Fluid & Electrolytes II

  1. Populations at risk for dehydration due to the inability to percieve or respond to the thrist mechanism include:
    • Infants
    • Clients with neurological or psychological problems
    • Some older adults (elderly)
  2. ADH prevents ___, thus causing the body to save water.
  3. True or False.

    The Atrial Natriuretic Peptide (ANP) acts as a diuretic that causes sodium loss and inhibits the thirst mechanism.
  4. _____ loss is continuous and occurs through the skin and lungs. A person does not perceive the loss, but it can significantly increase with fever or burns
    Insensible water
  5. ___ loss occurs through excess perspiration and can be perceived by the client or through inspection.
    Sensible water
  6. Fluid output occurs through four organs of water loss:
    • Kidneys
    • Skin
    • Lungs
    • GI tract
  7. The normal range for serum potassium concentrations is ____.
    3.5 - 5 mEq/L
  8. Calcium is necessary for:
    • Bone and teeth formation
    • Blood clotting
    • Hormone secretion
    • Cell membrane integrity
    • Cardiac conduction
    • Transmission of nerve impulses
    • Muscle contraction
  9. Normal range for chloride range from _____.
    95 - 105 mEq/L
  10. ____ regulates many metabolic activities and is necessary for glycogen deposits in the liver and skeletal muscle, transmission and conduction of nerve impulses, normal cardiac conduction, and skeletal and smooth muscle contraction.
  11. The normal pH arterial blood ranges from ___.
    7.35 to 7.45
  12. Acid-base balance exists when _____.
    The rate at which the body produces acids or bases equals the rate at which acids or bases are excreted
  13. Factors that contribute to alterations in fluid are:
    • Trauma
    • Disease
    • Medication
    • Burns
    • Vomitting
    • Diarrhea
    • Inability to communicate fluid needs
  14. What is hyponatremia?
    It is a lower than normal concentration of sodium in the blood (serum).
  15. What is hypernatremia?
    It is a greater than normal concentration of sodium in the extracellular fluid.
  16. How can hypernatremia be caused?
    It can be caused by excess water loss or an overall sodium excess.
  17. True or False.

    When hypernatremia occurs, the body conserves as much water as possible through renal reabsorption.
  18. ____ is one of the most common electrolyte imbalances, in which an inadequate amount of potassium circulates in ECF.
  19. Name 2 common causes for hypokalemia.
    • Vomitting
    • Use of potassium-wasting diuretics
  20. What is the primary cause of hyperkalemia?
    Renal failure
  21. ____ represents a drop in total serum and/or ionized calcium. It results from illness, which directly affects the thyroid and parathyroid glands.
  22. Signs & symptoms of hyponatremia include:
    • Apprehension
    • Personality change
    • Postural hypotension
    • Postural dizziness
    • Abdominal cramping
    • Nausea and vomiting
    • Diarrhea
    • Tachycardia
    • Dry mucous membranes
    • Convulsions and coma
  23. Related causes of hyponatremia include:
    • Vomitting
    • Diarrhea
    • NG suction
    • Kidney disease
    • Adrenal insufficiency
    • Excessive perspiration
    • Burns
    • Psychogenic polydipsia
    • Syndrome of inappropriate ADH (SIADH)
  24. Related causes of hypernatremia include:
    • Water deprivation
    • Diabetes insipidus
    • Excess aldosterone secretion
    • Increases sensible & insensible water loss
    • Excess salt intake
  25. Related causes of hypokalemia include:
    • Polyuria
    • Extreme sweating
    • Diarrhea & vomitting
    • Alkalosis
    • Use of potassium-wasting diuretics
    • Excess aldosterone secretion
    • Treatment of diabetic ketoacidosis with insulin
    • Excessive use of potassium free IV solutions
  26. Signs & symptoms of hypokalemia include:
    • Weakness and fatigue
    • Muscle weakness
    • Nausea and vomiting
    • Intestinal distention
    • Decreased bowel sounds
    • Decreased deep tendon reflexes Ventricular dysrhythmias
    • Paresthesias and weak
    • Irregular pulse
  27. Related causes of hyperkalemia include:
    • Renal failue
    • Fluid volume deficit
    • Massive cellular damage such as from burns and trauma
    • Iatrogenic administration of large amounts of potassium intravenously
    • Adrenal insufficiency
    • Acidosis, especially diabetic ketoacidosis
    • Rapid infusion of stored blood
    • Use of potassium-sparing diuretics
    • Ingestion of K+ salt substitutes
  28. Signs & symptoms of hyperkalemia include:
    • Anxiety
    • Dysrhythmias
    • Paresthesia
    • Weakness
    • Abdominal cramps
    • Diarrhea
  29. Signs & symptoms of hypocalcemia include:
    • Numbness and tingling of fingers and circumoral (around mouth) region
    • Hyperactive reflexes
    • Positive Trousseau's sign (carpopedal spasm with hypoxia)
    • Positive Chvostek's sign (contraction of facial muscles when facial nerve is tapped)
    • Tetany
    • Muscle cramps
    • Pathological fractures (chronic hypocalcemia)
  30. Related causes of hypocalcemia include:
    • Pancreatitis
    • Vitamin D deficiecy
    • Alkalosis
    • Chronic renal failure
    • Chronic alcoholism
    • Hypoparathyroidism
    • Hypoalbuminemia
    • Rapid administration of blood transfusions causing citrate
  31. Related causes of hypercalcemia include:
    • Hyperparathyroidism
    • Osteoporosis
    • Osteometastasis
    • Paget's disease
    • Prolonged immobilization Acidosis
  32. Signs & symptoms of hypercalcemia include:
    • Anorexia
    • Nausea and vomiting
    • Weakness
    • Hypoactive reflexes
    • Lethargy
    • Flank pain (from kidney stones)
    • Decreased level of consciousness
    • Personality changes
    • Cardiac arrest
  33. True or False.

    Chloride imbalance is usually associated with sodium imbalance.
  34. _____ exist when water and electrolytes are gained or lost in equal proportions but osmolality remains unchanged.
    Isotonic deficit and excess
  35. The 4 main types of acid-base imbalances are:
    • Respiratory acidosis
    • Respiratory alkalosis
    • Metabolic acidosis
    • Metabolic alkalosis
  36. Respiratory acidosis is the result of ___.
  37. Electrolyte changes such as ___ & ___ may accompany respiratory acidosis.
    Hyperkalemia & hypercalcemia
  38. Compesation for metabolic acidosis is an ____.
    Increased CO2 excretion by the lungs with an increase in rate and depth of respiration.
  39. Name 2 causes for metabolic acidosis.
    • Severe diarrhea
    • Renal disease
  40. ____ is the result of the heavy loss of acid from the body or an increase in levels of bicarbonate.
    Metabolic alkalosis
  41. Name 2 common causes for metabolic alkalosis.
    • Vomitting
    • Gastric suctioning
  42. Risk factors for fluid & electrolyte, and acid-base imbalances include:
    • Age (very young & old)
    • Gender (women)
    • Environment (diet; exercise; hot weather and sweating)
    • Chronic diseases (cancer, diabetes, malnutrition, COPD, renal disease)
    • Trauma (burns, crush injuries)
    • Therapies (diuretics, steroids, IV therapy, TPN)
    • GI losses (fistulas, NG suctioning, gastroenteritis)
  43. Medications that cause fluid & electrolyte, and acid-base imbalances include:
    • Diuretics Metabolic alkalosis, hyperkalemia, and hypokalemia
    • Steroids: Metabolic alkalosis
    • Potassium supplements: Gastrointestinal disturbances, including intestinal and gastric ulcers and diarrhea
    • Respiratory center depressants (e.g., opioid analgesics): Decreased rate and depth of respirations, resulting in respiratory acidosis
    • Antibiotics: Nephrotoxicity (e.g., vancomycin, methicillin, aminoglycosides); hyperkalemia and/or hypernatremia (e.g., azlocillin, carbenicillin, piperacillin, ticarcillin, Unasyn)
    • Calcium carbonate (Tums): Mild metabolic alkalosis with nausea and vomiting
    • Magnesium hydroxide (Milk of Magnesia): Hypokalemia*
    • Nonsteroidal antiinflammatory drugs (NSAIDs): Nephrotoxicity
  44. Oral replacement of fluids is contraindicated when the client is ____.
    • Vomiting
    • Has a mechanical obstruction of the GI tract
    • Is at risk for aspiration
    • Has impaired swallowing
  45. The normal range for sodium is ____.
    135 to 145 mEq/L
  46. True or False.
    The body conserves potassium poorly, so any
    condition that increases urine output decreases the serum potassium
  47. Severe _____ produces marked cardiac conduction abnormalities.
  48. The normal serum ionized calcium is ______.
    4 to 5 mEq/L
  49. The normal total calcium is _____.
    8.5 - 10.5 mg/100mL
  50. How is magnesium regulated?
    • Dietary intake
    • Renal mechanisms
    • Actions of the parathyroid hormone
  51. Plasma concentrations of magnesium range from ______.
    1.5 - 2.5 mEq/L
  52. When serum _____ levels fall, the reabsorption
    of the bicarbonate ion occurs to maintain electrical neutrality
  53. True or False.
    Calcium and phosphate are inversely
    proportional; if one rises, the other falls.
  54. The normal serum level of Phosphate is ___.
    2.5 - 4.5 mg/100mL
  55. (1) is regulated by the lungs; ___(2) is a base regulated by the kidneys.
    • 1. Carbon dioxide (CO2)
    • 2. Bicarbonate

  56. Whenever carbon dioxide
    increases, there is an ____ in hydrogen ions produced.
  57. True or False.
    Whenever hydrogen ions are
    produced, there is more carbon dioxide produced.
  58. The two physiological buffers in the body are the ____ & ___.
    Lungs & the kidneys
  59. When the concentration of hydrogen ions is altered, the lungs ____.
    React to correct the imbalance by altering the rate and depth of respiration.
  60. When a client is ____ and uses up readily
    available oxygen, the reserve oxygen (oxygen attached to hemoglobin) is drawn
    upon to provide oxygen to the tissues.
  61. _____ is marked by a decreased PaCO2, and increased pH.
    Respiratory alkalosis
  62. _____ is marked by a decreased HCO3 and a decreased pH.
    Metabolic acidosis
  63. ____ is marked by an increased HCO3 and an
    increased pH.
    Metabolic alkalosis
Card Set
Fluid & Electrolytes II
nursing 200