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Fluids Electrolytes (DSCC)

Terms

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Intracellular
fluid found inside cells
Extracellular
fluid found outside cells
Intravascular
fluid in blood plasma
Interstitial
fluid between cells & outside blood vessels
Electrolytes
solutes that separate into electrically charged particles called ions when dissolved in a solvent
Anion
negatively charged ion
Cation
positively charged ion
Diffusion
process in which particles in a fluid move from higher to lower concentration
Osmosis
movement of a pure solvent thru a differentially permeable membrane from a solution with lower to higher solute concentration
active transport
movement across membrane from a less to more concentrated solution which expends metabolic energy
Filtration
process by which water & diffusable substances move together in response to fluid pressure from a higher to lower pressure
Fluid Regulation
body fluids are regulated by intake, hormonal control, & fluid output
Intake Regulation
intake regulated primarily by the thirst mechanism
Skin Fluid Loss
regulated by sympathetic nervous system
Lung Fluid Loss
regulated by rate & depth of respirations
GI Fluid Loss
loss thru feces & disease
Kidneys
major regulatory organs of acid-base balance
Acid-Base Balnace
metabolic processes maintain a steady balance between acids & bases for optimal cell functioning
Buffer
a substance or group of substances that can prevent excessive pH changes by removing or releasing hydrogen ions
Respiratory Control
adapt rapidly to imbalance by changing rate & depth of respirations to release or retain CO2
Renal Control
kidneys regulate balance by excreting or conserving bicarbonate or hydrogen ions
Sodium
body uses to maintain proper extracellular fluid concentration
Sodium Values
135 - 145 mEq/L
Sodium Sources
bacon, ham, & processed foods
Sodium Control
thirst mechanism, ADH, & kidneys
Hyponatremia
deficiency (< 120 mEq/L) of Na in relation to body water
Hyponatremia Causes
Na loss (burns, diuretic, perspiration), fluid increase, & pituitary disfunction
Hyponatremia S/S
LOC changes, lethargic, skin & mucous dry, tachycardia, hypotension, & N/V
Hyponatremia Treatment
Identify cause & correct, regulate Na intake, & administer IV (0.3% NS)
Hyponatremia Interventions
monitor LOC, labs, & I&O
Hypernatremia
excessive (> 155 mEq/L) Na levels
Hypernatremia Causes
Na gain, water loss, & inadequate water intake
Hypernatremia S/S
LOC changes, confusion, increased muscle tone, skin dry & flushed, thirsty, N/V, & edematous
Hypernatremia Treatment
Dietary control & diuretics
Hypernatremia Interventions
monitor LOC, labs, I&O, & frequent oral care
Potassium Functions
cardiac, nerve, & muscle function
Potassium Values
3.5 - 5.0 mEq/L
Potassium Sources
bananas & orange juice
Hypokalemia
deficiency (<2.5 mEq/L)
Hypokalemia Causes
insufficient intake, or loss
Hypokalemia S/S
muscle cramps, irregular HR, & hyporeflexia
Hypokalemia Treatment
identify cause & correct, dilute oral K
Hypokalemia Interventions
monitor VS, labs, & dietary intake
Hyperkalemia
> 7 mEq/L
Hyperkalemia Causes
increased intake, decresed urinary excetion, & renal failure
Hyperkalemia S/S
muscle weakness & tingling, bradycardia,
Hyperkalemia Treatment
identify & correct, limit intake, & Kayexalate
Hyperkalemia Interventions
monitor VS, I&O, restrict intake
Calcium Functions
formation & structure of bones & teeth, cell membrane permeability, & blood clotting
Calcium Control
negative feedback, dietary intake, & body storage
Calcium Values
8.4 - 10.2 mg/dL
Calcium Sources
milk, dairy products, dark leafy veggies
Hypocalcemia
< 6 mg/dL
Hypocalcemia Causes
insufficient intake, improper absorption, excessive losses
Hypocalcemia S/S
muscle spasms, tetani, Chevostek's sign, Trousseau's sign, increased risk of bleeding & bruising
Hypocalcemia Treatment
Ca & Vit D supplements
Hypocalcemia Interventions
monitor cardiac functions
Hypercalcemia
> 13 mg/dL
Hypercalcemia Causes
excessive intake, thyroid & parathyroid conditions, & cancer
Hypercalcemia S/S
decreased DRTs, heart block, disarrythmias, N/V, & flank pain,
Hypercalcemia Treatment
loop diuretic,
Hypercalcemia Interventions
monitor Ca levels, VS, & cardiac finctions
Magnesium Functions
neuromuscular conduction, cardiac function, & blood clotting
Magnesium Values
1.2 - 2.6 mg/dL
Magnesium Sources
green leafy veggies, oatmeal, chicken, tuna, & raisins
Hypomagnesemia
< 1 mg/dL
Hypomagnesemia Causes
Mg loss, inadequate intake, steroid use
Hypomagnesemia S/S
disorientation, confusion, Chvostek's & Trousseau's signs, tachycardia, & sudden cardiac death
Hypomagnesemia Treatment
Mg w/ antacids containing Mg, IV Mg w/ a dilute
Hypomagnesemia Interventions
monitor cardiogram, muscle spasms, reflexes, & Ca tests
Hypermagnesemia
> 5.0 mg/dL
Hypermagnesemia Causes
increased intake
Hypermagnesemia S/S
decreases DRTs, lethargic & c/o parathesia, irregular HB (bradycardia), & disarrythmias
Hypermagnesemia Treatment
Mg, IV Ca gluconate is Mg antagonist. Stop all meds w/ Mg
Hypermagnesemia Interventions
monitor LOC, cardiograph, & neuro functions
Phosphorous Functions
interdependent w/ Ca, required for muscle function, primary buffer to maintain urinary pH
Phosphorous Control
parathyroid hormone
Phosphorous Values
2.5 - 4.5 mg/dL
Phosphorous Sources
milk, cheese, egg yolks, meat, & fish
Hypophosphatemia
< 1.0 mg/dL
Hypophosphatemia Causes
decreased P, Al antacid overuse, & hyperthyroidism
Hypophosphatemia S/S
LOC, seizure activity, decreased reflexes & parathesia, generalized fatigue & muscle weakness, & high risk of bleeding
Hypophosphatemia Treatment
increased dietary intake & IV w/ K & P
Hypophosphatemia Interventions
monitor LOC, bleeding, & respirations
Hyperphosphatemia
> 4.5 mg/dL
Hyperphosphatemia Causes
renal failure & high use of P laxatives/enemas
Hyperphosphatemia S/S
muscle spasms, tetani, & tachycardia
Hyperphosphatemia Treatment
limit intake
Hyperphosphatemia Interventions
monitor respiratory, cardiac, labs, muscles, & stool colors
Chloride Values
98-106 mEq/L
Chloride Sources
diet high in salt
Hypochloremia Causes
r/t GI loss, diuretics, & aggressive diaphoresis
Hypochloremia S/S
neuromuscular twitching
Hypochloremia Interventions
monitor respirations
Hyperchloremia Causes
r/t dehydration
Hyperchloremia S/S
LOC & lethargy
Assessment Lifestyle
dietary habits, stress, job, activity level, & work indoor or outdoor
Assessment Weight
sudden changes & intentional or unintentional
Assessment I&O
any changes in fluid intake more/less
Assessment Preexisting diseases
kidney problems
I&O
NOT A MEASUREMENT OF BODY FLUID VOLUME!!! WEIGHT IS BEST WAY TO CHECK

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