NURSING EXAM4U

 Electrolyte imbalances 1 hyponatremia Serum sodium level less than 135mEq /L -causes Increased sodium excretion  -diaphoresis  -diuretics  -vomiting  -wound drainage  -renal disease Inadequate sodium intake Dilution of serum sodium  -renal failure  -DI -assessment Normovolemic Rapid pulse rate Normal bp Hypervolemic Thready weak pulse,hypotension Flat neck veins Normal cvp(3-8mm hg) Hypervolemic Bounding pulse Normal /elevated BP Normal/ elevated CVP ·         -shallow respirations ·         -neuro muscular   Generalized skeletal muscle weakness   Diminished deep tendon reflexes ·         Cerebral function   Headache   Personality change   Confusion   Seizure   Coma ·         GI   Increased...

Causes of fluid volume deficit Isotonic dehydration Inadequate intake Fluid shifts Hypertonic dehydration Excessive perspiration Hyperventilation Ketoacidosis Prolonged fevers Diarrohoea Early stage renal failure DI Hypotonic dehydration Chronic illness Excessive fluid replacement Renal failure Chr.malnutrition Assessment Cardio vascular Pulse-thready and increased Bp-decreased and orthostatic hypotension Diminished peripheral pulse Flat neck Respiratory Increased rate  and depth of respi Neuromuscular-lethargy ,coma Renal-decreased urinary output & increased urine specific gravity Integumentary-dry, poor turgor, tenting present, dry mouth GI –constipation, thirst Decreased wt Hypotonic dehydration Skeletal muscle weakness Hypertonic-hyper active deep tendon reflexes Pitting edema Lab results Increased osmolality Increased hematocrit Increased BUN level,  increased sodium level ...

TYPES OF SOLUTIONS Ø ISOTONIC SOLUTIONS-These are isotonic to the human cells, therefore little osmosis occurs. Ex ; 0.9%NS,5%  dextrose in water 5% dextrose in 0.225% Ns RL Ø HYPERTONIC SOLUTIONS –contains higher concentration of solute . Ex: 3%NS,5%NS,10%dextrose,5%dextrose in 0.9%NS,5% dextrose in 0.45% NS,5%dextrose in RL. Ø HYPOTONIC SOLUTIONS-contains lower concentration of salts or more water. Ex:0.45% ns,0.225%ns,0.33%ns Body fluid excretion. Skin by diffusion-400ml Skin by perspiration-100ml Lungs-350ml Feces-150ml Kidneys -1500ml Total =2500ml Water loss through the skin and the lungs is called insensible loss. Body fluid replacement . Orally ingested fluids Water in foods Water formed by oxidation of the foods. Total =2500ml Fluid volume imbalances Fluid volume deficit Dehydration Types Isotonic dehydration Water and dissolved  solutes are lost in equal proportions./hypovolemia Result in  decreas...

Fluid transport Diffusion –solute will spread from an area of higher concentration to an area of lower  concentration in a solution (solute movement) Osmosis -osmotic pressure is the force that drains the solvent from an area of  less concentration of solute  to an area of higher concentration of solute through a selectively  permeable membrane .(solvent movement) Filtration –movement of solute and solvent by  hydro-static  pressure from an area of higher pressure to lower pressure . Hydro static  pressure -pressure exerted by the wt of a solution . Osmolality -no of  osmotic-ally  active particles /kg of water Normal osmolality of plasma is 270-300 milli osmo/kgof water.  

Fluids and electrolytes Body fluid compartments 1 .Intracellular compartment. ICF Fluid inside the cell Most body fluids are inside the cell. 2 Extra cellular fluids.ECF Include, a) interstitial fluid – fluid between cells   Blood, lymph, connective tissue water and trancellular fluids like peritoneal fluid, pleural fluids etc.. Third spacing Accumulation and sequestration of ECF in to a actual or a potential space. Edema Excess accumulation of fluids in the interstitial space Types ·         Local ·         Generalized also called anasarca (through out the body) BODY FLUIDS  Total body fluids = ICF+ECF =60% of total body weight in adults. =55%in older adults =80% in infants.