nursing interventions for fluid and electrolyte imbalance – Flashcards
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How should you treat thickened secretions that result from fluid volume deficit?
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-replace fluids 3000ml a day for a normal healthy person -warm drinks and gargle -cough deep breathe -humidity -hot shower
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Why do you need to watch for clots with FVD, and what needs to be done?
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The blood thickens and DVT precautions should be taken.
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What effect does cardiac output in an individual with FVD have on cerebral function?
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In FVD, cardiac output decreases and so does blood flow to the brain, resulting in confusion. Fall precautions should be taken.
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What is a quick and effective pharmacological solution to fluid volume excess.?
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Loop diuretics (ides) lasix/furosemide bumex/bumetanide demadex/ torsemid
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What vital sign has to be monitored when administering diuretics?
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blood pressure
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What is a potassium sparing diuretic?
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aldactone
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Loop diuretics can cause what side effect if given two quickly?
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ototoxicity
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It is important to monitor O2 saturation, have patient in high fowlers, use incentive spirometer, and TCDB with fluid volume excess why?
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excessive fluid will move to the plueral space
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What is the treatment for hypoproteinuria?
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Diet high in protein, but be sure also include carbohydrate for energy, so that protein can be replaced
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What is needs to be monitored when giving fluid replacement to a patient with hypernatremia and why?
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vital signs need to be monitored and cerebral edema needs to be watched for
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You never give potassium how?
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IV push
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What is the maximum amount of m/Eq/hour for K+ runs?
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10 (floor)-20 (ICU)
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K+ can cause what complication when given intravenously?
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phlebitis, it should be given in the largest vein possible
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How do you treat hyperkalemia?
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eliminate K+ at the source, give oral or IV diuretics
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What is the drug of choice to treat hyperkalemia?
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Kayexalate
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Why is D5W and insulin an effective emergency treatment?
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It pulls K+ into the cell
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Calcium gluconate can treat what effect of hyperkalemia?
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It quiets cardiac irritability
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NaHCO3 induces alkalosis. How does this treat hyperkalemia?
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alkalosis pulls potassium into the cell
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What is a long term treatment for hyperkalemia?
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dialysis
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What can give a false high potassium reading?
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prolonged use of a tourniquet, small needle
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When assessing for hyperkalemia, what medication class is it important to assess for?
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ACE inhibitors, particularly captopril
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What is the priority for a person with hypocalcemia?
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airway
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What is a treatment for acute hypocalcemia?
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IV Ca++ (CaCl and Ca gluconate large difference in amount given)
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Why is it important to check the IV site before giving Ca++?
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Ca++ is a vesicant, it pulls from tissue and can cause necrosis
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Why should you have the patient on a heart monitor when administering Ca++?
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Ca++ has sedative effects and can cause bradycardia
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Why do patients with hypercalcemia need to stay hydrated?
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Hypercalcemia can lead to kidney stones
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What do diuretics do for hypercalcemia?
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They can rid the body of Na and Ca++
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Biphosphates push Ca++ where?
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Ca is pushed into bone
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Why would you give MgSO4 by IV in the emergency room?
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To prevent seizures in a case of hypomagnesia
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What do you treat with hypermagnesia?
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identify underlying cause and treat
