Electrolytes
Normal electrolyte ranges
Potassium 3.5-5.0
Magnesium 1.5-2.5
Calcium 4.5-5.6
Sodium 135-145
Chloride 96-106
What populations are at high risk for fluid volume deficit?
Elderly, infants, obese
Normal pH values? Bicarb? Co2?
7.35-7.45; 22-24, 35-45
Minimum urinary output in ml/hr for adults?
30ml/hr
Give examples of Sensible losses and insensible losses
urine, feces, drainage, wounds; perspiration, expiration
Nursing interventions for a patient with hypermagnesemia include administering what?
IV Calcium Gluconate
Which organ has an important role in fluid balance?
Which electrolyte would the nurse identify as the major electrolyte responsible for determining the concentration of the extracellular fluid?
Kidneys; Sodium
What are some causes of respiratory acidosis?
COPD, coma, over sedation or drug use, cystic fibrosis, sleep apnea, pneumonia, head injury
How well the kidneys are filtering the blood?
Glomerular filtration rate
signs of dehydration
skin turgor, concentrated urine, dry mucous membranes, fatigue, dizziness, headache, confusion
A patient is admitted in the hospital due to having lower than normal potassium level in her bloodstream. Her medical history reveals vomiting and diarrhea prior to hospitalization. Which foods should the nurse instruct the client to increase?
Bananas, oranges, raisins, apricots, avocados, beans, and potatoes
What is diffusion? What type of process?
Movement of particles through membrane from high concentration to low concentration; passive
What are some causes of metabolic alkalosis?
vomiting, excessive gi suctioning, excess bicarbs, diuretics
If the patient presents with extreme anxiety, increased pulse, increased blood pressure & increased respiration, what will be the result if hyperventilation continues? What is the treatment?
Respiratory alkalosis
pH 7.1,
CO2 52
HCO3 28
Respiratory acidosis
What is the treatment for hyperphosphatemia? Why?
Administer calcium; phosphorus interacts inversely to calcium, high phosphorus due to hypocalcemia, you will want to increase calcium intake
Type of solution that has same amount of electrolytes as body fluids.
Isotonic solutions
Order the different buffers from quickest to slowest to take effect and how long?
Blood- seconds
Lungs- 1-2 min
kidneys- hours to days
When doing a skin assessment on a patient you notice that after you have pinched the skin over his sternum it does not flatten right away. What does this lead you to suspect? What changes in vitals would you suspect?
Dehydration; increased HR, decreased BP
ph 7.6
CO2 30
HCO3 40
Metabolic Alkalosis
The nurse should question an order for the administration of NS for a patient with hypernatremia - true or false? Why?
false; cells are dehydrated, need to rehydrate slowly
A patient weighed 180lbs yesterday. Upon assessment, the nurse found the patient to weigh 187lbs the next morning. How many L of fluid difference is this?
3L
What is the difference between compensated and uncompensated?
Compensated- pH will be in normal range even though bicarb or co2 is out of range
Uncompensated, pjh is out of range
What are nursing interventions for hyponatremia?
restrict fluids, diuretics, safety, seizure precautions, monitor I/O, Vitals
Chvostek and Trousseau sign seen in? Explain how they are manifested
Hypocalcemia
Chvostek=increased irritability of the facial nerve, manifested by the twitching of facial muscles on percussion of the facial nerve
Trousseau= carpal spasm when blood pressure cuff is inflated