Fluid Balance
Define fluid balance in terms of intake and output.
What is intake and output are relatively equal.
The electrolyte that regulates osmotic pressure.
What is sodium?
Normal lab values for sodium (Na).
What are 135 to 145 mEq/L?
Normal ranges for potassium and Magnesium?
What are 3.5 to 5.0 mEq/L and 1.5 to 2.5 mEq/L?
Normal values for pH, PCO2 and HCO3-?
What are pH = 7.35 to 7.45, PCO2 = 35 to 45, and HCO3- = 22-26?
4 Interventions for a patient with fluid volume excess.
What are monitor daily weight (weight loss indicates successful intervention), administer diuretics and O2 as ordered, fluid and sodium (Na) restrictions, monitor I & O and put in Fowler's position?
Percentage of weight loss that indicates severe dehydration.
What is 10%?
Simple action a nurse can take to help someone with hyponatremia.
A food you can encourage someone with hypokalemia to eat.
Bananas, sweet potatoes, soybeans, tomato juice, dried apricots, kidney beans, orange juice, spinach
A health condition that puts a patient at risk for respiratory acidosis?
What is a chronic lung disease such as COPD, asthma, cystic fibrosis.
Also accepting acute conditions such as pneumonia, bronchiolitis, etc.
4 Signs/symptoms of fluid volume excess?
What are Bounding pulse, increased BP, weight gain, increased and dilute urine output , increased and shallow respirations? May see neck vein distention, pitting edema of lower extremities, crackles in the lungs.
Type of dehydration indicated with hyponatremia.
What is hypotonic dehydration?
4 signs and symptoms of hyponatremia.
What are Nausea and vomiting, HA, confusion, loss of energy, drowsiness and fatigue, restlessness and irritability, muscle weakness, spasms or cramps, seizures, and coma?
Signs/symptoms of hypokalemia
What are Muscle fatigue and cramping, mental status changes, shallow ineffective respirations due to diminished skeletal muscle activity, irregular and weak/thready pulse, dysrhythmias?
A nursing intervention for a patient experiencing a severe anxiety episode and respiratory alkalosis.
What is having the patient breathe into a paper bag?In an anxiety attack, the patient hyperventilates causing loss of CO2 resulting in respiratory alkalosis. Rebreathing the air in the paper bag provides more CO2 to correct the respiratory alkalosis.
4 Assessment parameters for hydration.
What is daily weights, skin turgor, mucous membrane moisture/color, urine output, capillary refill, fatigue.
The measure of the concentration of solutes (waste products) in urine compared to water.
What is the specific gravity of urine?
A patient at risk for hyponatremia.
Who are patients with excessive thirst, heart disease, kidney disease, syndrome of inappropriate antidiuretic hormone, use of diuretics, GI suctioning (especially continuous), vomiting, diarrhea, adrenal insufficiency, decreased aldosterone, excess ingestion of hypotonic fluids, any condition that causes fluid overload?
An example of how a client may become hyperkalemic.
Too much K+ replacement in IVFs, kidney disease, DM, adrenal insufficiency.
The blood gas values you expect to see in a patient with respiratory acidosis.
Respiratory acidosis: pH less than 7.35, PCO2 greater than 45, HCO3- between 22-26
4 Interventions for a patient with fluid volume deficit.
What are monitor daily weight (most accurate way to evaluate fluid balance), monitor I & Os, increase fluid intake, monitor for symptoms of dehydration, treat underlying cause, monitor VS?
2 lab findings indicative of dehydration.
What are elevated Hct and BUN, increased urine specific gravity, hypernatremia,
Nursing interventions for a patient with hypernatremia.
What are monitor weight, monitor I & O, encourage hypotonic fluid intake, administer hypotonic IV fluids, restrict dietary sodium, monitor lab values?
A medication that may cause someone to become hypokalemic and a medication that may cause hyperkalemia.
What are furosemide causing K+ loss and Spironolactone which is K+ sparing and could cause build up or too much K+ supplements (K-dur).
A sign the body is compensating for metabolic acidosis.
What are Kussmaul respirations or deep, labored, rapid breathing pattern?