Fluid & Electrolytes

Question 1

Fluid Intake

Answer 1

2500 ml/day

Question 2

Fluid Output

Answer 2

1400-1500 ml/day

Question 3

Anasarca

Answer 3

associated w/ FVE
extreme generalized edema
swelling of skin/tissue
leading of cellular fluid

Question 4

Lymphedema

Answer 4

chronic swelling collection of protein rich fluid

Question 5

Hypernatremia neuro

Answer 5

restlessness
irritability
lethargy
seizures
confusion to coma
dyspnea
tachycardia
orthostatic hypotension
dryness
flushed skin
low urine
muscle weakness

Question 6

Chlorine to Sodium

Answer 6

attracted to each other (directionally proportional)

Question 7

Hypokalemia s/s

Answer 7

skeletal muscle weakness legs to diaphragm
constipation
PVCs/heart blocks
fatigue

Question 8

Hyperkalemia s/s

Answer 8

v-fib/cardiac arrest

hyperactivity

Question 9

Fluid/Electrolyte Imbalances Assessment

Answer 9

PMH, RF, Meds
Age/lifestyle
i&O
weight changes
renal function/endocrine disease
loc
capillary refill 
jugular vein distention 
skinn color/temp

Question 10

FVD Teaching

Answer 10

prevention of orthostatic hypotension
maintaing fluid intake
prevntion of fluid deficet

Question 11

FVE Teaching

Answer 11

Sodium restriction 
provide alternative mattress/heel protectors
fowler's position
monitor o2/labs
elevate areas of edema

Question 12

ARF common causes

Answer 12

hypoperfusion r/t
prerenal (most common from conditions that lower GFR)
postrenal (obstructive ex BPH)
Intrinsic (r/t ATN kidney diseas, acute glomerulonephritis)

Question 13

ATN

Answer 13

acute tubular necrosis
severe irreversible damage to kidney tubules
caused by prolonged ischemia (ex hypovolemia, dehydration, sepsis, burns, trauma, surgery)

Question 14

ARF Etiology

Answer 14

5% of all hospitalized clients
high mortality
can occur any time of life

Question 15

ARF RF

Answer 15

trauma/surgery
infection
hemorrhage
severe heart failure
severe liver disease
lower urinary tract obstruction 
older adults
child w/ renal insufficiency

Question 16

ARF Prevention

Answer 16

counteract vasoconstriction
enhance blood flow via nephron
preempt risks like IV contrast

Question 17

ARF Phases

Answer 17

Initiation
Maintenance
Recovery

Question 18

ARF Initiation s/s

Answer 18

lasts hours to days
begins with event
ends w/ tubular injury
often asymptomatic

Question 19

ARF Maintenance s/s

Answer 19

fall in GFR
tubular necrosis
oliguria
edema
muscle weakness
n/d
EKG changes
possible cardiac arrest
hyperphosphatemia
hypocalcemia
metabolic acidosis
anemia
confusion/agitation/lethargy
seizures/coma
hyperreflexia
anorexia
uremic syndrome

Question 20

ARF REcovery s/s

Answer 20

tubule cell repair
gradual return of GFR to normal
diuresis
creatinine, BUN higher
potassium/phosphate levels high
may take up to a year

Question 21

Chronic Kidney Disease causes

Answer 21

diabetic nephropathy
hypertension
chronic glomerulonephritis
chronic pyelonephritis
polycystic kidney disease
systemic lupus erythematosus
infection
dehydration hypertension

Question 22

CKD Prevention

Answer 22

aggressive management of chronic disease
low-sodium diet
regular exercise
avoid smoking
limit alcohol intake

Question 23

CKD s/s

Answer 23

impaired regulation of F/E
increased potassium and phosphate
decreased calcium
metabolic acidosis

Question 24

CKD Children s/s

Answer 24

gross hematuria

paleness/lethargy

Question 25

CKD younger adults

Answer 25

oliguria most dramatic symptom

Question 26

CKD older adults

Answer 26

might not have oliguria
postural hypotension common
increase in BUN/serum creatinine

Question 27

ARF Pharmacological

Answer 27

Dopamine
loop diuretics
osmotic diuretics
electrolytes
discontinue nephrotoxic drugs
blood volume expanders
IV fluids
GI drugs
adjust drug dosages

Question 28

CKD Pharmacological

Answer 28

Adjust dosages
protein-bound drugs may lead to toxicity
avoid drugs eliminated by kidneys
loop diuretics
ACE inhibitors
electrolyte replacement
bicarbonate glucose and insulin to decrease hyperkalemia
folic acid
iron supplements

Question 29

ARF Fluid management/nutrition

Answer 29

restrict fluids/monitor fluids
limit protein intake
increase carbs watch diabetes

Question 30

CKD dietary modifications

Answer 30

restrict protein intake
increase carbs
regulate water/sodium
avoid salt substitutes/eggs/diary products/meat