Fluid Balance
These losses can be measured and include fluid lost during urination, defecation, and wounds.
What are sensible losses?
The value for normal serum (blood) osmolarity
What is 280-300 mOsm/kg?
Patients with this condition have greater water loss than electrolyte loss. Assessment findings include thirst, dry flushed skin, ↓BP, fever, confusion, ↑HR, ↓U/O, ↓ weight, tenting, thready pulse, flat neck veins. Lab values include ↑HCT, BUN, urine SG >1.030 and ↑Na+, serum osmolality >295
What is clinical dehydration?
Patients with clinical dehydration need this type of solution.
What is hypotonic solution?
The type of IV fluid that might be of benefit to a client with a low serum albumin level.
What is hypertonic?
These losses cannot be measured or seen and include fluid lost from evaporation through the skin and as water vapor from the lungs during respiration.
What are insensible losses?
This is the normal value for albumin, a serum protein synthesized by the liver.
3.5-5
↑ Hematocrit (>45% for women and >50% for men), ↑ BUN >25, and ↑ urine specific gravity greater than 1.030 are lab values that indicate this type of fluid imbalance.
What is isotonic fluid imbalance?
Patients with fluid volume deficit are treated with this kind of IV solution.
What are isotonic solutions?
A nurse is caring for a group of patients. The patient with which problem would the nurse identify is at high risk for fluid volume excess?
1) Renal failure
2) Vomiting
3) Hypernatremia
4) NPO for surgery
What is 1) Renal failure?
The major way fluids are transported in which water shifts from low solute concentration to high solute concentration to reach homeostasis.
What is osmosis?
This is the value for normal sodium.
What is 135-145 mEq/L?
Nursing interventions for this type of fluid imbalance include monitoring CV, resp, renal systems; restoring normal fluid balance; drug therapy with furosemide, diet therapy; decrease Na⁺; fluid restriction; monitoring I&O; monitoring weights and electrolytes; patient education.
What is fluid volume overload?
This is a hypotonic solution that provides Na+, Cl–, and free water. It is used as a basic fluid for maintenance needs, and often used to treat hypernatremia (because this solution contains a small amount of Na+, it dilutes the plasma sodium while not allowing it to drop too rapidly).
What is 0.45% normal saline?
The nurse is reviewing the medical record of the client. The nurse should identify which of the following findings is a risk factor for the development of hypocalcemia?
1) Bariatric surgery
2) Diarrhea
3) Thyroid cancer
4) Diabetes mellitus
5) Hyperlipidemia
What is 1) Bariatric surgery, 2) Diarrhea, and 3) Thyroid cancer?
Cells placed in this type of solution will shrink as water flows out of cell.
What is a hypertonic solution?
This is the normal range for urine specific gravity.
What is 1.010-1.030?
This type of electrolyte deficiency results from decreased intake, prolonged NPO status, chronic alcoholism & nasogastric suctioning. Assessment findings include muscle weakness, cardiac changes, mental changes, hyperactive reflexes & other hypocalcemia signs and symptoms.
What is hypomagnesemia?
This IV solution contains multiple electrolytes in about the same concentrations as found in plasma (note that this solution is lacking in Mg2+), and it is used in the treatment of hypovolemia, burns, and fluid lost from GI sources.
What is Lactated Ringer's solution?
The nurse is reviewing data on the client who has hypovolemia. The nurse should identify which of the following findings is a manifestation of hypovolemia?
1) Increased hematocrit
2) Increased blood pressure
3) Decreased urine specific gravity
4) Decreased urine output
5) Increased sodium level
What is 1) Increased hematocrit, 4) Decreased urine output, and 5) Increased sodium level?
When levels of this serum protein are low, patients tend to "leak" fluid into the interstitial spaces. Assessment findings may include central edema, ascites, sacral edema, peripheral edema, and/or hypotension
What is albumin?
This is the normal range for serum calcium.
What is 8.6-10.2mg/dL?
The cells of a patient with this condition shrink as water shifts from the ICF to the ECF. Assessment of this patient includes thirst, dry mucous membranes and lips, oliguria, increased temperature, increased heart rate, flushed skin, and confusion. Interventions include IV therapy and diet therapy.
What is hypernatremia?
This hypertonic solution supplies fluid and calories to the body, replaces electrolytes, and shifts fluid from the intracellular compartment into the intravascular space, expanding vascular volume.
What is 5% dextrose in lactated Ringer’s solution?
A nurse is monitoring a patient who is receiving an IV infusion of normal saline at 250 mL /hr. The patient is apprehensive and presents with a pounding headache, rapid pulse, chills, and dyspnea. What would be the nurse’s priority intervention related to these symptoms?
1) Discontinuing the infusion immediately, monitoring vital signs, and reporting findings to the primary care provider immediately
2) Slowing the rate of infusion, notifying the primary care provider immediately, and monitoring vital signs
3) Pinching off the catheter or securing the system to prevent entry of air, placing the patient in the Trendelenburg position, and calling for assistance
4) Discontinuing the infusion immediately, applying warm compresses to the site, and restarting the IV at another site
What is 1) Discontinuing the infusion immediately, monitoring vital signs, and reporting findings to the primary care provider immediately?