AM - Galen 170 Exam 1 (Perioperative,
Comfort, Anemia) 20-30 (Fluid &
Electrolytes, Acid Base) 20-30
AM - Galen 170 Exam 1 (Perioperative,
Comfort, Anemia) 20-30 (Fluid &
Electrolytes, Acid Base) 20-30
Best indicator for fluid volume overload? - ANSWER-Weight
Assessment for FVO - ANSWER-- Bounding + increase pulse
- High BP
- Dyspnea, crackles, edema
- Decreased hematocrit, serum sodium, and urine specific gravity
Causes of FVO - ANSWER-- ESRD, CHF, water intoxication, SIADH, corticosteroid
therapy, rapid fluid replacement
Treatment for FVO - ANSWER-- Diuretics
- Fluid Restriction
- Salt restriction
- Monitor I&O's
intracellular fluid - ANSWER-fluid within cells; 66%; 25 L
Extracellular fluid - ANSWER-- Fluid outside the cell; 33%; 15L
- Most important for homeostasis
Homeostasis - ANSWER-- Proper functioning of all body systems
- Extracellular (intravascular and interstitial fluid)
Fluid balance - ANSWER-- 2 to 3 liters a day
- urine output 400-600 ml per day
- increases during stress, fever and tachy
Fluid Volume Deficit (FVD) (dehydration) - ANSWER-- Increased HR; decreased B/P
- Lethargy; decreased UOP; dry mucous membranes; constipation; thirst
- Increased hemoconcentration; BUN; sodium; urine specific gravity
Causes of FVD - ANSWER-vomiting, diarrhea, ileostomy, laxitives, burns, fever,
diuretics, GI suctioning and NPO
Interventions of FVD - ANSWER-- Halt OTC
, AM - Galen 170 Exam 1 (Perioperative,
Comfort, Anemia) 20-30 (Fluid &
Electrolytes, Acid Base) 20-30
- Outdoor activity
- Weight gain/loss
- Diet habits
BUN and Creatinine are? - ANSWER-Kidney markers and are sensitive to decreased
blood flow.
Normal BUN levels - ANSWER-10-20 mg/dL
Normal creatinine levels - ANSWER-0.6-1.2
BUN and creatinine rise when - ANSWER-- Nitrogenous wastes are found in the blood
indicating kidney impairment.
- Also dehydration
Hypernatremia - ANSWER-- Due to sodium loss, water gain, or inadequate intake
- Diuretics, Anticonvulsants, SSRI's
- Water Gain: CHF, SIADH, polydipsia
- Dehydration
- Common: Restlessness or agitation, anorexia, N/V, weakness, lethargy, confusion,
crave water
- Worst case scenario: Decreased LOC, seizures, coma
- Treatment: Fluids! PO/IV; what type of IVF?- - Nursing implications: Frequent VS,
Monitor neurologic status, Seizure/fall precautions, strict I/O's, assess skin/MM, oral
care, monitor labs
Hypokalemia - ANSWER-- Not enough in: Inadequate K+ intake
- Too much out: GI fluid losses
- Depleting drugs: Diuretics, corticosteroids, insulin, excessive laxative use, albuterol
- Black licorice?
- Common: Cardiac arrhythmias, leg cramps (hallmark), muscle weakness, decreased
GI motility (decreased BS, constipation, N/V), decreased DTR's, muscle weakness,
alkalosis
- Worst case scenario: Life threatening cardiac arrhythmias/Cardiac arrest!
- **Hypokalemia may potentiate dig toxicity**
- Treatment: Increase dietary intake of potassium, K supplementation. Give IV
potassium SLOWLY!!!
- Nursing implications: Frequent VS, cardiac monitoring, patent IV, monitor labs
(recheck after supplementation), NEVER give potassium IVP or bolus!
Hyperkalemia - ANSWER-- Too much intake: Increased dietary intake, salt substitutes,
potassium supplements
