2.6.18 Fluids Patho

Question 1

Edema/Hypervolemia

Answer 1

the excessive accumulation of fluid within the interstitial space
increased cap hydro press
decreased plas onco press
increased cap membrane permeablity
lymphatic channel obstruction (inflammation)

Question 2

Dehydration/Hypovolemia

Answer 2

too small of volume of fluid in the extracellular compartment (vascular and interstitial); body fluids are too concentrated
look for:
poor turgor, tachycard, dry mucous membranes, decreased weight,
peds: no tears, thirsty, dark urine, depressed fontanels

give fluids SLOWLY

Question 3

Sodium

Answer 3

135-145 mEq/L
Major EXTRAcellular cation
maintains tonicity of EF; regulates A-B; nerve conduction and neuro-muscular fxn; maintains water balance

Question 4

Hyponatremia

Answer 4

serum levels below 135 mEq/L; too much EF to Na
AE: malaise, N/V, headache, seizures, coma, death
from GOW or LOS (renal disease; replace water w/out salt)

Question 5

Hyperatremia

Answer 5

serum above 145 mEq/L: too little water to Na
GOS (tube feeding, salt tabs, no water) or LOW (emesis, diarrhea, diaphoresis)
CM: thirsty, hypotension, tachycardia, oliguria, lethargy, seizures, coma, death
Treat: cause; PO or IV 5%DW slowly

Question 6

Potassium

Answer 6

3.5-5 mEq/L
major INTRAcellular fluid cation
maintains cell electrical neutrality; facilitates cardiac muscle contraction and electrical conductivity; neuromuscular transmission of nerve impulses
maintains A-B

Question 7

Hypokalemia

Answer 7

decreased potassium ion concentration in the EF
CF: decreased intake: NPO, fasting, diet; alkalosis (shifts into cell), increase K excretion or loss
CM: muscle weakness/paralysis, cardiac dysrhythmeia
replace PO IV be careful of hyperkalemia

Question 8

Hyperkalemia

Answer 8

elevation of K in EF
CF: increased intake (blood transfusions); shifts to EF (acidosis, crushing injuries), decreased excretion
CM: cramping, diarrhea, weakness/paralysis, dysrhythmeias
treatment: fix cause, pharm, dialysis

Question 9

Calcium

Answer 9

9-11 mg/dl
vital for cell permeability, bone and teeth formation, blood coagulation, nerve impulse transmission, and normal muscle contraction
plays important role in cardiac action potential and essential for pacemaker

Question 10

Hypocalcemia

Answer 10

CF: decreased intake (diet), decrease in physiologic availability (alkalosis), increased excretion (pancreatitis)
CM: increased neuromuscular excitability, twitching, seizures, dysrhythmias

Question 11

Hypercalcemia

Answer 11

CF: increased vita D, shift from bone to ECF (tumor), decreased excretion
CM: decreased nm excitability, weakness/decreased reflexes, CNS fatigue, headache, lethargy; dysrhythmias, kidney stones
treat: cause, pharm

Question 12

Acid-base homeostasis 3 parts

Answer 12

buffers, respiratory system, renal system
pH: 7.35-7.45
Paco2: 36-44 mmHg
Hco3-: 22-26 mEq/L

Question 13

Respiratory Acidosis

Answer 13

any condition that causes excess of carbonic acid
Causes:
impaired gas exchange: asthma, COPD, pneumonia
inadequate NM fxn: pain, gilian
impairment of respiratory control in the brainstem: respiratory depression

CM: headache, tachycard, dysrhythmia
ABG: increased CO2, decreased pH

Question 14

Respiratory Alkalosis

Answer 14

any condition that causes a carbonic acid deficit
causes: hyperventilation: panic attack/anxiety, crying, acute pain, hypoxemia, brainstem injury

CM: excited/confused, tingling, feet and hand spasms
ABG: decreased PaCO2, increased pH

Question 15

Metabolic acidosis

Answer 15

relative excess of any acid except carbonic acid
causes: increased in metabolic acid: ketoacidosis, burns, circ shock
decreased
decreased in base/bicarb: diarrhea

CM: fruity, acetone breath, N/V, dehydration, diarrhea, CNS: depression, HA, confusion, lethargy, coma. Tachycard, dysrhythmias.
ABG: decrease HCO3 and pH

Question 16

Metabolic alkalosis

Answer 16

any condition that causes a relative deficit of any acid (except carbonic acid)

causes: increase in base (overuse of antiacids, hypovolemic)
decrease in acid: emesis, remove gastric sec
combo

CM: hypotension, N/V, diarrhea, CNS: tingling, tetany, seizures, hypokalemia with bilateral muscle weakness.
ABG: increase HCO3 and pH