Fluid and Electrolytes

100問 • 2年前

ユーザ名非公開

通報

問題一覧

True or false? Infants have more body fluid and ECF than adults, thus are more prone to fluid volume deficits.

True

Intracellular fluid (ICF) makes up what total percent of body weight?

35-40%

Extracellular fluid (ECF) makes up what perecentage of TBW?

15-20%

Match the definition to the correct term. Concentration level.

osmolarity.

What electrolyte controls and regulates volume of body fluids/ affecting BP?

Sodium (ECF)

What electrolyte is chief regulator of cellular enzyme activity and water content? (Cardiac)

Potassium (ICF)

What electrolyte aids in metabolism of carbohydrates and proteins, vital actions involving enzymes (ATP)?

Magnesium (ICF)

What electrolyte maintains osmotic pressure in blood, and produces hydrochloric acid in the stomach?

Chloride

What electrolyte is the body’s primary buffer system?

Bicarbonate

What electrolyte is involved in important chemical reactions in the body, cell division, and hereditary traits?

Phosphate

What electrolyte is involved in nerve impulses, blood clotting, muscle contractions, and b12 absroption?

Calcium

What electrolytes are Monica and Rachel? (order does not matter)

H2O, Na+

Fluid moves from areas with more fluid to areas where there is less fluid (passive)?

Osmosis

Solutes move from higher concentration to lower concentration (passive)?

Diffusion

Solutes move from lower concentration to higher concentration?

Active transport

Forces fluid and solute through the capillary wall (passive)?

Filtration

Prevents too much fluid from leaving the capillaries (passive)?

Reabsroption

Hydrostatic pressure is also…?

Blood Pressure

Hydrostatic pressure forces capillary _____?

Filtration

What protein is a “magnet for water”, vital in fluid balance, pulls and hold water into the vessel and is too large to move through capillaries (once you have it it stays where it needs to be)?

Albumin

Equilibrium is achieved when _____ pressure and ____ ____ pressure are equal. Select the correct options to fill the banks in order (2 selections).

Hydrostatic, Plasma osmotic

True or false? Equal pressure allows for filtration and diffusion to occur “normally”

True

What hormone causes the kidneys too retain H2O and triggers thirst?

ADH

What hormone causes vasoconstriction and Na+, H2O retention?

Aldosterone

What is the minimum amount of urine needed to excrete toxic waste products?

400-600 mL/day

What hormone helps to regulate BP and triggers the secretion of aldosterone?

Renin

What hormone stops the renin-angiotensin-aldosterone system, is stored in the cells of the atria, and is released when atrial pressure increases (CHF)?

ANP

True or false? Renin increases BP by increasing vasoconstriction, and is also more related to cardiac function.

True

What is normal serum osmolality?

300mOsm/kgwater

What is the range and avg urine osmolaltiy?

50-1400, 500-800 mOsm

Decreased volume of water and electrolye changes in ECF, triggers ICF shift (shrinking cells).

Dehydration

What is a deficiency in the amount of water and electrolytes in EF with near normal water/electrolyte proportions, most likely lost a lot of blood?

Hypovolemia

What is a distributions shift of body fluids into potential body spaces?

Third-space fluid shift

Excessive accumulation of ECF, in either the intravascular capartments or interstitial spaces, CHF, kidney retention can cause organ failure.

Hypervolemia

Same concentration of particles as plasma (or water).

Isotonic

Greater concentration of particles than plasma (or water)?

Hypertonic

Lesser concentration of particles than plasma (or water)?

Hypotonic

Where are hypertonic solutions given?

ICU ONLY!

D5W is isotonic in the bag but what in the body?

Hypotonic

Select the two isotonic solutions,

0.9 NS (normal saline), LR or RL (Lactate Ringer’s)

Select the two hypotonic solutions.

0.45 NaCl, 0.33 NaCl

The following solutions are what? D50.9NS, D50.45NS, D5RL, D10W.

Hypertonic solutions

What kind of solutions should not be given in neuro patients?

Hypotonic

What kinda of solutions can cause cell dehydration, that you should avoid on renal, cardiac and DKA pts, also the should only be given in ICU?

Hypertonic

Albumin pulls fluid into the blood stream a how many times as fast within 15 mins of administration?

What’s S/S should you watch for after administering albumin?

SOB, Increased BP, Increased pulse, Hypervolemia

1L of water is equal to 1 kg which is how many lbs?

2.2

A weight change of 1lb is qual to a fluid volume change of about how many mLs?

500

What is the most accurate in terms of determining fluid volume changes?

Daily weights

A decreased volume of water and electrolyte changes in ECF triggers ICF shift (cell shrinkage) that happens overtime?

Dehydration

Just know that Isotonic dehydration happens where water and sodium are lost from the body in proportional equal amounts.

YAY I LOVE FLUID AND ELECTROLYTES!

S/S of Dehydration?(isotonic)

Dry skin, Sunken eyes, Dry mucous membranes, Decreased turgor, Increased HR, Decreased BP, Headache, Weakness, Decreased output

Causes of Dehydration? (Isotonic)

Vomiting, Diarrhea, Hemorrhage, Burns, Heat Stroke, Sweating

Causes of hypertonic dehydration?

Impaired thirst, Increased need, Lower body water content (infants), Inability to communicate needs, Confused, Immobility, Tube feeding/ without supplemental H2O

S/S of Hypertonic dehydration? (Increased concentration of solutes as a result of decreased amount of fluid)

Dry mucous membranes, Orthostatic hypotension/ Low BP, Poor skin turgor, Rapid/ weak pulse, Hypernatremia, Hyperglycemia, Severe: Mental status changes, seizures, coma.

Causes of Hypotonic dehydration. (Sodium loss in greater amounts than free water)

Low sodium diet, Diuretic overuse, Diluted urine/ large amounts, Hyperglycemia, Diabetes inspidus

S/S of hypotonic dehydration. (Sodium loss in greater amounts than free water)

Dry mucous membranes, Orthostatic hypotension, Poor skin turgor, Tachycardia, Rapid/weak pulse, Fever (lack of fluid for sweat), Hyponatremia, Hyperglycemia

Lab/ diagnostics for dehydration.

If your high dry (cell shrinkage), Increase BUN, Increase HCT, Decreased urine output, Concentrated urine over 300, Increase in serum Na+ a abover 145, Urine specific gravity above 1.030

Select interevntions for dehydration.

Replace missing fluids, Avoid hypertonic solutions, Encourage oral fluids (No Gatorade), Hypotonic replacement (given slowly/ 48 hrs, edema, cerebral edema), Albumin, Blood, Daily weights, Strict I&O’s, Skin care

Select Intervetnions for dehydration.

Oralcare, IV site maintenance, Always evaluate labs, Progression of S/S, Foley (if extreme), Document respons/ interventions, Teaching

What is a deficiency in the amount of water and electrolytes in ECF with near-normal water/ electrolyte proportions.

Hypovolemia

True or False? Hypovolemia will eventually turn into Hypervolemia.

True

Select causes of Hypovolemia. (Hypotonic fluid loss from extracellular space)

NG tube suction/ drainage, Hemorrhage, Trauma/ SX, Severe burns, GI losses (vomiting, diarrhea), Sweating/ fever, Third space shift, Thoracentesis, Decreased intake, Polyuria, Diuretics, Diabetes insipidus

Fluid loss

Mild 10%, Moderate 25%, Severe/ Shock 40%

Select S/S of Hypovolemia.

Orthostatic hypotension, Dizziness, Weight loss, Delayed capillary refill, Flat jugular veins, Weak/ threads pulses, Nausea, Tachycardia, Thirst, Anxiety, Dry mucous membranes

True or false? No one lab or diagnostic for hypovolemia.

True

Select interventions for hypovolemia

Identify and treat cause, Daily weights, Large bore IV fluid replacement, with Isotonic IVF, albumin, blood, Monitor I&O’s, Skin and mucous membrane care, Watch for shock (AMS), Apply O2 as needed (decreased blood volume and metabolic acidosis)

Select S/S of hypovolemic shock.

Decreased urine output, Cyanosis, AMS, Loss of consciousness, Hypotension, Increased HR

Select causes of hypovolemic shock

Hemorrhage/ bleeding, Trauma, Severe burns, Diabetes insipidus

Select interventions for hypovolemic shock

Prevention, Fluid replacement, Identify the source, Stop the loss

What is it called when you have hypovolemia when fluid moves out of intravascular space but not into extracellular space.

Third space shift

True or false? With third space shifting you may or may not see weight gain.

True

Select cause for third space shifting.

Cardiac pulmonary/ peripheral edema, Malnourishment (albumin), Trauma, Infection (pericardial effusion), Burns, Sepsis, Liver failure (ascites), Cancer

What is excessive accumulation of ECF, in either the intravascular compartments or interstitial spaces. An excess of isotonic fluid (water and sodium) in the ECF, increases of fluid either in the interstitial or intravascular.

Hypervolemia

Select causes of Hypervolemia

Increased Na+ and increased fluid intake, Kidneys (failed excretion), CHF backup, IV fluid replacement, Low protein diet, Low albumin, Hyperaldosteronism, Fluids after a burn

Select assessment findings for hypervolemia.

Edema (dependent starts in lower extremities and creeps up, pulmonary edema), Taught shiny skin, Rapid bounding HR/ pulse, Increased BP, Distended veins (JVD), Weight gain, Polyuria, SOB, S3 gallop

Select lab and diagnostics for hypervolemia.

Descreased BUN, Decreased HCT, Normal Na+, Decreased K+ (unless in renal failure), Low urine specfic gravit, Decreased O2, CXR pulmonary congestion

Select the interevntions for hypervolemia.

Dx and treat, Fluid and Na+ restrictions, Diuretics, Morphine, Nitroglycerin, Digoxin, Potassium levels, Lung sounds

Select interventions for Hypervolemia

Raise HOB, O2 as needed, Foley for I&O’s, Daily weight, Skin care/ prevention, Hemodyalysis, Overcorrection (hypovolemia)

What is an increase in hydrostatic pressure or a decrease in colloid osmotic pressure

Edema

What develops with changes in normal hydrostatic pressure (HTN)

Edema

Right sided heart failure= what kind of edema?

Peripheral (Can be caused diabetes)

Left sided heart failure= what kind of edema

Pulmonary (can be caused by COPD)

What two other things can cause Edema

Lack of proteins, unable to pull fluid in, Capillary integrity/ damage

What is the normal range for calcium?

8.5-10.5

What is the normal range for Mg+

1.3-2.1

What is the normal level for chloride?

95-105

What is the normal level for PO4-

2.5-4.5

Sodium and potassium have what kind of relationship?

Inverse

Magnesium and potassium have what kind of relationship?

Similar

Sodium think neuro.

Thanks

Where is sodium absorbed?

Intestines

Low sodium is what?

Hyponatremia

Select the diagnostic labs for hyponatremia

Serum osmolality less than 280, Serum sodium level less that 135, Urine specific gravity less than 1.010

Sodium levels may appear low because too much fluid is in the body.

Isovolemic hyponatremia

Select S/S for Isovolemic hyponatremia.

May show no signs, No S/S of fluid overload, Thirst (in SIADH), Primary polydipsia

Select causes for Isovolemic hyponatremia .

Glucocotricoid deficiency (causing inad. filtration), Hypothyroidism (causes limited water excretion), Renal failure (increased H2O levels), Medications, SIADH, TBI, Adrena insufficiency

Select interventions for Isovolemic hyponatremia

Treat underlying cause, Oral urea (extreme), Fluid restrictions, High Na+ diet, Strict I&O’s, Neuro checks, Sodium chloride tabs

Both sodium and water are decreased in the extracellular area but sodium loss is greater than water loss.

Hypovolemic hyponatremia

100

Select S/S of hypovolemic hyponatremia.

Mental confusion, Altered LOC, Hyperirritability anxiety, seizures, edema, hyperreflexia

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問題一覧

True or false? Infants have more body fluid and ECF than adults, thus are more prone to fluid volume deficits.

True

Intracellular fluid (ICF) makes up what total percent of body weight?

35-40%

Extracellular fluid (ECF) makes up what perecentage of TBW?

15-20%

Match the definition to the correct term. Concentration level.

osmolarity.

What electrolyte controls and regulates volume of body fluids/ affecting BP?

Sodium (ECF)

What electrolyte is chief regulator of cellular enzyme activity and water content? (Cardiac)

Potassium (ICF)

What electrolyte aids in metabolism of carbohydrates and proteins, vital actions involving enzymes (ATP)?

Magnesium (ICF)

What electrolyte maintains osmotic pressure in blood, and produces hydrochloric acid in the stomach?

Chloride

What electrolyte is the body’s primary buffer system?

Bicarbonate

What electrolyte is involved in important chemical reactions in the body, cell division, and hereditary traits?

Phosphate

What electrolyte is involved in nerve impulses, blood clotting, muscle contractions, and b12 absroption?

Calcium

What electrolytes are Monica and Rachel? (order does not matter)

H2O, Na+

Fluid moves from areas with more fluid to areas where there is less fluid (passive)?

Osmosis

Solutes move from higher concentration to lower concentration (passive)?

Diffusion

Solutes move from lower concentration to higher concentration?

Active transport

Forces fluid and solute through the capillary wall (passive)?

Filtration

Prevents too much fluid from leaving the capillaries (passive)?

Reabsroption

Hydrostatic pressure is also…?

Blood Pressure

Hydrostatic pressure forces capillary _____?

Filtration

What protein is a “magnet for water”, vital in fluid balance, pulls and hold water into the vessel and is too large to move through capillaries (once you have it it stays where it needs to be)?

Albumin

Equilibrium is achieved when _____ pressure and ____ ____ pressure are equal. Select the correct options to fill the banks in order (2 selections).

Hydrostatic, Plasma osmotic

True or false? Equal pressure allows for filtration and diffusion to occur “normally”

True

What hormone causes the kidneys too retain H2O and triggers thirst?

ADH

What hormone causes vasoconstriction and Na+, H2O retention?

Aldosterone

What is the minimum amount of urine needed to excrete toxic waste products?

400-600 mL/day

What hormone helps to regulate BP and triggers the secretion of aldosterone?

Renin

What hormone stops the renin-angiotensin-aldosterone system, is stored in the cells of the atria, and is released when atrial pressure increases (CHF)?

ANP

True or false? Renin increases BP by increasing vasoconstriction, and is also more related to cardiac function.

True

What is normal serum osmolality?

300mOsm/kgwater

What is the range and avg urine osmolaltiy?

50-1400, 500-800 mOsm

Decreased volume of water and electrolye changes in ECF, triggers ICF shift (shrinking cells).

Dehydration

What is a deficiency in the amount of water and electrolytes in EF with near normal water/electrolyte proportions, most likely lost a lot of blood?

Hypovolemia

What is a distributions shift of body fluids into potential body spaces?

Third-space fluid shift

Excessive accumulation of ECF, in either the intravascular capartments or interstitial spaces, CHF, kidney retention can cause organ failure.

Hypervolemia

Same concentration of particles as plasma (or water).

Isotonic

Greater concentration of particles than plasma (or water)?

Hypertonic

Lesser concentration of particles than plasma (or water)?

Hypotonic

Where are hypertonic solutions given?

ICU ONLY!

D5W is isotonic in the bag but what in the body?

Hypotonic

Select the two isotonic solutions,

0.9 NS (normal saline), LR or RL (Lactate Ringer’s)

Select the two hypotonic solutions.

0.45 NaCl, 0.33 NaCl

The following solutions are what? D50.9NS, D50.45NS, D5RL, D10W.

Hypertonic solutions

What kind of solutions should not be given in neuro patients?

Hypotonic

What kinda of solutions can cause cell dehydration, that you should avoid on renal, cardiac and DKA pts, also the should only be given in ICU?

Hypertonic

Albumin pulls fluid into the blood stream a how many times as fast within 15 mins of administration?

What’s S/S should you watch for after administering albumin?

SOB, Increased BP, Increased pulse, Hypervolemia

1L of water is equal to 1 kg which is how many lbs?

2.2

A weight change of 1lb is qual to a fluid volume change of about how many mLs?

500

What is the most accurate in terms of determining fluid volume changes?

Daily weights

A decreased volume of water and electrolyte changes in ECF triggers ICF shift (cell shrinkage) that happens overtime?

Dehydration

Just know that Isotonic dehydration happens where water and sodium are lost from the body in proportional equal amounts.

YAY I LOVE FLUID AND ELECTROLYTES!

S/S of Dehydration?(isotonic)

Dry skin, Sunken eyes, Dry mucous membranes, Decreased turgor, Increased HR, Decreased BP, Headache, Weakness, Decreased output

Causes of Dehydration? (Isotonic)

Vomiting, Diarrhea, Hemorrhage, Burns, Heat Stroke, Sweating

Causes of hypertonic dehydration?

Impaired thirst, Increased need, Lower body water content (infants), Inability to communicate needs, Confused, Immobility, Tube feeding/ without supplemental H2O

S/S of Hypertonic dehydration? (Increased concentration of solutes as a result of decreased amount of fluid)

Dry mucous membranes, Orthostatic hypotension/ Low BP, Poor skin turgor, Rapid/ weak pulse, Hypernatremia, Hyperglycemia, Severe: Mental status changes, seizures, coma.

Causes of Hypotonic dehydration. (Sodium loss in greater amounts than free water)

Low sodium diet, Diuretic overuse, Diluted urine/ large amounts, Hyperglycemia, Diabetes inspidus

S/S of hypotonic dehydration. (Sodium loss in greater amounts than free water)

Dry mucous membranes, Orthostatic hypotension, Poor skin turgor, Tachycardia, Rapid/weak pulse, Fever (lack of fluid for sweat), Hyponatremia, Hyperglycemia

Lab/ diagnostics for dehydration.

If your high dry (cell shrinkage), Increase BUN, Increase HCT, Decreased urine output, Concentrated urine over 300, Increase in serum Na+ a abover 145, Urine specific gravity above 1.030

Select interevntions for dehydration.

Select Intervetnions for dehydration.

Oralcare, IV site maintenance, Always evaluate labs, Progression of S/S, Foley (if extreme), Document respons/ interventions, Teaching

What is a deficiency in the amount of water and electrolytes in ECF with near-normal water/ electrolyte proportions.

Hypovolemia

True or False? Hypovolemia will eventually turn into Hypervolemia.

True

Select causes of Hypovolemia. (Hypotonic fluid loss from extracellular space)

Fluid loss

Mild 10%, Moderate 25%, Severe/ Shock 40%

Select S/S of Hypovolemia.

Orthostatic hypotension, Dizziness, Weight loss, Delayed capillary refill, Flat jugular veins, Weak/ threads pulses, Nausea, Tachycardia, Thirst, Anxiety, Dry mucous membranes

True or false? No one lab or diagnostic for hypovolemia.

True

Select interventions for hypovolemia

Select S/S of hypovolemic shock.

Decreased urine output, Cyanosis, AMS, Loss of consciousness, Hypotension, Increased HR

Select causes of hypovolemic shock

Hemorrhage/ bleeding, Trauma, Severe burns, Diabetes insipidus

Select interventions for hypovolemic shock

Prevention, Fluid replacement, Identify the source, Stop the loss

What is it called when you have hypovolemia when fluid moves out of intravascular space but not into extracellular space.

Third space shift

True or false? With third space shifting you may or may not see weight gain.

True

Select cause for third space shifting.

Cardiac pulmonary/ peripheral edema, Malnourishment (albumin), Trauma, Infection (pericardial effusion), Burns, Sepsis, Liver failure (ascites), Cancer

Hypervolemia

Select causes of Hypervolemia

Increased Na+ and increased fluid intake, Kidneys (failed excretion), CHF backup, IV fluid replacement, Low protein diet, Low albumin, Hyperaldosteronism, Fluids after a burn

Select assessment findings for hypervolemia.

Edema (dependent starts in lower extremities and creeps up, pulmonary edema), Taught shiny skin, Rapid bounding HR/ pulse, Increased BP, Distended veins (JVD), Weight gain, Polyuria, SOB, S3 gallop

Select lab and diagnostics for hypervolemia.

Descreased BUN, Decreased HCT, Normal Na+, Decreased K+ (unless in renal failure), Low urine specfic gravit, Decreased O2, CXR pulmonary congestion

Select the interevntions for hypervolemia.

Dx and treat, Fluid and Na+ restrictions, Diuretics, Morphine, Nitroglycerin, Digoxin, Potassium levels, Lung sounds

Select interventions for Hypervolemia

Raise HOB, O2 as needed, Foley for I&O’s, Daily weight, Skin care/ prevention, Hemodyalysis, Overcorrection (hypovolemia)

What is an increase in hydrostatic pressure or a decrease in colloid osmotic pressure

Edema

What develops with changes in normal hydrostatic pressure (HTN)

Edema

Right sided heart failure= what kind of edema?

Peripheral (Can be caused diabetes)

Left sided heart failure= what kind of edema

Pulmonary (can be caused by COPD)

What two other things can cause Edema

Lack of proteins, unable to pull fluid in, Capillary integrity/ damage

What is the normal range for calcium?

8.5-10.5

What is the normal range for Mg+

1.3-2.1

What is the normal level for chloride?

95-105

What is the normal level for PO4-

2.5-4.5

Sodium and potassium have what kind of relationship?

Inverse

Magnesium and potassium have what kind of relationship?

Similar

Sodium think neuro.

Thanks

Where is sodium absorbed?

Intestines

Low sodium is what?

Hyponatremia

Select the diagnostic labs for hyponatremia

Serum osmolality less than 280, Serum sodium level less that 135, Urine specific gravity less than 1.010

Sodium levels may appear low because too much fluid is in the body.

Isovolemic hyponatremia

Select S/S for Isovolemic hyponatremia.

May show no signs, No S/S of fluid overload, Thirst (in SIADH), Primary polydipsia

Select causes for Isovolemic hyponatremia .

Glucocotricoid deficiency (causing inad. filtration), Hypothyroidism (causes limited water excretion), Renal failure (increased H2O levels), Medications, SIADH, TBI, Adrena insufficiency

Select interventions for Isovolemic hyponatremia

Treat underlying cause, Oral urea (extreme), Fluid restrictions, High Na+ diet, Strict I&O’s, Neuro checks, Sodium chloride tabs

Both sodium and water are decreased in the extracellular area but sodium loss is greater than water loss.

Hypovolemic hyponatremia

100

Select S/S of hypovolemic hyponatremia.

Mental confusion, Altered LOC, Hyperirritability anxiety, seizures, edema, hyperreflexia