Fluid and Electrolyte Study guide Term II PDF

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Unitek College study guide or assignment term II LPN program Reno 2022
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Fluid and Electrolyte Tutorial (instructure.com)

1A. What is Hypovolemic? Hypovolemic shock is an emergency condition in which severe blood or other fluid loss makes the heart unable to pump enough blood to the body. This type of shock can cause many organs to stop working

1B. What should treatment focus on when a patient is hypovolemic?

Extracellular fluid deficit and encouraging fluid intake

2. Is The body’s ability to maintain constant conditions in the fluid compartments is acidbase balance? No-Homeostasis is a dynamic equilibrium that is maintained in body tissues and organs.. Your blood needs the right balance of acidic and basic (alkaline) compounds to function properly. This is called the acid-base balance. Your kidneys and lungs work to maintain the acid-base balance.

3. How does the healthy kidney adjust the volume and composition of filtrate that prevents excessive fluid loss?

Tubular reabsorption 4. 1 liter of fluid (water) weighs __________.

1 kg 5. What manifestation will you likely see in dehydration of any cause?

Increased laboratory values of hemoglobin and hematocrit

6. ANF= Atrial natriuretic factor

The ANF is responsible for water reabsorption in the capillaries, concentrated urine and

False. It increases excretion and dilutes urine,

reduced excretion.

FYI-Atrial natriuretic factor (ANF) is a 28 amino acid polypeptide hormone secreted mainly by the heart atria in response to atrial stretch. ANF acts on the kidney to increase sodium excretion and glomerular filtration ratio, to antagonize renal vasoconstriction, and to inhibit renin secretion

7. Patient has a sodium level of 155 mEq/L. The nurse would expect to see all of the following but_

Hypertension

You would expect to potentially see decreased level of consciousness/Rationale increased thirst with dry, sticky mucous membranes, hot, dry skin; fever; and decreased sweating. 8. ABG test revealed the following: pH = 7.30; PaCO2 = 62 mm Hg; HCO3 = 24mEq/L. This indicates….

respiratory acidosis

9. Prolonged NG tube suction or excessive vomiting can lead to?

Metabolic alkalosis 10.The movement of particles from a higher to lower concentration. Ex. oxygen leaves arteries and goes to the capillaries Diffusion 11.Potassium is primarily responsible for maintaining extracellular fluid osmolarity?

False

It is Sodium (NA+) that maintains osmolarity

Potassium is primarily in the intracellular fluid Sodium is primarily in the extracellular fluid.

12.

What process is responsible for the regulation of the balance between positive

and negative ions.

Diffusion

13.What process is often associated with hyperchloremia?

Metabolic acidosis Normal sodium (Na+) serum levels between 135 and 145 milliequivalents per liter

According to the Mayo Clinic, a normal range of potassium (K+) is between 3.6 and 5.2 millimoles per liter (mmol/L)

A normal serum calcium (Ca++) level is 8-11 mg/dL Or (2-2.75 mmol/L) when calculated in moles. Bicarbonate (HCO3−) 23 to 30 mEq/L Chloride (CL-) 96 to 106 milliequivalents per liter (mEq/L) or 96 to 106 millimoles per liter (millimol/L).

Here’s a 2nd slightly different set of normal values Just to confuse us all

Sodium 136-146 mEq/L (136-146 mmol/L) NA+ Chloride

96-106 mmol/L

(CL-)

Potassium 3.5-4.5 mEq/L (3.5-4.5 mmol/L) (K+)

Bicarbonate(HCO3−) 22-29 mEq/L (23-29 mmol/L)

Electrolytes are minerals that break up in the body to smaller particles called ions. Which ions are positively charged? Cations Sodium (Na+) Potassium (K+) Calcium (Ca2+) Magnesium (Mg2+)

Which ions are negatively charged?

Anions

Chloride (Cl-) Bicarbonate (HCO3-) Phosphate (HPO4-)

What maintains the osmoality of extracellular fluid ? Sodium is the ion that primarily maintains extracellular fluid osmolality What does a higher osmotality mean? A higher osmolality means there is a higher concentration of a solute in the water because the solution contains less water.

Excess fluid volume can cause many issue. In paticular it can cause ? 

heart failure and pulmonary edema.

Nursing considerations for potassium (Hypokalemia low K+) (hyperkalemia high K+) Potassium and high or low levels can have great effect on myocardial cells and can cause abnormal and potentially fatal heart rhythms. Encouraging supplemental K in the diet is a nursing educational aspect and can educate on Bananas, orange juice, spinach, fish avocados, melons

Nursing considerations for high sodium (Hypernatremia) Hypernatremia can be controlled with education to decrease sodium in the diet, preserved and processed foods are high in sodium

How do the kidneys reasorb water and solutes? Tubular reabsorption What is ADH? Antidiuretic hormone What does ADH do? It limits urine output. Increase water volume raises B/P

What is ANF? Atrial natriuretic factor  What does ANF do? Stimulates excretion of sodium and water by the kidneys  Decreased synthesis of renin  Decreased release of aldosterone and vasodilation  Reduces blood volume to lower blood pressure

How can fever negatively impact fliud and elecrtolyte balance? It can cause a dehydration risk What it tenting? Skin folded on back of hand is slow to unfold. What does tenting indicate? It indicates dehydration

What is the normal pH of urine? 4.6-6.8 Specific gravity? 1.016-1.022 Osmolarity? 250-1200 this can depict if the client is dehydrated if gravity is high

What can cause higher Serum hematocrit - both deficient fluid volume and dehydration can raise hematocrit

With the elderly, constipation can typically be the first sign of …….? Dehydration Co2 or bicarb can have abnormal levels and yet the PH will be in the normal range. What is this called? Compensated acid base imbalances With acid -base imbalances especially when severe require the nurse to….

Perform frequent assessments to neuro and mental status

CONDITION

Cause

pH (7.357.45)

HCO3- (21-28 mEq/L or SI 21-28 mmol/L

PaCO2 (35-45 mm Hg or SI 4.7-5.3 kPa)

Respiratory acidosis Respiratory alkalosis

Hypoventilation

Lower

Normal

Higher

Hyperventilation

Higher

Normal

lower

Metabolic acidosis

Diabetic ketoacidosis Lactic acidosis Diarrhea Renal insufficiency Vomiting HCO3- retention Volume depletion K+ depletion

Lower

lower

Normal

Higher

Higher

Normal

Metabolic alkalosis

How does the body naturally maintain a proper acid-base ? Blood buffers, lungs and kidneys are the main systems that work together to keep the PH in the normal range , any pt condition that would decrease respirations can lead to respiratory acidosis Which body fluids are responsible for transport of nutrients and wastes? Extracellular fluid is mainly responsible for the transport of nutrients and wastes throughout the body.

What is the transfer of water and solutes through a membrane from an area of high pressure to an area of lower pressure. Filtration...