Term
|
Definition
Balance-solvent and chemical
Transport nutrients to cells; waste away
Cushion, protect, lube, and insulate |
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Term
| Causes of increased H2O loss |
|
Definition
Fever, Diarrhea, diaphoresis, vomiting
Gastric suctioning, tachypnea
**Risk for dehydration |
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Term
|
Definition
Increased NA+ intake/retention
Excessive intake of water/secretion of ADH
**Risk for hyperhydration |
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Term
|
Definition
Intracellular-in cell
Extracellular-interstitial, intravascular |
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Term
| Methods of body fluid regulation |
|
Definition
filtration
secretion
reabsorption
excretion |
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Term
|
Definition
| Movement of PARTICLES from greater to lesser concentration |
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Term
|
Definition
Requires carrier molecule
**Glucose transport is an example |
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Term
|
Definition
| Movement of WATER from lesser to greater |
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Term
|
Definition
Pressure exerted by water to equalize both sides
**Particle concentration
Also called Osmotic pressure |
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Term
|
Definition
270-300 mOsm/L
>300=dehydration
<270=hyperhydration |
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Term
|
Definition
Osmolarity is same as ECF
*NS- 1L adds 250cc to ECF and 750cc to IF
****Given to increase blood volume |
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|
Term
| Isotonic SOLUTION examples |
|
Definition
| NS, Lactated Ringers, D5W |
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Term
|
Definition
Lower concentration of solutes
Cell swells; water moves in |
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|
Term
| Hypotonic SOLUTION examples |
|
Definition
|
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Term
|
Definition
Higher solute concentration
Cells shrink; water moves out
*Monitor for interstitial dehydration
**Used for CHF, brain swelling |
|
|
Term
| Hypertonic SOLUTION Examples |
|
Definition
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Term
|
Definition
| Movement of fluid through membrane as a result of liquid pressure differences on both sides of cell membrane |
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Term
|
Definition
Process by which some energy is spent to move lg. molecule or substance across an area of higher pressure
*Ex. Sodium-potassium pump |
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Term
| Regulation of fluid examples |
|
Definition
Filtration- BP
Secretion- movement of blood to tubules
Reabsorption- movement from tubules to blood
Excretion- movement from kidney to environment |
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Term
|
Definition
Kidneys:1-2L/day
Lungs:300-400mL/day
Skin:600mL/day
GI:100-200mL/day
*10% increase of water loss for every degree increase in temperature |
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Term
|
Definition
Loses F&E in same ratio
***Most common dehydration |
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Term
| Isotonic DEHYDRATION result |
|
Definition
Hypovolemia (decreased blood volume)
**Causes decreased tissue perfusion |
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Term
| Isotonic DEHYDRATION causes |
|
Definition
| burns, hemorrhage, diuretics, diarrhea, NG suction, fistulas, severe wounds, long term NPO, ileostomy |
|
|
Term
|
Definition
Losing more fluid than electrolytes
**2nd most common |
|
|
Term
| Hypertonic DEHYDRATION: causes |
|
Definition
| Hyperventilation, renal failure, fever, tube feedings, DI, watery diarrhea, unconsciousness, excessive fluid replacement |
|
|
Term
| Hypertonic DEHYDRATION: dx results |
|
Definition
| Elytes will be normal or slightly elevated |
|
|
Term
| Hypertonic DEHYDRATION: tx |
|
Definition
|
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Term
|
Definition
losing more elytes than fluid
*excessive Na+ or K+ loss from ECF |
|
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Term
| Hypotonic DEHYDRATION: causes |
|
Definition
chronic illness, renal failure, chronic or severe malnutrition, excessive fluid replacement
**First s/s are usually neurological |
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Term
| Hypotonic DEHYDRATION: tx |
|
Definition
|
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Term
|
Definition
Fever
Diarrhea
Diaphoresis
Vomiting
NG Suctioning |
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Term
|
Definition
| Thirst, decreased capillary refill, cool hands or feet, decreased BP, increased pulse, rapid and weak respiration, decreased urinary output, confusion, dry membranes, constipation, decreased bowel sounds, orthostatic hypotension, flat veins, daily weights |
|
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Term
|
Definition
Small, frequent oral rehydration
IV Fluids replacement |
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Term
|
Definition
Hgb, Hct, BUN, & creatinine- increased
WBCs normal or slightly elevated
Urine osmolarity- increased
Specific gravity- >1.030 |
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Term
|
Definition
Increased sodium intake/retention
Excessive intake of water
Excessive secretion of ADH |
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Term
|
Definition
**Excess fluid in ECF
Elytes normal
H&H low |
|
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Term
| Isotonic OVERLOAD: Causes |
|
Definition
| excess IV, enemas, steroid therapy |
|
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Term
| Isotonic OVERLOAD: Results |
|
Definition
Circulatory overload
Pitting edema |
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Term
|
Definition
|
|
Term
| Hypotonic OVERLOAD: causes |
|
Definition
| CHF, excessive water intake, irrigation w/ hypotonic fluid |
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|
Term
| Hypotonic OVERLOAD: result |
|
Definition
| Cellular swelling, elyte dilution |
|
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Term
|
Definition
**increase in Na+ w/ water
ICF shifts to ECF
Cells shrink |
|
|
Term
| Hypertonic OVERLOAD: causes |
|
Definition
Excessive Na+ intake/ retention
Rapid infusion of hypertonic solution |
|
|
Term
| Hypertonic OVERLOAD: result |
|
Definition
Circulatory overload
Pitting edema |
|
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Term
|
Definition
Leg/ankle edema
Wheezy, dry cough
Periorbital edema
Increased BP
Rapid respiratory rate
Moist coughing |
|
|
Term
|
Definition
Frothy sputum
Maybe crackles
Hgb, Hct, protein decreased
Decreased urine gravity |
|
|
Term
| Nsg care for fluid overload |
|
Definition
Monitor V/S
Check neck and hand veins
Respiratory status
I&O, daily weights, elevate HOB |
|
|
Term
| More nsg care for fluid overload |
|
Definition
Diuretics, restrict fluids
Mouth care-because of fluid restriction
Peripheral edema |
|
|
Term
1 kg of weight=
OR
1 lb of weight= |
|
Definition
increase of 1L of fluid
OR
increase of 450mL of fluid |
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Term
|
Definition
| Elements or compounds that develop electrical charge when dissolved in water |
|
|
Term
|
Definition
Negatively charged
**HCO3, Cl- |
|
|
Term
|
Definition
Positively charged
**Na+, K+ |
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|
Term
|
Definition
|
|
Term
|
Definition
Muscle contraction
Heart contraction
Transmission of nerve impulses
Kidney urine concentration |
|
|
Term
|
Definition
<136 mEq/L
low amounts of Na+ in blood
Results in drawing water back into cells |
|
|
Term
|
Definition
| Greatest indicator is neuro changes |
|
|
Term
|
Definition
sweating
vomiting
diarrhea
diuretics
tap water enema
increased ADH |
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|
Term
|
Definition
H/a, lethargy, brain swelling, confusion, convulsions, coma
Rapid thready pulse, postural hypotension
N/V, diarrhea
Weakness, spasms
Decreased deep tendon reflexes
*Assess resp. status if muscle strength decreases |
|
|
Term
|
Definition
Intake and output, daily weights
Monitor lab values
Assess skin care
Monitor IVs
NGT- irrigate w/ NS, limit ice chips
Administer hypertonic solns
IV- NS, elyte diuretic (Mannitol) |
|
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Term
|
Definition
BP bottoms out
HR increases
*weak and thready |
|
|
Term
|
Definition
145 mEq/L
*causes cells to shrink |
|
|
Term
|
Definition
Excessive PO intake
Increased water loss
Hypertonic tube feedings w/o water following
Diabetes insipidus |
|
|
Term
|
Definition
Gain of sodium in excess of water
Loss of water in excess of sodium
*Profuse watery diarrhea
*Hyperventilation w/ excessive insensible loss |
|
|
Term
|
Definition
Dry, sticky mucus membranes
Elevated temperature
Confusion, seizures, and agitation
Increased heart rate
Oliguria or anuria
Mild- muscle twitches, spontaneous contraction
Severe- dim. deep tendon, musc. weakness |
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|
Term
|
Definition
|
|
Term
|
Definition
Transmission of nerve impulses
*promotes myocardial, skeletal, and smooth musc contraction
Aids in utilization of glucose |
|
|
Term
| Potassium in Acid-Base Balance |
|
Definition
Increase= acidosis
Decrease= alkalosis |
|
|
Term
|
Definition
Bananas
cantaloupe
green leafy veg
dried fruit |
|
|
Term
|
Definition
<3.5 mEq/L
Decreased K+ intake
GI suctioning
K+ wasting diuretics
Vomiting and Diarrhea
Burns |
|
|
Term
|
Definition
Fatigue, weakness, heaviness in legs
Decreased bowel motility
N/V
Postural hypotension
**Ventricular arrhythmias |
|
|
Term
|
Definition
Shallow respirations
Thready, weak pulse
HR-may be increased or decreased
Muscles may become weak |
|
|
Term
|
Definition
Foods high in K+
KCl by IV
*20-40 mEq/L of IVF
Take PO w/ a glass of water
Give K+ sparing diuretic |
|
|
Term
|
Definition
|
|
Term
|
Definition
Renal failure-most common cause
K+ sparing diurectics
Burns, tissue trauma
Rapid admin of K+
Metabolic acidosis |
|
|
Term
|
Definition
Muscle weakness, cramps
N/V, diarrhea
Intermittent colic
ECG changes, arrhythmias
Low BP, bradycardia, irregular HR
Numbness, tingling of extrem, face, and tongue |
|
|
Term
|
Definition
Kayexalate: PO or rectal
IV Hypertonic glucose & insulin
IV NaHCO3
Decrease dietary intake of K+
Dialysis
Cardiac monitoring |
|
|
Term
|
Definition
Binds K+ in exchange for Na+
*excreted in stool |
|
|
Term
| IV Hypertonic Glucose & insulin |
|
Definition
| facilitates movement of K+ back into cell |
|
|
Term
|
Definition
corrects acidosis and moves K+ back into cell
*metabolic acidosis |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Teeth and bone formation
Contraction of the muscle
Blood clotting
Transmission of nerve impulses
*99% of Ca is in bone |
|
|
Term
| Ca and Phosphorous Relationship |
|
Definition
|
|
Term
|
Definition
Parathormone-released in response to low Ca levels
*increases Ca out of bone
Calcitonin- stimulated by increased Ca levels
Vitamin D- essential for absorption by GI tract |
|
|
Term
|
Definition
<9.0 mg/dL
Vitamin D deficiency
Pancreatitis
Multiple blood transfusions
Chronic renal failure
Removal of parathyroid gland |
|
|
Term
|
Definition
positive Chovestek's & Trousseau's
Tetany w/ hyperreflexia
Numbness and tingling in extrem, & around mouth
Muscle cramps
Depression, irritability, fatigue, anxiety |
|
|
Term
|
Definition
Increased gastric motility
hyperactive bowel sounds
Decreased BP |
|
|
Term
|
Definition
Oral Calcium Supplements- TUMS
Vitamin D Replacements
IV Supplements- Cal Gluconate, Cal Chloride |
|
|
Term
|
Definition
Re: foods high in Ca++
Pt. on seizure precautions |
|
|
Term
|
Definition
>10.5 mg/dL
Hyperparathyroidism
Thiazide diuretic- holds on to Ca++
Reabsorption of the bone |
|
|
Term
| Reabsorption of the bone: causes |
|
Definition
prolonged immobilization
Multiple fractures
bone tumors |
|
|
Term
|
Definition
Altered LOC, lethargy, confusion, blurred vision
Deep bone pain
Kidney stones
Constipation, anorexia, N/V |
|
|
Term
|
Definition
Hypoactive or absent bowel sounds
Tachycardia(early sign)
Bradycardia(late sign)
Cardiac arrest
**Monitor dig levels
**Do Homan's sign |
|
|
Term
|
Definition
NS IVF
Loop diuretics
PO or IV PO4 preparation
Plicamycin-slows bone reabsorption
Calcitonin-slows bone reabsorption
Laxatives- for constipation
Dialysis for LT levels |
|
|
Term
|
Definition
3.0-4.5 mg/dL
Contributes to metabolism of glucose, fat and protein
Aids in acid-base balance
Muscle contraction
Conversion of glycogen to glucose
Function of RBCs
**Must have adequate renal function |
|
|
Term
|
Definition
<3.0 mg/dL
Alcoholism and malnutrition
DKA
Prolonged hyperventilation
Frequent use of TUMS |
|
|
Term
|
Definition
Muscle weakness, rhabdomyolysis, decr deep tendon,
bruising, decr musc. contractility, ataxia
Confusion, CNS depression, irritability
seizures, immunosuppression, shallow respirations |
|
|
Term
|
Definition
Try dietary first
Oral supplement: K-phosphate
IV w/ K+ or NaPO4
IV PO4 given ONLY when levels: <1 mg
Infuse IV SLOWLY |
|
|
Term
| HyperPHOSPHATEMIA: Causes |
|
Definition
>4.5 mg/dL
Renal failure
Chemotherapy
Increased phosphate intake and absorption |
|
|
Term
|
Definition
Tetany, numbness, cramps
Muscle twitch
Nervouseness
Irritability |
|
|
Term
|
Definition
Dietary restriction of phosphates
PO4 binders(ex. amphogel, alternagel, basagel)
Correct underlying hypocalcelmia |
|
|
Term
|
Definition
1.3-2.1 mg/dL
Aids in neuromuscular transmission
Aids in cardiac muscle contraction
Activates enzymes for cellular met of carbs&proteins
Maintaining active trans mech at cell level
Aids in DNA and RNA synth |
|
|
Term
|
Definition
<1.3 mEq/L
Malnutrition, alcoholism, IBD, fluid loss
Loop diuretics, ABX
Diarrhea, NG suction, fistulas
Severe dehydration |
|
|
Term
|
Definition
Severe deep musc. depression
*Shallow resp
Apathy, depression, confusion, irritability
Musc. weakness, tremors and tetany
Hyperreflexia
LT cardiac arrhythmias, HTN
**Clinically resembles hypocalcemia |
|
|
Term
|
Definition
Diet: green veg, legumes, fruits, chocolate
IV or IM MgSO4
*1g/h
IV b/c IM causes pain and tissue damage
**Also tx for HYPOcalcemia |
|
|
Term
|
Definition
>2.1 mEq/L
Laxatives/antacids that contain Mg
Chronic renal failure
MgSo4 for eclampsia |
|
|
Term
|
Definition
reduced deep tendon
Inability to swallow
Flushed skin
severe muscle weakness
Depressed resp
decreased BP, bradycardia |
|
|
Term
|
Definition
| can lead to cardiac and resp arrest |
|
|
Term
|
Definition
d/c mg drugs
IV Cal Gluconate to counteract effects
Dialysis for chronic renal failure
Mechanical vent if resp arrest |
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