Exam (elaborations)
FLUID AND ELECTROLYTE IMBALANCE EXAM 1
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FLUID AND ELECTROLYTE IMBALANCE EXAM 1...
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Normal lab values for sodium - ANSWER 135-145 mEqNormal lab values for potassium - ANSWER 3.5-5.0 mEq
Normal lab values for calcium - ANSWER 8.5-10.5 mg/dL
Normal lab values for phosphorus - ANSWER 2.4-4.4 mEq
normal lab values for Cl - ANSWER 96-106 mEq
normal lab values for magnesium - ANSWER 1.7-2.7 mEq
Which has more fluid in the body? adult or infant - ANSWER infant
males or females have more fluid in their body? Why? - ANSWER males,
because water is in muscles not fat
Which has more fluid? ICF or ECF? - ANSWER ICF
Volume problems mainly affect what area? Osmolarity problems affect what? -
ANSWER heart; brain- CNS
,Treatment of hypovolemia - ANSWER 1. oral rehydration
2. IV replacement with Lactated Ringers or isotonic NaCl (0.9% or normal
saline) or blood
Treatment for hypervolemia - ANSWER 1. give diuretics
2. fluid restriction
3. abdominal para-or thoracentesis
Treatment for hyponatremia - ANSWER 1. restrict fluids
2. Give lactated ringers or normal saline IV fluid
3. administer 3 or 5% NaCl IV solutions slowly (only ICU setting)
4. administer loop diuretics to decrease water or withhold diuretics
5. administer oral rehydration fluids with electrolytes
treatment for hypernatremia - ANSWER 1. dilute the sodium concentration
2. administer IV D5W or 0.4% NaCl
3. restrict sodium intake
4. administer free water
5. administer diuretics to excrete sodium
Fluid volume deficit does what to BUN, Na, and hct? - ANSWER increases
Fluid volume excess does what to BUN, Na, and hct? - ANSWER decreases
,If a patient has a fluid imbalance as a nurse you should assess what? -
ANSWER 1. daily weigh
2. I & O
3. lung sounds
4. vital signs
5. monitor lab results for BUN, Na, and hct
6. assess neurological changes
7. assess skin
treatment for hypokalemia - ANSWER 1. administer potassium orally or IV
(drip only)
-Lidocaine for pain
-Liquid potassium by mouth can cause GI lesions
treatment for hyperkalemia - ANSWER 1. stop/limit potassium intake
2. dialysis
3. Kayexalate - a cation exchange resin given orally or rectally to bind with
potassium
4. force potassium from ECF to ICF with IV insulin with dextrose- causes
increase potassium intake at cellular level, beta adrenergic agonists, NaHCO3-
moves Na into cells
5. stabilize cardiac membranes with IV calcium chloride or gluconate - types of
calcium
6. monitor EKG
sign to test for hypocalcemia in which you tap on facial nerve leading to facial
contractions - ANSWER Chvostek's sign
, sign to test for hypocalcemia in which you inflate BP cuff above systolic bp
leading to carpal spasms - ANSWER Trousseau's sign
treatment for hypocalcemia - ANSWER 1. oral or IV calcium
2. promote CO2 retention- to control muscle spasms
treatment for hypercalcemia - ANSWER 1. IV or oral fluids with normal
saline - flushes out excess calcium
2. IV phosphorus- opposes calcium
3. Calcitonin- decreases calcium
4. Biphosphonates- impede bone resorption
5. low calcium diet
6. dialysis
7. mobilization- increases bone mineralization
Name the two electrolytes that are reciprocals? - ANSWER Calcium and
potassium
clear IV solutions - ANSWER crystalloids
blood and blood products IV - ANSWER colloids
3 categories of IV solutions- definition, osmolality, and types - ANSWER 1.
hypertonic: causes cells to shrink
-<250
-0.45% NaCl (normal saline); D5W in patient
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