PPT - IV Prep

• What are the learning outcomes for the nursing class on fluids and electrolytes?


  Describe physiologic factors and common alterations
• What are the two main compartments of body fluids?

  Intracellular fluid and extracellular fluid
• What is the solvent in body fluids?

  Water
• What happens to red blood cells in a hypotonic solution?

  They swell and may burst
• What is the effect of a hypertonic solution on red blood cells?

  They shrink due to water moving out
• What are the types of intravenous fluids and their effects?

  • Hypotonic: Hydrates cells
  • Isotonic: Stays put
  • Hypertonic: Expands volume
• What is the normal osmolarity range of a solution?

  275-295 mOsm/L
• What is hydrostatic pressure?

  Force of water pressing against walls
• What is the third space syndrome?

  Fluid shifts to inaccessible spaces
• What factors affect fluid, electrolyte, and acid-base balance?

  • Vomiting
  • Diarrhea
  • Diaphoresis
  • Diuretics
  • Chronic illness
  • Renal failure
  • Surgery
  • Pregnancy
  • Respiratory failure
• What is the primary regulator of fluid intake?

  Thirst mechanism
• How much urine do kidneys produce daily?

  About 1500 ml
• What is sensible water loss?

  1500 ml/day of urine
• What is insensible water loss from the skin?

  400 ml/day
• What is the role of antidiuretic hormone?

  Regulates fluid balance in the body
• What percentage of body weight is water in older adults?

  45% to 50%
• Why is skin turgor not always accurate in older adults?

  Reduced homeostatic mechanisms
• What are the best methods to monitor fluid status?

  • Daily weights
  • Record of intake and output
• What is the normal serum sodium level?

  135-145 mEq/L
• What is the normal potassium level?

  3.5-5.0 mEq/L
• What are the cations in electrolytes?

  Sodium, potassium, calcium, magnesium
• What are the anions in electrolytes?

  Chloride, phosphate, sulfate
• What should be checked in infants during a nursing assessment?

  Fontanelle
• What is assessed in capillary refill?

  Blood flow to extremities
• What does checking breath sounds for crackles indicate?

  Possible fluid in the lungs
• What laboratory studies are included in nursing assessments?

  • Serum electrolytes
  • Urine osmolality
  • Urine specific gravity
  • ABG Analysis
• What is neuromuscular irritability associated with?

  Electrolyte imbalances
• What are the cations in electrolytes?

  • Sodium (Na+)
  • Potassium (K+)
  • Calcium (Ca++)
  • Magnesium (Mg++)
• What are the anions in electrolytes?

  • Chloride (Cl-)
  • Phosphate (HPO4-)
  • Dihydrogen phosphate (H2PO4-)
  • Sulfate (SO4-)
• What is the normal serum value for sodium?

  135-145 mEq/L
• What is the normal serum value for potassium?

  3.5-5.0 mEq/L
• What is the normal serum value for calcium?

  4.3-5.3 mEq/L
• What is the normal serum value for magnesium?

  1.5-1.9 mEq/L
• What is the normal serum value for phosphorus?

  1.8-2.6 mEq/L
• What are the normal values for acid-base balance?

  • pH: 7.35-7.45
  • PaCO2: 35-45 mmHg
  • PaO2: 80-100 mmHg
  • HCO3: 22-26 mEq/L
• What are the types of acid-base imbalances?

  • Respiratory Acidosis
  • Respiratory Alkalosis
  • Metabolic Acidosis
  • Metabolic Alkalosis
• What systems are involved in acid excretion?

  • Lungs excrete carbonic acid.
  • Kidneys excrete metabolic acids.
• How do lungs excrete carbonic acid?

  By exhaling CO2 and water
• What do kidneys excrete?

  All acids except carbonic acid
• What are common nursing diagnoses related to fluid and electrolyte imbalances?

  • Decreased cardiac output
  • Acute confusion
  • Impaired gas exchange
  • Excess fluid volume
  • Risk for electrolyte imbalance
  • Risk for injury
  • Deficient fluid volume