Fluid and Electrolytes Lecture Notes Review

Flashcards covering fluid and electrolyte balance, including normal serum ranges, deficiency/excess symptoms, assessment techniques like the edema scale, and nursing interventions.

How is the movement of fluids through cell walls and vessel walls defined in the transcript?

Osmosis

How is diffusion defined in relation to fluid and electrolyte movement?

The movement from a higher concentration to a lower concentration.

What is the definition of a hypotonic fluid?

A fluid containing fewer particles compared to the amount of fluid.

What is the definition of a hypertonic fluid?

A fluid containing more particles than the amount of fluid.

What are the major cations listed in the transcript?

Sodium ($Na^+$), magnesium ($Mg^{2+}$), potassium ($K^+$), calcium ($Ca^{2+}$), and hydrogen ($H^+$).

What are the major anions listed in the transcript?

Chloride ($Cl^-$), bicarbonate ($HCO_3^-$), and phosphate ($PO_4^{3-}$).

What is the normal serum range for Sodium ($Na$)?

$$135-145\,mEq/L$$

What criteria defines hyponatremia?

A serum sodium level less than $135\,mEq/L$.

What are the signs and symptoms of hyponatremia?

Confusion, lethargy, weakness, muscle cramping, seizures, anorexia, nausea, vomiting, and a serum osmolality of $< 290\,mOsm/kg$.

What characterizes hypernatremia?

A serum sodium level greater than $145\,mEq/L$.

What are the signs and symptoms of hypernatremia?

Thirst, dry sticky mucous membranes, weakness, elevated temperature, confusion, irritability, decreased LOC, hallucinations, seizures, and a serum osmolality of $> 290\,mOsm/kg$.

What is the normal serum range for Potassium ($K$)?

$$3.5-5\,mEq/L$$

What are the signs and symptoms of hypokalemia?

Weak irregular pulse, fatigue, lethargy, anorexia, nausea, vomiting, muscle weakness and cramping, decreased peristalsis, hypoactive bowel sounds, paresthesia, and cardiac dysrhythmias.

What is a critical nursing precaution regarding the administration of Potassium ($K^+$)?

Never administer $K^+$ as an IV Bolus or IV Push.

What intervention is used in hyperkalemia to move potassium back into the cell?

Administering glucose and insulin.

What is the normal serum range for Calcium ($Ca$)?

$$9-10.5\,mg/dL$$

What are the specific physical signs associated with hypocalcemia?

Positive Trousseau's and Chvostek's signs.

What are the signs and symptoms of hypercalcemia?

Lethargy, stupor, coma, depressed deep muscle strength and tone, dysrhythmias, anorexia, nausea, vomiting, constipation, pathological fractures, and kidney stones.

What is the normal serum range for Magnesium ($Mg$)?

$$1.5-2.5\,mEq/L$$

What are the signs and symptoms of hypomagnesemia?

Neuromuscular irritability with tremors, disorientation, vertigo, confusion, increased reflexes, convulsions, positive Trousseau’s and Chvostek’s signs, tachycardia, elevated BP, respiratory difficulties, anorexia, and dysphagia.

What are the signs and symptoms of hypermagnesemia?

Warm flushed appearance, peripheral vasodilation, N/V, drowsiness, lethargy, generalized weakness, decreased deep tendon reflexes, hypotension, bradycardia, heart block, and respiratory depression or arrest.

In fluid assessment, what fluid volume is equivalent to a weight change of $1\,kg$ ($2.2\,lb$)?

$1\,L$ ($1000\,mL$) of fluid.

Describe the 3+ level on the pitting edema scale.

Obvious indentation of $6\,mm$ that lasts for several seconds.

Describe the 4+ level on the pitting edema scale.

Deep indentation of $8\,mm$ that remains for several minutes.

What does 'tented' skin during a turgor assessment indicate?

Fluid volume deficit.

How should fluid intake be distributed for a client on a fluid restriction?

Use $50\%$ of the fluid amount during the day when the client is most active and consumes two meals, with the remainder divided between meals and medication administration.

What are the physical signs and symptoms of IV infiltration?

Swelling, tenderness, coolness, firmness of the extremity, and blanching of the skin.

According to the infiltration scale, what characterizes a Grade 4 severity?

All lower grade symptoms plus tight, leaking skin, deep pitting edema, circulatory impairment, and moderate to severe pain (typically considered extravasation).

What is the difference between crystalloid and colloid IV solutions?

Crystalloids are divided by tonicity (hypo, iso, hyper), while colloids contain protein or starch particles that remain in the vessel to re-establish circulating volume and oncotic pressure.