Chapter 31 Acid Base Disorders 1. What laboratory monitoring should be performed in a client with nasogastric suctioning?

K+, Na+, CL- and Mg. 2. What is the indication for hypotonic solutions? Hypotonic solutions have a lesser concentration of solutions than plasma where water moves from plasma to interstitial fluid and cells. 3. What is the indication for an isotonic solution? Isotonic solutions have the same concentration of solutes (same osmolality) as plasma where no net fluid change. 4. What is the indication a hypertonic solution? Hypertonic solutions contain a greater concentration of solutes than plasma that the water moves from cells and interstitial fluid to plasma. 5. What early sign tells us our client is receiving too much IV fluid? (Hypervolemic signs) elevated BP, irritative cough, shortness of breath, jugular vein distension, and crackles on auscultation, peripheral edema. 6. How do crystalloids differ from colloids? Crystalloids are IV solutions that contain electrolytes and other agents that closely mimic the bodys extracellular fluid. Crystalloids solutions are capable of quickly diffusing across membranes and entering the interstitial fluid and ICF. Crystalloids could be isotonic, hypotonic, or hypertonic solution. Colloids are proteins, starches, or other large molecules that remain in the blood for a long time because they are too large to easily cross the capillary membranes. They act as hypertonic solutions, drawing water molecules from the cells and tissues into the plasma, sometimes called plasma volume expanders. They are particularly important in treating hypovolemic shock due to burn, hemorrhage, or surgery. 7. What are 2 primary concerns with dextran use? 1) Administration of colloids to dehydrated clients can lead to renal failure. Before initial therapy, evaluate clients fluid balance and obtain lab tests, including CBC, serum electrolytes, blood urea nitrogen (BUN), and creatinine level. 2) Some colloids solutions decrease platelet adhesion and lead to decreased coagulation. Plasma expanders lower hematocrit and hemoglobin levels because of increased intravascular volume. Report a hematocrit below 30% to the physician immediately. 8. How quickly can KCl be infused? 10 mEq/h max. 9. What is Kayexelate? A sodium polystyrene sulfonate, to exchange potassium ion for sodium in intestine. Why is it administered with sorbitol? Mix with non absorbable Who is most likely to receive Kayexelate? Given to client with high K+ - one who is in renal failure. 10. How can IV fluids facilitate excretion of drugs? Crystalloids that are IV solutions can be used to promote urine output.