Q14 LFGFGGG

What makes up intracellular fluid ?

Fluid inside body cells; about 2/3 of total body water

What makes up extracellular fluid?

Plasma, interstitial fluid, lymph, and transcellular fluids

What is fluid volume deficit ?

Loss of both water and electrolytes causing decreased circulating blood volume hypovolemia

What is fluid volume excess ?

Excess retention of sodium and water in equal proportions (hypervolemia)

What are compensatory mechanisms for dehydration?

Thirst, ADH and aldosterone release

What is a major risk of severe dehydration?

Hypovolemic shock and seizures

What GI conditions can cause FVD?

Vomiting, diarrhea, NG suction

What renal causes lead to FVD?

Diuretics, kidney disease, adrenal insufficiency

What skin related cause leads to FVD?

Excessive diaphoresis (sweating)

What is third spacing?

Fluid shifts into nonfunctional spaces (e.g., burns)

What is a major cause of FVD from intake issues?

NPO status, anorexia, nausea, confusion

What vital sign changes occur in dehydration?

Tachycardia, hypotension, hypothermia hypovolemia , tachypnea

What skin findings occur in dehydration?

Poor skin turgor, dry mucous membranes, cool skin, sunken eyes capillary refill

What urinary finding occurs in dehydration?

Oliguria (low urine output)

What neuro signs occur in dehydration?

Confusion, dizziness, weakness, possible seizures

What lab change is seen in dehydration?

Increased Hct, increased Na+, increased BUN, increased urine specific gravity

What is fluid volume excess ?

Excess isotonic retention of sodium and water

What can severe FVE lead to?

Pulmonary edema and heart failure

What are cardiovascular signs of FVE?

Hypertension, bounding pulse, tachycardia, increased CVP

What respiratory signs occur in FVE?

Crackles, dyspnea, orthopnea

What physical signs occur in FVE?

Edema, JVD, weight gain

What lab finding occurs in FVE?

Decreased hematocrit and low urine specific gravity

What is a key nursing position for FVE?

Semi Fowler’s position

What is sodium’s main role?

Fluid balance, nerve conduction, muscle function

What is hyponatremia?

Sodium less then 136 mEq/L

What causes hyponatremia?

Excess water, SIADH, diuretics, GI loss, NPO

What happens in hyponatremia neurologically?

Brain cell swelling → confusion, seizures, coma

What is hypernatremia?

Sodium over 145 mEq/L

What causes hypernatremia?

Water loss or sodium excess (dehydration, DI, hypertonic IV fluids)

What does hypernatremia do to cells?

Pulls water out → cellular dehydration

What is potassium’s main role?

Cardiac function, nerve impulses, muscle contraction

What is hypokalemia?

Potassium less 3.5 mEq/L

What causes hypokalemia?

Diuretics, vomiting, diarrhea, NG suction, insulin, alkalosis

What ECG changes occur in hypokalemia?

U waves, flat T waves, ST depression, PVCs

What are symptoms of hypokalemia?

Weakness, cramps, constipation, arrhythmias

What is hyperkalemia?

Potassium > 5.0 mEq/L

What causes hyperkalemia?

Kidney failure, ACE inhibitors, acidosis, cell breakdown, potassium intake

What ECG change is seen in hyperkalemia?

Peaked T waves, widened QRS

What is the biggest risk of hyperkalemia?

Cardiac arrest

What is the priority treatment for hyperkalemia?

Stop K+, IV insulin + dextrose, calcium gluconate, dialysis if severe

What does calcium regulate?

Bones, muscle contraction, clotting, nerve function

What is hypocalcemia?

Calcium lower than 9 mg/dL

What causes hypocalcemia?

Thyroidectomy, low vitamin D, malabsorption, pancreatitis, alkalosis

What are signs of hypocalcemia?

Tetany, tingling, Chvostek’s sign, Trousseau’s sign

What is Chvostek’s sign?

Facial twitch when facial nerve is tapped

What is Trousseau’s sign?

Carpal spasm from BP cuff inflation

What is hypercalcemia?

Calcium higher than 10.5 mg/dL

What causes hypercalcemia?

Hyperparathyroidism, bone cancer, thiazides

What are symptoms of hypercalcemia?

Bone pain, constipation, lethargy, shortened QT

What is hypomagnesemia?

Magnesium lower than 1.3 mEq/L

What causes hypomagnesemia?

Alcohol use, diarrhea, diuretics, malnutrition

What are signs of hypomagnesemia?

Tremors, tetany, seizures, hyperactive reflexes

What is hypermagnesemia?

Magnesium higher 2.1 mEq/L

What causes hypermagnesemia?

Kidney failure, magnesium

What are signs of hypermagnesemia?

Low BP, bradycardia, respiratory depression, lethargy

What is a severe complication of hypermagnesemia?

Cardiac arrest

What is normal sodium range?

136–145 mEq/L

What is normal potassium range?

3.5–5.0 mEq/L

What is normal calcium range?

9–10.5 mg/dL

What is normal magnesium range?

1.3–2.1 mEq/L

What indicates dehydration in urine specific gravity?

1.030

What indicates overhydration urine specific gravity?

< 1.010

What should you expect with a patient with hypercalcemia?

Muscle weakness, decreased reflexes, constipation, nausea, lethargy, confusion, and cardiac dysrhythmias

Which patient could be at risk for fluid volume excess (FVE)?

Patients with heart failure, kidney failure, liver disease, or excessive IV fluid administration

If you have a patient with hypocalcemia, what can you do to help the patient?

Administer calcium supplements as prescribed, monitor cardiac status, and encourage calcium rich foods

If you have a patient with hypocalcemia, what is your priority action?

Assess airway and monitor for tetany, seizures, and laryngeal spasms

Which lab value shows a patient is experiencing fluid volume excess?

Decreased hematocrit and decreased serum sodium due to hemodilution

What are interventions for a patient with hyponatremia?

Restrict fluids if indicated, administer sodium replacement, monitor neurological status, and seizure precautions

If a patient has hypernatremia, what should you do?

Encourage or administer fluids as prescribed and monitor neurological status urinary output no sodium hypotonic

What signs show hyperkalemia in lab results?

Serum potassium greater than 5.0 mEq/L and ECG changes such as peaked T waves

If you have a patient with hypernatremia, what symptoms should you expect?

Thirst, dry mucous membranes, confusion, restlessness, and seizures

If a patient has hyperkalemia, what foods should they stay away from?

Bananas, oranges, potatoes, tomatoes, avocados, spinach, and dried fruits

What is teaching for a patient with dehydration?

Increase fluid intake, monitor urine output, avoid excessive caffeine, and recognize signs of worsening dehydration

If you have a patient with excess fluid volume, what are the interventions?

Restrict fluids and sodium, monitor daily weight, administer diuretics, and assess lung sounds semi fowlers

If giving a patient fluid therapy, what indicates it is working?

Improved blood pressure, increased urine output, moist mucous membranes, and decreased heart rate

What are indications that treatment for hypocalcemia is working?

Normal calcium levels, decreased muscle cramps, absence of tetany, and improved neuromuscular function

What should a nurse know when educating a patient with fluid volume deficit?

Drink adequate fluids, monitor for dizziness, change positions slowly, and report decreased urine output

If a patient is overhydrated, what will we see and what intervention will we be doing?

Edema, weight gain, crackles, and hypertension; implement fluid restriction, administer diuretics, and monitor respiratory status

What are interventions for a patient taking a potassium wasting diuretic who develops hypokalemia?

Monitor potassium levels, provide potassium supplements as prescribed, encourage potassium rich foods, and monitor cardiac rhythm