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Concepts 2 FINAL > Acid Based Balance, Electrolytes > Flashcards

Acid Based Balance, Electrolytes Flashcards

1
Q

acid base balance

A

refers to the mechanisms the body uses to keep its fluids close to neutral pH so the body can function normally
- regulation of HYDROGEN ions

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2
Q

cations

A

Positively charged electrolytes

  • in bodys fluid supply: sodium, potassium, magnesium
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3
Q

anions

A

negatively charged electrolytes

  • in bodys fluid supply: chloride, phosphate, sulfate, bicarbonate
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4
Q

electrolytes

A

chemical substances that separate into electrically charged particles called ions when dissolved in fluids

  • the ions are capable of conducting electric currents vital for the function of nerves & muscles
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5
Q

What is the major electrolyte in extracellular fluid?

A

Sodium

is the major electrolyte in extracellular fluid, with potassium being present at much lower concentrations.

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6
Q

What is the major electrolyte in intracellular fluid?

A

Potassium

is the major electrolyte in intracellular fluid, with sodium found in lesser concentrations.

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7
Q

HYPONATREMIA & causes + diseases

A
  • Low serum Sodium
  • Usually caused by excessive sweating, diarrhea, vomiting, NG suction
  • CHF, Renal disease, liver disease/cirrohsis
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8
Q

s/s of hyponatremia

A
  • dizziness
  • confusion
  • weakness
  • low blood pressure
  • shock.
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9
Q

HYPERNATREMIA & causes + diseases

A
  • Happens when sodium blood levels become too high:
    because of excessive water loss (through GI system, lungs or skin), fluid restriction, or sodium ingestion
  • cushings syndrome, diabetes insipidus
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10
Q

s/s of hypernatremia

A
  • extreme thirst
  • dry swollen tongue
  • restlessness
  • agitation
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11
Q

POTASSIUM

A
  • Creates much of the osmotic pressure in intracellular fluid and is the most abundant cation in it.
  • essential for neuron and muscle cells
  • an imbalance can cause hypokalemia or hyperkalemia
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12
Q

HYPOKALEMIA & cause

A
  • Results when blood levels of potassium become too low
  • is usually a consequence of vomiting, diarrhea or kidney disease.
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13
Q

s/s of HYPOKALEMIA

A
  • fatigue
  • confusion
  • possible cardiac arrest.
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14
Q

HYPERKALEMIA & cause

A
  • comes as a result of blood levels of potassium becoming too high
  • cause: usually a consequence of Addison’s disease
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15
Q

s/s of HYPERKALEMIA

A
  • weakness
  • abnormal sensations
  • cardiac arrhythmias
  • possible cardiac arrest
  • hypotension
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16
Q

CALCIUM

A
  • Found most abundantly (98%) in bones and teeth with the remaining in tissues and fluids.
  • It maintains normal excitability of neurons & muscle cells & is essential for blood clotting.
  • An imbalance causes hypocalcemia or hypercalcemia.
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17
Q

HYPOCALCEMIA + causes

A
  • Occurs when the blood levels of calcium become too low usually because of a decreased function of the parathyroid gland or a decreased calcium intake
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18
Q

S/S of HYPOCALCEMIA

A

muscle spasms leading to tetany (a continuous spasm)

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19
Q

HYPERCALCEMIA cause

A

Occurs when the parathyroid over functions.

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20
Q

S/S of hypercalcemia

A
  • muscle weakness
  • bone fragility
  • possible kidney stones
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21
Q

PHOSPHATE

A
  • most abundant (85%) in bones and teeth.
  • functions primarily as an intracellular anion and is part of the nucleic acids-DNA, RNA, and ATP
  • as well as phospholipids and the phosphate buffer system
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22
Q

BICARBONATE

A
  • part of the buffer system
  • helps regulate pH
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23
Q

what is used to measure pH (capacity of hydrogen)

A

arterial blood
- Carbon dioxide and bicarbonate blood levels

24
Q

The normal range of arterial blood pH is

A

7.35 - 7.45

25
Q

3 regulatory systems that helps the body maintain the acid-base balance

A
  1. chemical buffers: neutralize the offending acid or base imbalance
  2. respiratory system: regulates the retention or exhalation of acids
  3. kidneys: excrete or retain acids as needed
26
Q

Hypermagnesemia causes

A
  • excessive use of magnesium-containing antacids and laxatives
  • untreated diabetic ketoacidosis
  • excessive magnesium infusions
27
Q

Hypomagnesemia causes

A
  • malabsorption related to GI disease
  • excessive loss of GI fluids
  • acute alcoholism/cirrhosis
  • diuretic therapy
  • hyper-or-hypothyroidism
  • pancreatitis
  • preeclampsia
  • NG suctioning
  • fistula drainage
28
Q

Fluid and electrolyte loss

A

vomit, sweat, dilated gut, diarrhoea, urine

29
Q

Fluid and electrolyte replacement

A

mouth, IV drip, intreperitoneal drip

30
Q

Role of lungs in acid-base balance

A
  • release CO2 from lungs
  • CO2 is a waste product of metabolism of O2
  • CO2 gets excreted into blood, & the blood carries it to the lungs
  • as CO2 accumulates in blood, pH decreases (acidity increases)
31
Q

role of the kidneys in acid-base balance

A
  • excrete excess acids or bases
  • kidneys have some ability to alter the amount of acid or base that is excreted (slower than lungs), takes several days
32
Q

hypovolemia & causes

A
  • a decreased volume of circulating blood in the body
  • caused by:
    Loss of blood (external or internal bleeding)
    Loss of plasma (severe burns and lesions discharging fluid)
    Loss of body sodium and consequent intravascular water; e.g. diarrhea or vomiting
33
Q

true or false: Excessive sweating is a cause of hypovolemia

A

false.

because the body eliminates significantly more water than sodium

34
Q

Signs and Symptoms of Hypovolemia

A
  • sweating, moist skin
  • anxiety or agitation
  • cool, clammy skin
  • confusion
  • decreased or no urine output
  • general weakness
  • pale skin colour (pallor)
  • rapid breathing
35
Q

Nursing interventions for Hypovolemia

A
  • measure daily weights
  • assess LOC
  • measure intake and output
36
Q

Signs & symptoms of hypervolemia?

A
  • Edema
  • headache
  • stomach bloating
  • high blood pressure caused by excess fluid in the bloodstream
  • shortness of breath caused by extra fluid entering the lungs and reduce ability to breathe normally
  • heart problems, because excess fluid can speed up or slow your heart rate
37
Q

Hypervolemia causes

A

caused by:
excessive water intake
excessive intake of sodium from foods
IV solutions and blood transfusions
medications

38
Q

Nursing interventions for hypervolemia

A
  • diuretics
  • limit intake of water, fluids
  • limit intake of sodium and salt
39
Q

Acidosis

A

blood has too much acid (or too little base) resulting in a decrease in blood pH

40
Q

Alkalosis

A

blood has too much base (or too little acid) resulting in an increase in blood pH

41
Q

metabolic acidosis

A

when there is an accumulation of H+ (acids) or a loss of bicarbonate (base) in extracellular fluid- blood

42
Q

causes of metabolic acidosis

A
  • overproduction of ketones in body
  • can occur with diabetes, cardiac failure, starvation, severe infection with fever
  • can also occur from a decreased ability of the kidneys to excrete acids (impaired kidney function)
  • abnormal loss of alkali (diarrhea)
  • K+ sparing diuretic
43
Q

S/S of metabolic acidosis

A
  • resp: hyperventilation (compensate for excess acid)
  • CNS: drowsiness, disorientation, coma and death
  • cardiac: tachycardia, arrhythmias, decreased output and decreased BP, warm flushed skin
  • gastro: nausea, vomiting, diarrhea
44
Q

treatment of metabolic acidosis

A
  • if severe: sodium bicarbonate IV to neutralize acidity
  • maintain IV
  • dialysis
  • ventilation
  • assess LOC
  • if from diabetes=insulin
  • remove toxin from body
45
Q

Metabolic alkalosis

A

loss of acid and a gain of bicarbonate or both

46
Q

Causes of metabolic alkalosis

A
  • loss of acid from vomiting or drainage of the stomach (NG suctioning)
  • overactive adrenal gland (cushings syndrome)
  • use of diuretics
  • kidney disease
47
Q

diagnosis of metabolic acidosis

A

measurement of blood pH in sample of arterial blood (radial artery)

48
Q

S/S of metabolic alkalosis

A
  • neuro: dizziness, irritability, confusion
  • cardio: tachycardia, dysrhythmias (hypokalemia from compensation)
  • neuromuscular: tremor, muscle cramps, tingling in figners & toes, muscle cramps
  • gastro: anorexia, nausea, vomiting
49
Q

treatment of metabolic alkalosis

A
  • monitor vitals
  • O2 if hypoxic
  • assess LOC
  • watch for muscle weakness/tetany/decreased activity
50
Q

respiratory acidosis

A
  • when the body is unable to rid itself of enough CO2 to maintain a healthy pH balance (excess CO2)
  • occurs when you hypoventilate (unable to blow off CO2)
  • in acute: pH decreases (kidneys try to compensate by retaining bicarbonate or making, but not fast enough)
51
Q

Causes of respiratory acidosis

A
  • hypoventilation: depression of resp centre (drug overdose, brain injury)
  • problems with neuromuscular functioning, lung disease or airway obstruction
  • mechanical hypoventilation
52
Q

S/S of Respiratory Acidosis

A
  • neuro: headache, disorientation, confusion, coma, death
  • cardiac: tachycardia, decreased BP, warm flushed skin
    seizures
53
Q

treatment of respiratory acidosis

A
  • focus on improving ventilation
  • monitor vitals (tachy)
  • monitor neuro status
  • maintain patent airway
  • O2 therapy
  • adequate humidification to moisten secretions
  • chest auscultation
  • deep breathing
  • careful with sedatives
54
Q

respiratory alkalosis

A

develops when rapid, deep breathing (HYPERVENTILATION) causes too much CO2 to be expelled from bloodstream

55
Q

causes of resp alkalosis

A
  • anxiety is #1
  • aspirin overdose (early stages)
  • fever
  • low O2 in blood
  • pain
56
Q

S/S of respiratory alkalosis

A
  • neuro: lethargy, light-headed, confusion
  • cardio: tachy, dysrhythmias
  • gastro: nausea, vomiting, epigastric pain
  • neuro-muscular: numbness, tingling of extremities, seizures
57
Q

treatment of resp alkalosis

A
  • O2 if hypoxic
  • anti-anxiety meds
  • controlled breathing exercises
  • hyperventilation can be treated by breathing into a paper bag which forces patient to rebreathe exhaled CO2

Concepts 2 FINAL (7 decks)

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