/L Causes, Signs, Medical Therapy |
*Causes:Excess perspiraton or drinking, excess vomiting or diarrhea, nasogastric suction, infusion of Lg. volumes of electrolyte free IV solutions, diuretic administration, low sodium diets* Signs: abdominal cramps, nausea, vomiting or diarrhea, rapid pulse, orthostatic or postural hypotension, cold clammy skin, convulsions, apprehension, anxiety, confusion, decreased urine output, dry mucous membranes, decreased skin turgor. *Medical Therapy: administration of sodium chloride (IV-NS)
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Hypernatremia(Sodium Excess)
Serum Na+ >145mEq/L Causes, Signs, Medical Therapy |
inadequate water intake, excess salt intake, vomiting, diarrhea, tube feedings, diabetes insipidus or polyuria(Steroid Therapy), heat stroke. *Signs: thirst, dry, sticky mucous membranes, flushed skin, short attention span, agitated behavior, confusion, restlessness, disorientation, hallucinations, fever, oliguria, tachycardia, hypotension, and muscle weakness as it gets worse. *Treatment: treat reason for excess;IV fluids of choice being D5W, unless diabetic.
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Hypokalemia(Potassium Deficit) Serum K level <3.5mEq/L (MOST COMMON ELECTROLYTE IMBALANCE)
Causes, Signs, Medical Therapy |
*Causes: vomiting, diarrhea or NG suctioning, excess perspiration, polyuria, prolonged use of K+ wasting diuretics, poor intake of K+ use of strong laxatives, hyperaldosteronism or excess IV fluid administration w/out potassium replacement. * Signs: Parethesias, muscle weakness & fatigue, anorexia, nausea , vomiting, abdominal distention, decreased bowel sounds, irregular pulse, cardiac arrhythmias, hypotension. *Treatment: Replacement of potassium
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Hyperkalemia(Potassium Excess) Serum K+Level >5.0mEq/L
Causes, signs, medical therapy |
*Causes: RENAL FAILURE, dehydration or fluid volume deficit, intake of K+ conserving diuretics, high potassium intake, Infusion of stored blood administration or large amts of potassium IV fluid administrations, Seen in patients w/Large areas of tissue damage such as burns or trauma.*Signs: paresthesia, weakness, GI hyperactivity, diarrhea, irritability, anxiety, confusion, cardiac arrhythmias.*Treatment: reduction of K+levels, Kaexelyate ememas
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Hypocalcemia(Calcium Deficit) Serum Ca level <4.5mEq/L
Causes, signs, medical therapy |
*Causes: Hypoparathyroidism, Vitamin D deficiencies, inadequate dietary intake of calcium, high protein diets, pancreatitis, diarrhea, administration of multiple units of blood, caffeine, laxative, and nicotine use. *Signs: Numbness and tingling of extremities and around mouth, hyperactive reflexes, tetany, muscle spasms, Positive Chvostek's and Trousseau's sign. *Treatment: Oral or IV calcium administration, increase Vitamin D intake.
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Hypercalcemia(Calcium Excess) Serum Ca levels >5.5 mEq/L
Causes, signs, medical therapy |
Causes: Hyperparathyroidism, Osteoporosis, prolonged immobilization or immobility, related to cancer newplasms, multiple fractures, use of thiazide diuretics or excess intake of calcium supplements.
*Signs: anorexia, nausea, vomiting, weakness, lethargy, decreased level of consciousness, anxiety, cardiac arrhythmias. *Treatment: indentify cause, increasing the excretion of calcium by giving NS and diuretics. |
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Hypomagnesium(Magnesium Deficit) Serum Mg level < 1.5 mEq/L
Causes, signs, medical therapy |
Causes: chronic alcoholism in the MOST COMMON CAUSE, inadequate intake, malnutrition, inadequate absortption, vomiting, fdiarrhea, intestinal disorders, dseptic infections, *Signs: muscle tremors, hyperactive reflexes, confusion and disorientation, will also have a positive Chvostek's and Trousseau's sign, cardiac arrhythmias. *Treatment: identify & treat cause, Improve nutritional intake
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Hypermagnesium(Magnesium Excess) Serum Mg level > 2.5 mEQ/L
Causes, signs, medical therapy |
*Causes; patients with remal failure, overuse, of antacids or laxatives in the elderly. *Signs: Hypoactive deep tendon reflexes, decreased rate and depth of respirations, drowsiness, sedation, bradycardia, hypotension, coma, and death. *Treatment: indentify cause. Patients with renal failure will require dialysis
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Hypochloremia(Chloride Deficit) Serum Cl level < 95mEq/L
Causes, signs, medical treatment |
Causes: Most Common cause is GI loss from vomiting or nasogastric suctioning, excess urination or sweating. *Signs: muscle tremors, hyperexcitability, respiratory depression due to acid base imbalance the body trying to conserve Co2 and hypotension. *Treatment: identify & treat cause, Monitor for electrolyte imbalancecs
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Hyperchloremia(Chloride Excess) Serum Cl levels > 105mEQ/L
Causes, signs, symptoms |
*Causes: may occur in patients w/metabolic acidosis. *Signs: weakness, lethargy, deep rapid breathing as acidosis gets worse, decreased level of consciousness and cardiac arrhythmias and death. *Treatment: identify cause, treat patient for acidosis.
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Respiratory Alkalosis
pH>7.45, Pa)2 80-100, PaCO2<35, HCO3 22-26 |
hyperventilation, blowing off too much CO2. causes: fever, anxiety pulmonary infection anemia, cns injury asa overdose, Treatment; removal of cause, rebreather mask or paper bag, relief of anxiety, reduction of fever
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Respiratory Acidosis
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occurs when exhalation of Co2 inhibited and hypoventiolation occurs. Causes; CNS depression, COPD, chest wall injuries, drug overdoses, neuro disease. Signs; rapid bounding pulse, slow shallow respirations, dyspnea, increased BP confusion, lethargy. Treatment; IV or oral
sodium bicarbonate or sodium lactate. correction of cause |
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Metabolic Alkalosis
pH>7.45, PaO2 in range, PaCO in range, HCO3>26 |
excess intake of bicarbonates, other alkalies; prolonged vomiting, gastric suction, prolonged diuretic use (K-wasting) adrenal gland imp. signs; decreased respiratory rate & depth, dizziness, confusion, agitation, paresthesia, muscle hypertonicity, nausea, & vomiting
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Metabolic Acidosis
pH<7.35, PaO2 in range, PaCO2 in range, HCO3<22 |
when bicarbinate is low in rrelation to carbonic acid levals. Cause; diabetes, mellitus, renal impairments, starvation, prolonged diarrhea, shock, drug use, alcohol intoxication. Signs; headache, lethargy, confusion, weakness, tachycardia, increased repid deep respirations(Kussmaul's) , flushed skin, fruity, acetone smelling breath
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Nursing Measurements for identifying fluid and electrolyte balance
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dietary modification, modicication of fluid intake, medicine administration, IV therapy, blood and blood product replacement, TPN, alleviating anxiety, appropraiate family, PT teaching
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Identify labratory test used for identifying fluid & electrolyte imbalance
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CBC, Serum electrolytes, BUN, Creatin, Uring pH, specific gravity, ABG
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Give examples of nursing diagnoses R'T fluid, electrolyte, and acid base imbalances
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Fluid & Electrolyte Problems:
Excess Fluid Volume, Deficient Fluid Volume, Risk for Imbalanced Fluid Volume, |
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Common purposes of IV therapy
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FASTER response
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Identify various types of IV solutions
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Isotonic, Hypotonic, Hypertonic Solutions, pgs 1705
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Identify typical measures required to maintain IV therapy
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pg 1710 iniation of IV infusion, regulation and monitoring, solution and tubing changes, infusion site care,
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Identify potential complications of IV therapy and nursing interventions.
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Patient most source of information for complications, pt. position, circulatory status, pt. anxiety, inffiltration, phlebitis, thrombophlebitis, fluid overload, embolus, sepsis (pgs 1713)
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Identify what is to be marked on IV bottle and how it is to be labeled
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Name, Date, Time
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Technique used for discontinuing iv infusions, changing IV solution and tubing, crediting iv fluids and assessing iV site.
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pg 1719.
wear clean gloves, supine postion, slowly remove cath, apply pressure, measure cath to length in chart, document procedure and how pt tolerated |