6587517
Descripción
Fichas por Gwen Paparone, actualizado hace más de 1 año
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Creado por Gwen Paparone
hace alrededor de 8 años
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| Pregunta | Respuesta |
| What is the primary body fluid? | Water |
| What is the adult water weight %? | 55-60% water |
| How much weight loss results from 10% body fluid loss? | SERIOUS- 8 % |
| How much weight loss results from 20% body fluid lost? | FATAL- 15% weight loss |
| What is the average amount of fluid gained and lost every day? | 2-3 Liters |
| What is the minimum output per hour necessary to maintain renal function? | 30 ml/hr |
| Examples of fluid intake? | PO fluids/Tube Feeding IV Fluids Blood and Blood products |
| Examples of Output? | Urine Vomit Blood Drainage |
| Osmolarity | Concentration of particles in a solution |
| Posterior pituitary | releases ADH (anti diuretic hormone) in response to increased serum osmolarity- causes renal absorption of water. |
| Normal Serum osmolarity? | 280-295 mosm/kg |
| What increases the osmotic pressure? | Increased osmolarity |
| Hypothalamus | Triggers Thirst mechanism in response to increased serum osmolarity |
| Renal Regulation | nephron receptors sense low osmolarity (pressure) and secrete renin |
| Renin | stimulates production of angiotensin I- followed by angiotension II |
| Angiotensin II | causes Na and h20 retention by kidneys. Stimulates the adrenal cortex. |
| Adrenal Cortex | Secretes aldosterone when stimulated by angiotension II. |
| Aldosterone | Secreted by the adrenal cortex following angiotension production. - Causes kidneys to secrete Potassium (k) and retain Na and H2o. |
| Hypertonic | High osmolarity (More than serum) |
| Hypotonic | low osmolarity (less than serum) |
| Isotonic | Equal osmolarity to the normal serum level |
| What are Isotonic imbalances? | When water and sodium levels have decreased or increased in volume but osmolarity is maintained. |
| Fluid Volume Defecit (FVD) | AKA hypovolemia Fluid volume low |
| Causes of FVD | decreased water or salt intake Increased output hemorrhage, burns Increased sweating |
| Assessment of FVD | Weight loss, Postural hypotension, Thready pulse, Dry mucous membranes- poor turgor, dark urine, thirst, restlessness, confusion, oliguria, cold clammy skin, hypotension, |
| Labs for FVD | Increased hematocrit (hCt) and BUN |
| Normal Hemoglobin labs | women 12-16g/100mL men 13-18g/100mL |
| Normal Hematocrit Labs | Women 40-48% Men 42-50% |
| Normal Blood urea nitrogen labs | 10-20mg/dl |
| Normal Serum creatinine | 0.7-1.2mg/dl |
| Fluid Volume Deficit Nursing Diagnosis Examples | Defecit fluid volume related to excessive fluid loss Risk for hypovolemic shock Risk for injury related to dizzyness Risk for impaired skin integrity |
| FVD interventions | Isotonic fluids and medications as ordered Reassessment I's and O's and lab results Comfort measures |
| Etiology of FVE | Excessive administration of isotonic fluids Renal retention of sodium and water Heart failure, cirrhosis, aldosterone excess |
| FVE Assessment | Sudden weight gain Dependent Edema NVD Pulmonary edema Decreased Hct and BUN |
| Hypernatremia | Loss of more water than salt or gain of more salt than water |
| What would the serum sodium level be for a patient with hypernatremia? | Sodium above 145 mEq/L |
| What would the serum osmolality be for a patient with hypernatremia? | Serum osmolality above 300 mOsm/kg |
| Hyponatremia | Gain of more water than salt or loss of more salt than water |
| What would the serum sodium levels be for a patient with hyponatremia? | Sodium levels below 135 mEq/L |
| What would the serum osmolality be for a patient with hyponatremia? | Serum osmolality below 280 mOsm/kg |
| What osmolality imbalance is associated with ADH deficiency and why? | Hypernatremia. Because ADH is an anti diuretic hormone and without it the body would not retain as much water. |
| What osmolarity imbalance is associated with an excessive amount of ADH? | Hyponatremia. Because the body retains more water. |
| What neurological symptom is a risk in both hyponatremia and hyponatremia? | Seizures. Especially when severe or sudden. |
| Clinical dehydration | A combination of volume and osmolarity imbalance. Water intake is less than output. |
| What osmolarity imbalance would be found in dehydration? | Hypernatremia |
| What symptoms are common with dehydration? | Commonly causes Fever. Commonly caused by severe vomiting or diarrhea. |
| Electrolytes | Solutes measured in mEq units. Sodium Potassium Calcium Magnesium |
| Sodium ranges | 135-145 mEq/L (ECF) |
| Potassium Ranges | 3.5-5.5 mEq/L (ICF) |
| Calcium Ranges | 8.5- 10.5 mg/100ml Or 4.5-5.5 mEq/L |
| Magnesium Ranges | 1.5-2.5 mEq/L |
| Anions | Chloride (Cl) Phosphate (Po4) Bicarbonate(HCO3-) |
| Chloride levels | 95-105 mEq/L |
| What is the chief electrolyte in the ECF? | Sodium |
| Role of sodium | Regulate volume of bodily fluids Needed for nerve impulses and muscle Fiber transmission |
| What regulates sodium levels? | The kidneys/ Hormones |
| What is the chief electrolyte in the ICF? | Potassium (K) |
| Roles of Potassium? | Major mineral in all cellular fluids Aids in muscle contraction Regulates enzyme activity Assists in acid base balance Regulates IC H20 Content |
| Hypokalemia | Serum Potassium level < 3.5 mEq/L |
| What causes hypokalemia? | Decreased intake loss via GI/Renal and potassium depleting diuretics |
| What are some effects of hypokalemia? | Life threatening. Muscle weakness- cramps Decreased GI motility, Arrythmias |
| What are some treatments for hypokalemia? | diet Supplements IV therapy |
| Hyperkalemia | Serum Potassium levels >5 mEq/L |
| What causes hyperkalemia? | Excessive intake trauma crush injuries Burns Renal Failure |
| What are signs and symptoms of hyperkalemia? | Muscle weakness, arrhythmias, N/V (nausea/vomit) Parathesias of face.fingers/tongue |
| What are the treatments for hyperkalemia? | Diet supplements IV therapy |
| What are the normal ranges for calcium? | 4.5-5.5 mEq/L or 8.5-10.5 mg/1ooml |
| What is the most abundant electrolyte in the body? | Calcium |
| What percentage of total body calcium is present in the teeth and bones? | 99% |
| What are some of the functions of calcium? | Nerve transmission Vitamin B12 Absorption Muscle Contraction Blood Clotting |
| What electrolyte does calcium have an inverse reaction with? | Phosphorus |
| What vitamin is needed for Ca absorption? | Vitamin D |
| What are the serum levels for hypocalcemia? | < 4.3 mEq/L |
| What are the causes of hypocalcemia? | Low intake Loop diuretics Parathyroid disorders Renal Failure |
| What are the symptoms of hypocalcemia? | Osteomalacia EKG changes Numbness in fingers muscle cramps tetany Chovstek sign Trousseau sign |
| What are the treatments for hypocalcemia? | Diet and IV therapy |
| Chovstek Sign | Wincing when cheek is poked sin of hypocalcemia |
| Trousseau's sign | Hand fasiculations when BP cuff is inflated |
| Hypercalcemia Serum Levels | > 5.3 mEq/L |
| What causes hypercalcemia? | Hyperparathyroidism cancers prolonged immobilizations |
| Signs and symptoms | Muscle weakness renal calculi Fatigue Altered LOC Decreased GI motility Cardiac Changes |
| Treatment for Hypercalcemia | Medication IV therapy |
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