NUR 453 Role Transition Exam 1 Study Guide All Latest Material.

Role Transition Exam 1 Study Guide Unit 1 - Fluid and Electrolytes Major intracellular electrolyte – K Major extracellular electrolyte – Na Maintaining Fluid and Electrolyte Balance ● RAAS – senses hypotension o Vasoconstriction o Aldosterone – Na retention o ADH – H2O retention ▪ Elevated w/ stroke tumor and TBI o Increase blood flow to vital organs Serum Values - Na: 135 to 145 milliequivalents per liter (meq/L). - K: 3.5 to 5.0 mEq/L - Cl: 95 to 105 mEq/L - Mg: 1.5 to 2.5 mEq/L - PO4: 2.8 to 4.5 mg/dl - Ca: 8.5 to 10.5 mg/dl Maintaining Fluid and Electrolyte Balance - Kidneys - Play a major role in controlling all types of balance in fluid and electrolytes - Adrenal glands - How do they help regulate water balance? - Through secreting aldosterone – reabsorb sodium / regulates amount of sodium reabsorbed by the kidneys. - Antidiuretic hormone (ADH) - How does it help regulate water balance? - hold on to water – increase in adh – sodium level goes down - Solutions ● Isotonic – fluid remains intravascular o ONLY fluid that can be used for bolus o NS, Lactated Ringers o equal to plasma, NS and lactated ringers .. Give to replace volume in vascular space and low blood volume ● Hypotonic – fluid shifts intracellular → pts with dehydration o Can cause cell rupture o 1/2 NS, D5W o lower tonicity than plasma – d5w, 0.45NS, cant bolus with it bc it’ll cause increase cerebral pressure / cerebral edema. Cause cell to burse .. Give to pts who are dehydrated. ● Hypertonic – fluid shift intravascular → pts w/ fluid overload or ICP o Dehydrates cells/cell shrinkage o Creates osmotic diuresis – DKA, hyperglycemia o 3% NS, combination fluids (ex: D5 ½ NS) o d51/2, manitol, give when you want to dehydrate the cells and dump into vascular space to be exreted. Give to those with increased ICP o ● Colloid o Plasma expanders o Pull fluid from interstitial compartment into vascular compartment o Increases vascular volume rapidly