NCLEX > Fluid & Electrolytes > Flashcards

Fluid & Electrolytes Flashcards

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1
Q

3 causes of hypervolemia

A

HF
RF
things with a lot of sodium

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2
Q

what are three things high in sodium

A

effervescent medications - (alka seltzer, fleet enema, IVF w Na)
Canned/processed food
IVF with sodium

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3
Q

what 3 hormones regulate fluid volume

A

aldosterone
atrial natriuretic peptide (ANP)
ADH

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4
Q

where is aldosterone found

A

adrenal glands

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5
Q

what is the role of aldosterone

A

retain sodium and water

increase blood volume

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6
Q

what diseases invovle too much aldosterone

A

cushing’s
hyperaldosteronism or Conn’s
(fluid overload)

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7
Q

what disease has too little aldosterone

A

addisons (losing sodium and water)

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8
Q

where is ANP found

A

atrium of heart (atrial natriuretic peptide)

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9
Q

How does ANP work

A

causes excretion of sodium and water

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10
Q

when is ANP released

A

when the heart stretches

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11
Q

how does Anti-diuretic hormone work (ADH)

A

retain water

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12
Q

what is the disease associated with too much ADH

A

Syndrome of Inappropriate ADH secretion (SIADH)

- retain H2O

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13
Q

What happens in SIADH

A

too many letters too much H2O
decreased urine output
increased blood volume

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14
Q

What disease is associated with not enough ADH

A

Diabetes Insipidus (DI)

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15
Q

what happens in DI

A

Diuresis!
fluid volume depletion
urine is dilute
blood concentrated

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16
Q

where is ADH found

A

pituitary gland between the eyes

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17
Q

when should you consider potential ADH problem

A

anytime there is a head injury or any condition that leads to increased ICP

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18
Q

when you see sphenoid think

A

sinus

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19
Q

when you see hypophysis

A

pituitary

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20
Q

what is another name for ADH (drug name)

A

vasopressin

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21
Q

what are signs and symptoms of ADH problems (8)

A 
distended veins
peripheral edema/third spacing
CVP goes up
lungs sound wet
polyuria
increased pulse
pulmonary edema
increased BP
weight increase
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22
Q

Where is CVP measured?

normal values

A

right atrium

2-6 mmHg

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23
Q

what is the treatment for hypervolemia or fluid excess

A 
low NA diet/fluid restriction
I & O 
daily weights 
diuretics 
bed rest 
fluid replacement
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24
Q

whne you see fluid retention what problems should you think first

A

heart problems

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25
causes of fluid volume deficit or hypovolemia
``` shock anything that causes fluid loss third spacing burns acites polyruia diseases - RF or diabetes ```
26
what happens with CVP when a person is experiencing fluid volume deficit
decreases
27
what happens to urine specific gravity during hypovolemia
goes up - very concentrated
28
treatment of hypovolemia
prevent further losses replace volume falls precautions monitor for overload
29
what do isotonic solutions do
stay where I put it
30
what do hypotonic solutions do
go Out of vessel
31
what do hypertonic solutions do
Enter the vessel
32
examples of isotonic solutions )4)
NS lactated ringers D5W D5 1/2 NS
33
examples of hypotonic soltions (3)
D (2.5)W 0.5NS .33NS
34
examples of hypertonic solutions
``` D10W 3%NS 5%NS D5LR D51/2NS, D5NS TPN Albumin ```
35
magnesium and calcium act like
sedatives
36
normal Mg levels
0.65-1.02
37
normal calcium levles
2.25-2.62
38
causes of hypermangesemia
RF | antacids
39
symptoms of too much Mg
flushing warmth (makes you dilate)
40
treatment for too much MG
ventilator dialysis calcium gluconate (IV slow adminster)
41
what element has an inverse relationship with Ca
phosphorus
42
what are the causes of hypercalcemia
hyperparathyroidism - too much PTH thiazides - retain Ca immobilization - have to bear weight to keep Ca in bones
43
what regulates calcium
parathyormone (PTH) - kicks in when Ca gest low and pulls Ca from the bone
44
what are signs and symptoms of too much calcium
brittle bones | kidney stones
45
what are signs and symptoms common in clinets with too much calcium or mag
``` decreased deep tendon reflex weak and flacid or low muscle tone arrhytmias decreased LOC decreased pulse decreased respirations ```
46
treatment for too much calcium
``` move fluids to prevent kidney stones add phosphorus to diet (inverse relationship) steroids (decrease serum ca) medications - biphosphates or calcitonin ```
47
what are causes of hypomagnesmia
diarreha - lots of Mg in intestines | alcoholism - hypertonic, suppreses ADH and not eating or drinking
48
signs and symptoms of too little Ca or Mg
``` rigid and tight muscles seizures stridor (airway is smooth muscle_ +'ve Chcosteks- "C" for cheek Trousseaus - pump up BP cuff - hand tremors arrythmias - heart is a muscle increase in reflexes mind changes swallowing problems - esophagus is a smooth muscle ```
49
treatment for too little Mg
``` give Mg (check kidney function first) seizure precations ```
50
what do you do if your client starts sweating and flushing when you start IV Mg
stop it
51
what are foods high in MG
green leafy foods seeds peppermint squash
52
what are causes of hypocalcemia
hypoparathyroidsim | neck surgery - low PTH decrases serum calcium
53
what is the treatment for too little calcium
give calcium (po or slow IV - heart monitor if IV) vitamin D 0 help utilize Ca phosphate binding medications
54
what are you looking for in an ECG when giving IV calcium
wide QRS complexes
55
what should you think of first with calcium and mag
MUSCLES
56
what should you think of first with sodium changes
NEURO changes
57
what is normal sodium lab voalues
135-145 mmol/L
58
what is the level of sodium in your blood totally dependent on
how much water you have in your blood
59
what is hypernatremia eqivalent to
dehydration - too much Na not enough H20
60
causes of hypernatremia
``` hyperventilation - you exhale H2O heat stroke DI vomiting diarrhea ```
61
what are the S&S of hypernatremia
dry mouth thirsty swollen tongue
62
what is the treatment for hypernatremia
``` restrict Na dilute client with fluids daily weights I& O lab work ```
63
what is hyponatremia
dilution; too much water not enough Na
64
what is the causes of too little Na
drinking H2O for fluid replacement (vomiting, sweating) psychogenic polydipsia - love to drink too much water D5W (sugar and water) SIADH
65
signs and symptoms of hyponatremia
headache seizure coma
66
treatment for hyponatremia
need sodium no water if having neuro problems need hypertonic saline 4%NS or 5%NS
67
normal potassium levels
3.5-5
68
what happens to potassium if the kidneys aren't working well
potassium goes up
69
what are the causes for too much K
kidney trouble | spironolactone
70
S & S of too much potassium
muscle twitching --> muscle weakness --> flaccid paralysis | life threatening arrhytmias
71
what are ECG changes with hyperkalemia
``` brady tall and peaked T waves proloinged PR flat or absent P waves widened QRS conduction blocks Vfib ```
72
what are ECG changes for hypokalemia
U waves PVC's Vtach
73
what is the treatment for too much potassium
``` dialysis (kidneys aren't working) calcium gluconate decreases arrythmias glucose and insulin - inulin carries glucose and K into cell; give glucose to prevent hypoglycemia sodium polystyrene (kayexalate) ```
74
potassium has an inverse realtionship with which element
sodium
75
what are causes of hypokalemia
vomiting suction (lot of potassium in stomach) diuretics not eating
76
signs and symptoms of too little K
muscle cramps muscle weakness life threatening arrhythmias
77
treatment for too little K
give K spironolactone eat more K
78
what is the major problem with giving oral K
GI upset
79
always run IV K through waht
pump
80
should you ever give K IV push
NEVER
81
does IV K burn during infusion
yes - eats up peripheral vessels
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