Fluids and Electrolytes Study Guide

Flashcards covering key principles and concepts from the Fluids & Electrolytes Study Guide.

What key principle governs the movement of water?

Water always moves from an area of less concentration to an area of more concentration.

What kind of forces are CHP and COP?

CHP = inside capillary forces that push fluids OUT into INTERSTITIAL SPACE

COP = albumin concentration pulling fluids back IN to BLOOD

Where are the forces located?

CHP = pressure build up on ARTERIOLE end

COP = albumin concentration on VENULE end

What drives colloid hydrostatic pressure?

Heart/Cardiovascular system

What are the differences between IHP and IOP?

IHP = interstitial space drives fluids back IN to blood

IOP = albumin in tissues pulls fluids OUT

What are the factors that influence fluid balance?

Age

sex

weight

hormone levels

High-risk factors

How do renin, angiotensin and aldosterone (RAAS) regulate sodium and water balance?

Renin (kidneys) → Angiotensin II (in blood/lungs, vasoconstrictor) → stimulates production of aldosterone (adrenal gland)→ ELEVATES BP

When are hypotonic solutions commonly used?

• cellular dehydration

• hypernatremia

• T2D

• CKD (T1D)

Which hormones are listed in relation to calcium (Ca) regulation?

PTH and calcitonin.

Which two conditions are listed to compare and contrast at the end of the study guide?

SIADH and DI.

what fluid/electrolyte imbalances are caused by vomiting/diarrhea?

hypovolemia

hyponatremia

hypomagnesia

what fluid/electrolyte imbalances are caused by diuretics?

hypovolemia

hyponatremia
hypokalemia
hypomagnesemia

hypocalcemia

hypercalcemia

what fluid/elctrolyte imbalances are caused by antibiotics?

hypokalemia

hypomagnesia

what fluid/electrolyte imbalances are caused by an increase in aldosterone?

hypokalemia

hypernatremia

hypervolemia

what fluid/electrolyte imbalances are caused by insulin use?

hypokalemia
hypomagnesemia

When should hypotonic fluids not be used?

ICP or severe head injury, as they may worsen cerebral edema.

What cautions should nurses take when delivering isotonic and hypotonic fluids?

• give slowly

• monitor for hypovolemia

• assess for liver disease/trauma hx

when are isotonic fluids commonly used?

• dehydration

• heavy blood loss

what cautions should nurses take when giving hypertonic fluids?

• give slowly

• monitor for fluid overflow that can cause:

  • bounding pulses

  • ↑ BP

when are hypertonic fluids commonly used?

• hypovolemia

• heat exhaustion

Hypovolemia is due to:

hypervolemia is due to:

What are the causes of hypovolemia?

• fluid loss from ANYWHERE

• polyuria = diabetes, diuretics, diaphoresis

• GI loss = diarrhea, vomiting

What are the causes of hypervolemia?

• heart failure

• kidney failure

• hypernatremia

• high salt/water intake

• SIADH

What are symptoms of hypovolemia?

• ↓ BP, weight loss, skin turgor, urine output

• ↑ HR = tachycardia

• dizziness

• weakness

• thirst

What are the symptoms of hypervolemia?

• ↑ BP, HR, weight, edema

• altered mental state

• intense thirst

What is the best treatment for hypovolemia?

fluid replacement

What are the best treatments for hypervolemia?

• diuretics

• low salt diet

What is ADH?

• antidiuretic hormone

• water retainer

• hormone promoting anti-peeing

what happens when there is too little ADH in the body?

The body experiences increased urine output, leading to higher fluid loss and potential dehydration, a condition known as diabetes insipidus.

what happens when there is too much ADH in the body?

The body retains excessive water, leading to decreased urine output, dilution of blood electrolytes, and a condition called SIADH.

what is aldosterone and how is it related to hypervolemia?

Aldosterone is a hormone produced by the adrenal glands that regulates sodium and water balance. In cases of hypervolemia, aldosterone secretion can increase to promote sodium reabsorption, leading to further fluid retention and exacerbating the volume overload.

What are the causes of hyponatremia?

• fluid Drainage —> SIADH issue —> ↓ fluid retention

• Diaphoresis —> water intoxication —> excessive sweating

• Diarrhea/vomiting —> hypovolemia

• Diuretic use —> effects kidneys —> ↑ peeing

• Drug use —> effects ADH —> ↓ fluid retention

What treatment therapies can help hyponatremia?

• mild cases

  • salt tabs

  • isotonic fluids

• medium cases

  • adkust diuretics

  • water restriction

• severe cases

  • hypertonic fluids

what interventions should nurses remember when treating hyponatremia?

• consider All treatment types

• monitor Diuretics/Dialysis

• Daily weight suggestions

• Safety of osmo demyelination (cardiac arrest)

• Airway precautions

• Limit water intake

• Teach about diet

what are the causes of hypernatremia?

• Big and Bloated

  • ↑ weight

  • ↑ BP

  • bounding HR

  • cardiac disrhythmia

• Loss of fluids

• ADH insufficiency

• Sodium excretion impaired

• Too much salt intake

• Diabetes insipidus

• Increased water loss (sweating)

• Vitamin/sodium supplement abuse

• ↑ Aldosterone

What type of patients are at high risk of developing hypernatremia?

• infants/elderly who can’t drink voluntarily

• critically ill patients

• kidney failure hx

• brain lesions of hypothalamus

what treatment therapies can help hypernatremia?

• treat and prevent dehydration

• hypotonic solutions

• diuretics

• sodium restriction

what interventions should nurses consider when treating hypernatremia?

• Monitor severe signs

• Avoid too much Na+ intake

• monitor specific Gravity

• IV fluids as needed

• Cardiac monitoring

What are the causes of hypokalemia?

• GI loss —> vomiting/diarrhea

• Osmotic diuresis —> increased kidney excretion

• Thiazide/loop diuretics —> ↓K+

• Severe acid imbalance = metabolic alkalosis

• Hyperaldosteronism = ↓H+ and ↓K+

• Other meds: antibiotics, corticosteroids —> ↑K+ excretion

• Transcellular shifts = insulin ECF to ICF

what are the severe symptoms of hypokalemia?

• Skeletal muscle weakness

• U-wave EKG changes

• Constipation

• drug related Toxicity

• Irregular pulse

• Orthostatic hypotension

• Numbness = parathesias

What treatment therapies can help hypokalemia?

mild cases

• ↑ dietary K+

medium cases

• oral potassium chloride taken w/ food

severe cases

• IV potassium chloride given slowly

What interventions should nurses consider when treating hypokalemia?

• IV must be diluted

• NEVER PUSH IV —> cardaic arrest

• avoid overshooting K+ treatment

what are the causes of hyperkalemia?

• Blood transfusions —> ↑K+ out to ECF

• Increased K+ intake

• Overdose of IV K+

• Medications: beta-blockers, antibiotics

• Acidosis (metabolic) —> ↑K+ out to ECF

• Tissue damage (severe) —> ↑K+ out to ECF

what type of patients are at high risk of developing hyperkalemia?

• kidney disease history

• undergoing chemotherapy

What are treatment therapies for hyperkalemia?

• low K+ diet

• glucose/inuslin infusion

• K+ binding meds

• loop/thiazide diuretics

• calcium IV

• dialysis

What interventions should nurses consider when treating hyperkalemia?

• Monitor EKG

• Diet education = low salt, fruits, leafy greens

• Kayexalate causes diarrhea

• IV sodium bicarb and calcium gluconate

• Diuretics and Dialysis

What are the causes of hypocalcemia?

• Chronic kidney disease

• Acute pancreatitis —> poor Ca2+ absorption

• Low albumin, Mag, Vit D, parathyroidism

• Malnutrition —> ↓ vit D

• Drug use: anticonvulsants, chemotherapy

• Alkalosis (metabolic)

• Severe burns —> sepsis

• Hyperphosphatemia = ↑phosphate —> ↓Ca2+

what patients are at high risk for developing hypocalcemia?

• menopausal women

• breastfeeding women

• kidney failure history

• low sunlight exposure

what are treatment therapies for hypocalcemia?

• oral Ca2+ and Vit D

• IV Ca2+

• Mg+ repletion

What interventions should nurses consider when treating hypocalcemia?

• Foods high in Ca2+

• Administer Ca2+ meds

• Seizure precautions

• Teach about diet

What are causes of hypercalcemia?

• hyperparathyroidism —> ↑ PTH excretion

• Cancer —> malignant cells destroy bones

what patients are at high risk for developing hypercalcemia?

• taking antacids = excess Ca2+

• thiazide diuretic use = ↓Ca2+ excretion

• taking Vit D or A

what are treatment therapies for hypercalcemia?

• hydrate (orally or IV)

• ↓Ca2+ dietary and med intake

• loop diuretics

• dialysis

what interventions should nurses consider when treating hypercalcemia?

• Safety (monitor falls)

• Loop diuretics

• IV phosphates

• Monitor EKG

• Fluids (normal saline)

• Avoid high Ca2+ diet

• Severe cases = dialysis

• Treatment w/ Ca2+ reabsorption substances

What are the causes of hypomagnesemia?

• GI loss: diarrhea/vomiting

• Alcohol abuse

• Malabsorption

• Poor diet

• Hemodialysis —> ↑ other ions —> ↓ Mg+

• Use of thiazide/loop diuretics

• Sepsis —> healing requires high Mg+ —> ↓ Mg+

• Kidney disease: aldosteronism, DKA, hyperparathyroidism

What patients are at high risk of developing hypomagnesemia?

• young mothers

• antibiotic use

• cyclosporine use

• laxative use

• insulin

what treatment therapies can help hypomagnesemia?

diet and supplements

• Chocolate

• Avocado

• Milk

• Pork, peas, peanut butter

• Oranges

• Nuts

• Bananas

What interventions should nurses taking when treating hypomagnesemia?

• Teach about diet

• Adverse effects

  • neuromuscular blockade

  • AV node suppression

  • respiratory paralysis

  • cardiac arrest

• IM/IV administration SLOWLY

• Safety with swallowing

what are causes of hypermagnesemia?

• Continuous Mg+ infusions

• Renal failure —> kidney issue w/ excreting Mg+

• Antacid use

• K+ excess

what treatment therapies help with hypermagnesemia?

• increase fluids —> ↓ Mg+ when peed

• if kidney failure history = dialysis

• if emergency = IV gluconate

what interventions should nurses consider when treating hypermagnesemia?

• Hemodialysis

• Avoid antacids/laxatives

• Monitor EKG and labs