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Definition
| charged molecules, positive or negative |
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| osmolality and normal range |
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| percent solute in water; range 278-298 mOsm/kg |
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| potassium, phosphorous, magnesium |
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Definition
| sodium, chloride, bicarbonate |
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Definition
| extracellular fluid volume deficit; dehydration. |
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| average daily fluid intake |
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Definition
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| 5 older adult impairments that cause decreased fluid intake: |
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Definition
| 1) cognitive 2) decreased renal function 3)increased percent total body fat 4) drug-drug interactions 5) multiple diseases |
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Definition
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| intracellular fluid is _ of total body fluids. |
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Definition
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| interstitial fluid, intravascular fluid, transcellular fluid |
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| hyperosmolar/hypertonic fluid deficit? |
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Definition
| water loss greater than electrolyte loss |
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| iso-osmolar/isotonic fluid deficit: |
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Definition
| water and electrolyte loss equal |
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Term
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Definition
| electrolyte loss greater than fluid loss |
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Term
| five clinical manifestations of dehydration |
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Definition
| weight loss, I & O changes, vital sign changes, thirst, mental status changes |
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Term
| osmolality findings in dehydration |
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Definition
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Term
| BUN levels in dehydration |
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Definition
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| hematocrit in dehydration |
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Definition
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| four nursing interventions for deficient fluid volume |
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Definition
| restore oral fluid intake, administer IV fluids, monitor for complications, control underlying problems |
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Term
| 3 nursing interventions for impaired oral mucous membranes |
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Definition
| assessments, oral care every two hours, adequate fluid intake/proper hydration |
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Term
| four nursing interventions for risk for injury related to fluid imbalance: |
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Definition
| assist with ADL's, call light in reach and bed alarm on, educate family and patient about safety plan, safety in position changes |
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Term
| amount of water for every 15 minutes of exercise |
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Definition
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Term
| four educational steps for the patient to prevent fluid loss: |
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Definition
| don't stop drinking w/ incontinence, drink when not thirsty, replace lost fluids during exercise, avoid heat and humidity |
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Term
| hypervolemia vs. third spacing |
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Definition
| both part of fluid overload; HV is in the vascular system and will affect blood pressure, TS is edema |
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Term
| when this decreases, fluid overload can occur |
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Definition
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| respiratory and cardiac manifestations of fluid overload |
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Definition
| crackles, cough, bounding pulse, elevated blood pressure, decreased O2 sat |
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Term
| change in osmolality, sodium, BUN, and hematocrit in hemodilution |
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Definition
| they are all decreased below the normal levels |
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Term
| four parts of outcome management in fluid overload |
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Definition
| restrict fluids, restrict sodium,, diuretics, control cardiac (ACE inhibitors) |
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Term
| how much should body weight change when controlling fluid overload? |
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Definition
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Term
| three clinical manifestations of water intoxication |
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Definition
| increased intracranial pressure, pupils unresponsive, ALOC |
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Term
| 2 steps of nursing management for water intoxication |
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Definition
| monitor I&O, IV, and daily weight. Encourage sodium rich foods |
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Term
| two causes of third spacing |
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Definition
| protein malnutrition, massive burns |
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Term
| four common signs of third spacing: |
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Definition
| pallor, cool limbs, hypotension, oliguria |
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Term
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Definition
| elevated BUN, sodium, hematocrit, and urine specific gravity |
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Term
| nursing management of third spacing (four steps) |
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Definition
| prevent skin breakdown, monitor for signs of fluid overload, assessment, measure abdomen/extremities for edema changes |
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Term
| four body secretions containing sodium: |
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Definition
| bile, feces, tears, urine. |
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Term
| four body secretions containing sodium: |
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Definition
| bile, feces, tears, urine. |
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Term
| 7 clinical manifestations of hyponatremia |
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Definition
| confusion, headaches, crackles/dyspnea, low BP with elevated HR, thready pulse, dry mucous membranes, nausea/vomiting |
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Term
| nursing interventions for risk for hyponatremia |
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Definition
| monitor lab values, encourage fluid intake, encourage balanced diet, prevent sodium loss (vomiting, diarrhea) |
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| four early/ six late symptoms of hypernatremia |
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Definition
| anorexia, polyuria, restlessness, and weakness/ coma, seizures, tremors, rigid muscle paralysis, confusion, muscle twitching |
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Term
| what is the fluid replacement for hypernatremia? |
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Definition
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Term
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Definition
| D5W, lactated ringers, 0.9% NS |
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Term
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Definition
| 0.45% NS, 0.33% NS, 2.5% dextrose |
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Term
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Definition
| D5 0.45% saline, D5NS, D5LR |
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Definition
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| major problem of hypokalemia |
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Definition
| slowed neuronal excitability |
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Term
| 7 manifestations of hypokalemia |
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Definition
| ECG changes and dysrhythmisa, anorexia, weakness and leg cramps, confusion, convulsions |
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Term
| two nursing diagnosis for hypokalemia |
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Definition
| risk for injury, imbalanced nutrition less than body requirements |
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Term
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Definition
| hyperkalemia as potassium is released from the cells |
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Term
| major effect of hyperkalemia |
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Definition
| altered excitability of nerves and muscles |
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Term
| clinical manifestations of hyperkalemia |
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Definition
| low BP, cardiac arrest r/t muscle paralysis, muscle irritability, diarrhea |
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Term
| cation exchange resin used in management of |
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Definition
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Term
| in patient self care for hyperkalemia, what is a major point? |
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Definition
| avoid salt substitutes, as they usually contain potassium. |
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Term
| best diagnostiic test of hyperkalemia? |
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Definition
| ECG- tall, narrow peaked T wave |
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Term
| major drug in treatment of hyperkalemia? |
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Definition
| kayexalate- allows secretion of K+ |
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Term
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Definition
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Term
| nephrogenic vs. neurogenic diabetes insipidus |
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Definition
| Nephro= kidneys unresponsive to ADH. Neuro= lack of secretion/production of ADH |
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Term
| symptoms of diabetes insipidus |
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Definition
| polyuria, polydipsia (excessive thirst), serum osmolality rises as urine osmolality falls. |
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Term
| five reasons why geri patients more at risk for fluid loss |
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Definition
| 1)impaired thirst mechanism 2) multidrug interaction 3) increase in body fat to water ratio 4) decreased renal functioning 5) altered ADH response |
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Term
| EKG changes with hypokalemia |
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Definition
| depressed/prolonged ST segment, inverted T waves, prominent U waves |
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Term
| consequences of overactive/underactive adrenal glands |
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Definition
| over: sodium, chloride, and water retention excessive, under: K+ retained while water, sodium, and chloride are lost in urine. |
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Term
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Definition
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Term
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Definition
| theophylline, aminophylline, diphylline |
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| minimal urine output for 8 hrs is |
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