Fluids, Electrolytes, and Acid-Base Balance Vocabulary Flashcards

A set of 90 vocabulary flashcards covering fluid balance, sodium, potassium, calcium, magnesium, and acid-base disorders strictly derived from lecture notes.

Fluid Volume Deficit Causes

GI losses, diuretics/laxatives, sweating/heat, hemorrhage, inadequate intake/NPO, and third spacing.

Fluid Volume Deficit Assessment Findings

Decreased weight, dry mucous membranes, decreased urine output, altered mental status, decreased skin turgor, decreased capillary refill, increased pulse, and decreased BP.

Fluid Volume Deficit Nursing Monitoring

Vital signs (VS), daily weights, intake and output (I&O), and laboratory values.

Hypovolemia IV Fluid Choice

Lactated Ringer's.

Fluid Overload Causes

Heart failure (HF), cirrhosis, renal failure, steroids, IV fluids, and postoperative fluid mobilization.

Fluid Overload Assessment Findings

Increased weight, cough, dyspnea, crackles, edema, bounding pulse, increased BP, and $S_3$.

Fluid Overload Nursing Interventions

Diuretics, fluid restriction, sodium-restricted diet, I&O, daily weights, and respiratory and cardiovascular assessments.

Isotonic Solution Cellular Effect

No net movement of water.

Hypotonic Solution Cellular Effect

Water moves into cells, causing cells to swell.

Hypertonic Solution Cellular Effect

Water moves out of cells, causing cells to shrink.

IV Potassium Administration Safety Example

$20\,\text{mEq}$ $\text{K}^+$ in $100\,\text{mL}$ fluid over $1\text{--}2\,\text{hours}$—never faster.

Normal Sodium Range

$$136\text{--}145\,\text{mEq/L}$$

Major Functions of Sodium

Fluid balance, nerve impulses, acid-base balance, and osmotic pressure ("Where sodium goes, water follows").

Hyponatremia Definition

$$\text{Na}^+ < 136\,\text{mEq/L}$$

Causes of Hyponatremia

Overhydration, liver/heart/kidney failure, inappropriate ADH, excessive $\text{Na}^+$ loss, diuretics, vomiting, diarrhea, and GI suction.

Neurological Findings of Hyponatremia

Confusion/altered mental status (AMS), headache, restlessness, seizures, and coma.

General Findings of Hyponatremia

Muscle cramps/weakness, fatigue, nausea/vomiting (N/V), anorexia, and drowsiness.

Hyponatremia Treatment (Sodium and Water Loss)

IV normal saline.

Treatment for Severely Low Sodium

Cautious $3\%$ or $5\%$ hypertonic $\text{NaCl}$, usually in intensive care.

Hyponatremia Treatment (Normal or Excessive Water)

Diuretics + fluid restriction.

Hypernatremia Definition

$$\text{Na}^+ > 145\,\text{mEq/L}$$

Causes of Hypernatremia

Dehydration, insufficient water intake, Cushing's disease, diabetes insipidus (DI), and primary aldosteronism.

Assessment Findings of Hypernatremia

Thirst/dryness, agitation, restlessness, confusion, lethargy, weakness, and seizures/coma.

Hypernatremia Treatment

Water replacement, diuretics, and dietary salt restriction.

Risk of Rapid Hypernatremia Correction

Rapid water movement can cause cerebral edema, permanent brain damage, or death.

Normal Potassium Range

$$3.5\text{--}5.0\,\text{mEq/L}$$

Primary Potassium Location

Inside cells — major intracellular cation.

Systems Affected by Potassium

Heart, GI tract, and skeletal muscle ("$\text{K}^+$ has a KICK").

Potassium-Rich Foods

Bananas, oranges, apricots, raisins, avocado, spinach, potatoes, tomatoes, milk, meat, fish, and nuts.

Hypokalemia Definition

$$\text{K}^+ < 3.5\,\text{mEq/L}$$

Causes of Hypokalemia

Diuretics, reduced intake, increased renal excretion, GI/biliary loss, and not taking prescribed $\text{K}^+$.

Cardiac Complications of Hypokalemia

Ventricular tachycardia (VT) and ventricular fibrillation (VF).

GI Findings of Hypokalemia

Nausea/vomiting (N/V), anorexia, constipation, and ileus.

Musculoskeletal Findings of Hypokalemia

Muscle weakness and leg cramps.

Hypokalemia Treatments

Oral $\text{K}^+$, dietary $\text{K}^+$, $\text{K}^+$ added to IV fluids, or IVPB potassium.

Hyperkalemia Definition

$$\text{K}^+ > 5.0\,\text{mEq/L}$$

Causes of Hyperkalemia

Acidosis, crush injuries/trauma, and decreased renal excretion.

First Indication of Hyperkalemia

Cardiac changes.

Cardiac Problems in Hyperkalemia

Dysrhythmias, heart block, asystole, and cardiac arrest.

Neuromuscular Findings of Hyperkalemia

Tremors/twitching, tingling/numbness leading to weakness and paralysis.

Hyperkalemia Treatments

Diuretics, calcium gluconate, $50\%$ glucose + insulin, Kayexalate, and dialysis.

Normal Calcium Range

$$9.0\text{--}10.5\,\text{mg/dL}$$

Main Functions of Calcium

Bone/tooth formation, blood clotting, muscle contraction, and nerve impulse conduction.

Requirement for Calcium Absorption

Active vitamin D.

Dietary Sources of Calcium

Dairy, spinach, broccoli, tofu, beans, almonds, and fortified foods such as orange juice.

Hypocalcemia Definition

$$\text{Ca}^{2+} < 9\,\text{mg/dL}$$

Causes of Hypocalcemia

Thyroidectomy/parathyroid removal, hypoparathyroidism, decreased albumin, decreased intake/absorption, severe respiratory alkalosis, pancreatitis, and renal failure.

Classic Hypocalcemia Findings

Tetany, positive Chvostek's sign, and positive Trousseau's sign.

Life-Threatening Respiratory Complication of Hypocalcemia

Laryngospasm leading to difficulty speaking/breathing.

Hypocalcemia Treatment

Oral calcium/dietary calcium or IV calcium.

Hypercalcemia Definition

$$\text{Ca}^{2+} > 10.5\,\text{mg/dL}$$

Causes of Hypercalcemia

Hyperparathyroidism, cancer, Paget's disease, prolonged immobilization, and hypophosphatemia.

Findings of Hypercalcemia

Fatigue, muscle weakness, decreased deep tendon reflexes (DTRs), constipation, ECG changes, and hypertension.

Hypercalcemia Treatment

IV normal saline (NS), diuretics, calcitonin, and bisphosphonates.

Normal Magnesium Range

$$1.8\text{--}2.6\,\text{mEq/L}$$

Functions of Magnesium

Regulates muscular contraction, neuromuscular control, and blood clotting; also helps with energy production and cell growth.

Dietary Sources of Magnesium

Green vegetables, grains, nuts, meat, and seafood.

Hypomagnesemia Definition

$$\text{Mg}^{2+} < 1.8\,\text{mEq/L}$$

Most Common Cause of Hypomagnesemia

Alcohol (ETOH).

Other Causes of Hypomagnesemia

Inadequate GI absorption/intake, renal disease, and overuse of diuretics.

DTR Response in Hypomagnesemia

Hyper-reactive deep tendon reflexes (DTRs) (increased).

Neuromuscular Findings of Hypomagnesemia

Tremors, tetany, numbness/tingling, muscle weakness, positive Chvostek's sign, and positive Trousseau's sign.

Hypomagnesemia Treatment

Dietary/oral replacement, IV magnesium sulfate, or addition of $\text{Mg}$ to total parenteral nutrition (TPN).

Hypermagnesemia Definition

$$\text{Mg}^{2+} > 2.6\,\text{mEq/L}$$

Classic Cause of Hypermagnesemia

Renal failure combined with magnesium-containing antacids or laxatives.

DTR Response in Hypermagnesemia

Deep tendon reflexes (DTRs) decrease and can eventually be lost.

Assessment Findings of Hypermagnesemia

Weakness, lethargy/CNS depression, respiratory depression, ECG changes, and hypotension.

Hypermagnesemia Reversal Agent

Calcium gluconate.

Other Hypermagnesemia Treatments

Stop magnesium-containing drugs, treat the cause, and dialysis.

Normal Blood pH Range

$$7.35\text{--}7.45$$

Normal PaCO2 Range

$$35\text{--}45\,\text{mmHg}$$

Normal HCO3- Range

$$22\text{--}28\,\text{mEq/L}$$

Organ Regulating CO2

Lungs.

Organs Regulating HCO3-

Kidneys.

Acidosis pH Threshold

$$\text{pH} < 7.35$$

Alkalosis pH Threshold

$$\text{pH} > 7.45$$

ROME Mnemonic Meaning

Respiratory Opposite, Metabolic Equal.

Respiratory Acidosis ABG Pattern

Decreased $\text{pH}$ and increased $\text{PaCO}_2$ ($\downarrow \text{pH} + \uparrow \text{PaCO}_2$).

Physiological Mechanism of Respiratory Acidosis

$\text{CO}_2$ is being retained.

Major Causes of Respiratory Acidosis

Hypoventilation/respiratory depression, opioids, benzodiazepines, sedation/anesthesia, airway obstruction, and inadequate chest expansion.

Assessment Findings of Respiratory Acidosis

Decreased respirations, anxiety, decreased level of consciousness (LOC), tachycardia, cyanosis, muscle weakness, hyporeflexia, and ECG changes.

Main Goal in Respiratory Acidosis Treatment

Improve ventilation and treat the cause.

Treatments for Respiratory Acidosis

Bronchodilators, respiratory stimulants, naloxone/flumazenil when indicated, oxygen, and assisted ventilation.

Nursing Rule for Anxiety in Respiratory Acidosis

Do NOT give sedation for anxiety.

Respiratory Alkalosis ABG Pattern

Increased $\text{pH}$ and decreased $\text{PaCO}_2$ ($\uparrow \text{pH} + \downarrow \text{PaCO}_2$).

Physiological Mechanism of Respiratory Alkalosis

Patient is blowing off too much $\text{CO}_2$ from hyperventilation.

Causes of Respiratory Alkalosis

Hyperventilation from anxiety/nervousness, pain, mechanical ventilation, CNS/brain-stem stimulation, and head injury.

Assessment Findings of Respiratory Alkalosis

Lightheadedness, paresthesias of lips/fingers/toes, twitching, anxiety, hypocalcemia, positive Chvostek's sign, and positive Trousseau's sign.

Body Compensation for Respiratory Alkalosis

$\text{HCO}_3^-$ drops.

Main Treatment for Respiratory Alkalosis

Treat the cause and slow the breathing rate; for ventilated patients, rate and/or tidal volume may be decreased.