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When comparing blood plasma and interstitial fluid:
they both have the same kind of ions.
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What is considered total input?
anything liquid, IV fluids, foods that become fluid at room temp
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What does insensible mean when related to fluid and electrolytes?
amount of fluids that cannot be measured, ie. skin 300-500 ml, breathing 400-500 ml, feces 100 ml
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Normal urine output:
1,000-1,500 mL or 1-1.5 L
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1 kg of body weight loss = ?
1 L of fluid loss
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What kinds of signs and symptoms are shown in a patient with excess extracellular fluid?
sacral edema, pedal edema (legs), dependent edema and lungs
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Right sided failure (fluid overload) = ?
neck vein distention, hepatomegaly
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Left sided failure (fluid overload) = ?
lungs (crackes and rales) and pulmonary edema
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Patient with vomiting and diarrhea for 3 days, what is the most accurate way of knowing if they have a fluid deficit (fluid status)?
changes in daily weight measurements
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How do we know if that same patient is adapting to the excess fluid loss?
skin turgor
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Besides diarrhea, what gives you fluid imbalance?
constipation or bowel obstruction
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Same pateint is severely dehydrated, what is the best way to rectify the situation?
Isotonic IV solution
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Common isotonic solution = ?
0.9 % normal saline
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Hypotonic solution = ?
0.45% normal saline
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Hypertonic solution = ?
2.0% normal saline
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Osmosis?
process of moving water from high to low concentration
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Diffusion?
process of moving solutes from high to low concentration
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Filtration?
pressure from high to low
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All three types of transport above are?
passive
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Active Transport requires?
ATP
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Active Transport substances:
protein, sugar, glucose, carbs and amino acids, all electrolytes and waste
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Albuminuria?
too much albumin in the urine (kidney problems)
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Albumin is a form of?
protein
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Oncotic/Colliod/Osmotic:
all pressure against the cell wall
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When administering plasma protein via IV to a patient, what do we monitor for?
signs and symptoms of fluid overload
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What electrolyte has the greatest effect on water?
sodium
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Normal sodium range?
135-145 mEq
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If someone has a serum sodium level of 130 what does this mean?
hyponatremia/hyperkalemia (restrict fluids)
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Patient is hypernatremic (sodium of 180), what behavioral changes will we see?
agitation and confusion
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Patient has undergone extensive surgery, what electrolyte would be most affected?
potassium
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Potassium Loss = ?
hypokalemia
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Most extracellular electrolyte = ?
sodium
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Most intracellular electrolyte = ?
potassium
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If a patient has hyperkalemia what should be done first?
second?
third?
- assess and do VS
- tell MD/RN
- check for irregular heart beat (will be slow)
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What organ is most affected by potassium?
heart
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High potassium = ?
slow heart beat
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Signs and symptoms of hyperkalemia?
restlessness, confusion, dysrrhythmias, vomiting, diarrhea and weakness
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Level of 1.9 for potassium is considered?
abnormal
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Normal calcium levels?
- 4.8 - 8.3 (bound)
- 5.0 - 10.1 (unbound)
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Normal chloride levels?
3.5 - 5.0
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Hypokalemic/hypernatremic:
too much sodium
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S/S of hypokalemia/hyponatremia?
edema, neck vein distention, ascites, dependent edema and rales
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What do we use chloride for?
makes HCl
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Patient with a positive chvostek sign is?
hypocalcemic
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S/S of chvostek?
facial twitch
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Patient has elevated calcium levels due to hyperparathyroidism (controls calcium and phosphate), what is the drug that will force the calcium back into the cell?
calcitonin
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Calcitonin is produced by?
the thyroid
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Prior to drawing ABG's what test to we perform?
allen's test
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What is the allen's test?
occlusion of the ulnar and radial arteries separately to see if the hand changes color, if pressing on ulnar we are hoping for no color change because the radial has enough flow and vice versa
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What are the two body systems involved in maintaining normal pH?
respiratory (CO2) and bicarbonate buffer system (urinary)
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Patient with chronic renal failure has?
high ammonia
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Kidney excretes ammonia which maintains?
the acid base balance
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What does the PaCO2 level indicate?
partial pressure of CO2 = respiratory function, how well one is ventilated
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If you are blowing off CO2 you will have?
alkolosis
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Normal CO2 levels = ?
35-45
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Normal O2 levels = ?
80-100 on ABG's and 95-100 on pulseox
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