Fluid Balance
This fluid compartment contains about 2/3 of the body's fluid.
What is intracellular fluid (ICF)?
GI losses, diuretics, severe diaphoresis, DKA, and SIADH can all contribute to this sodium imbalance.
What is hyponatremia?
A patient with renal dysfunction has a potassium of 6.1 mEq/L. The ECG finding specifically shown in the lecture slides that the nurse should watch for is this.
What are peaked T waves?
Edema is the accumulation of body fluid in this space.
What is the interstitial space?
A patient with heart failure has bilateral crackles, 3+ leg edema, and gained 3 kg in 48 hours. Approximately this many liters of fluid have been retained.
What is 3 liters?
This process involves the movement of water across a semipermeable membrane to equalize particle concentrations.
What is osmosis?
A patient with hyponatremia develops lethargy and seizures. These neurological manifestations occur because water moves in this direction.
What is into the cells, causing cellular swelling?
Hypokalemia commonly causes muscle weakness and this potentially dangerous cardiac problem.
What are cardiac dysrhythmias?
This happens when fluid shifts from the intravascular space to the interstitial space.
What is third spacing?
A patient has cellular dehydration and needs fluid to move from the extracellular space into the cells. What type of IV solution would accomplish this? Give an example.
What is a hypotonic solution, such as 0.45% NaCl?
A patient has decreased circulating volume. Baroreceptors detect the change and trigger this nervous system to cause vasoconstriction.
What is the sympathetic nervous system (SNS)?
Best nursing intervention used to treat hypernatremia when the patient is A/Ox4
What is give them free water?
A patient with DKA has hyperkalemia. This condition can increase serum potassium because there is not enough of this hormone to move potassium appropriately.
This pressure normally pushes fluid out of the capillary and into the interstitial space. If it becomes too high, more fluid leaves the blood vessels and can contribute to edema.
What is increased hydrostatic pressure?
A dehydrated patient needs rapid expansion of circulating volume. This general type of IV solution is used for rapid volume expansion.
What is an isotonic solution?
A patient's fluid imbalance causes an increase in serum osmolality, resulting in water moving out of the cells and causing intracellular dehydration. This fluid imbalance is occurring.
What is fluid volume deficit?
A patient's sodium decreases rapidly to 118 mEq/L and they develop confusion followed by a seizure. This nursing action takes priority.
What is initiate seizure precautions/protect the patient from injury and notify the provider immediately?
A patient has K⁺ 6.9 mEq/L with peaked T waves. The provider orders IV insulin with dextrose. Insulin lowers serum potassium through this mechanism.
What is shifting potassium from the extracellular fluid into the cells?
A patient has severe generalized edema related to decreased plasma protein. This specific protein is likely low.
What is albumin
A patient with cirrhosis develops a large amount of fluid within the abdominal cavity. The nurse recognizes this as a form of third spacing called this.
What is ascites?
This is the normal serum osmolality range.
What is 275–295 mOsm/kg?
A patient has Na⁺ 151 mEq/L with signs of fluid volume deficit and neurological changes. At the cellular level, water is moving in this direction.
What is from the ICF to the ECF, causing the cells to shrink?
Should you push IV potassium.
A patient has very low albumin levels. This decreases the pressure that normally pulls fluid back into the vascular space, causing fluid to remain in the interstitial tissues and produce edema. What pressure has decreased?
What is osmotic pressure?
A patient needs IV fluid that will expand the extracellular compartment by pulling water out of the cells. The nurse knows the patient must also be monitored closely for fluid overload. What type of solution should the nurse expect?
What is a hypertonic solution? Hypertonic fluids have a higher osmolarity than serum, causing water to shift from the ICF → ECF and expanding extracellular volume.