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Pathophysiology > Alterations Of Fluid And Electrolyte Balance > Flashcards

Alterations Of Fluid And Electrolyte Balance Flashcards

1
Q

The vast majority of the body’s potassium (K+) is located:

A

In the cytoplasm of all cells.

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2
Q

What are the functions of potassium balance?

A

Necessary for insulin-dependent glucose uptake by most cells.

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3
Q

Increase antidiuretic hormone (ADH) secretion from the posterior pituitary results in:

A

Retention of pure water by the kidneys.

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4
Q

What event causes the depolarization phase of a neuron acton potential?

A

Na+ infusing into the cell.

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5
Q

What causes Isotonic Fluid Overload?

A

Renal failure.
Excess administration of intravenous normal saline solutions.
Hypersecretion of aldosterone (hyperaldosteronism)

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6
Q

What are the manifestations of Isotonic Fluid Overload?

A

Weight gain.
Edema.
Hypertension.

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7
Q

What are the causes of Isotonic Hypovolemia?

A

Diuresis
Sweating
Hyposecretion of aldosterone (hypoaldosteronism)

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8
Q

What are clinical manifestations of Isotonic Hypovolemia?

A

Weight loss
Low blood pressure (hypotension)

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9
Q

Hyponatremia

A

Low plasma sodium

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10
Q

What are common causes of hyponatrenmia?

A

Vomiting/gastric suctioning
Excessive oral water intake
SIADH (Síndrome of inappropriate ADH) excess ADH secretion
Inadequate sodium intake

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11
Q

What are some clinical manifestations of Hyponatremia?

A

Weight gain
Edema
Neuronal swelling - lethargy and confusion, eventually coma. Gait disturbances, falls ( in the elderly)

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12
Q

What does Na+ affect more, the neurons or muscles?

A

Neurons

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13
Q

What is the pathophysiology of Hyponatermia?

A

ECF to ICF. The is lower sodium outside the cell, and higher sodium concentrations inside the cell.

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14
Q

What happens to the RPM during Hyponatremia when there is a decrease in Neuron excitability?

A

The RPM decreases

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15
Q

What are the causes of Hypernatremia?

A

Insufficient water intake
Decreased ADH secretion (diabetes insípidas)
Pure dietary sodium excess

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16
Q

Hypernatremia pathophysiology

A

Water shifts from the ICF to the ECF into the blood stream resulting in cellular and tissue dehydration.

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17
Q

What are the clinical manifestations for Hypernatremia?

A

Thirst
Low blood pressure (hypotension)
Dry mucous membranes
Poor skin turgor
Weight loss
Decreased urine output and concentrated urine.

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18
Q

Hypokalemia

A

Low plasma potassium

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19
Q

What are common causes of hypokalemia?

A

Gastrointestinal (diarrhea)
Renal losses (diuresis)
Over administration of insulin.

20
Q

What are the clinical manifestations of hypokalemia?

A

Cardiac arrhythmias
Skeletal muscle weakness, paralysis
Skeletal muscle cramps
Constipation, bowel obstruction

21
Q

What are common causes for Hyperkalemia?

A

Renal (kidney) failure
Increased potassium intake (with IV administration)
Cell trauma/lysis/death
Insulin deficiency in type 1 diabetes mellitus

22
Q

Clinical manifestations for Hyperkalemia

A

Skeletal muscle
Mild- restlessness, weakness
Severe- paralysis (muscle tetning)

23
Q

A nurse reviews a client’s health record and determines that the client is at risk for developing Hypernatremia if which situation is documented?

A

Has fluid volume deficit.

24
Q

What does aldosterone affects?

A

The retention of sodium and water.

25
Q

What organ releases ADH?

A

Posterior Pituitary

26
Q

What organ releases aldosterone?

A

Adrenal gland in the adrenal cortex.

27
Q

What is a consequence of renal failure?

A

Hyperkalemia

28
Q

When there’s an increase in ADH, what happens to the blood volume (BV) and the sodium concentration?

A

Blood volume increases and sodium decreases.

29
Q

When there’s an increase in aldosterone, what happens to the blood volume (BV) and the sodium concentration?

A

Blood volume increases and sodium concentration increases.

30
Q

What is the effect of increased antidiuretic hormone (ADH) secretion?

A

Decreased plasma osmolarity.

31
Q

Hypokalemia causes the cell membrane to become more negative, thus delaying the action potential of the cell.

A

True

32
Q

Hyperaldosteronism caused by a tumor in the adrenal cortex can result in hyponatremia.

A

False

Increased aldosterone secretion results in an increase in sodium reabsorption (retention) by the kidneys. This generally causes an isotonic increase in sodium and water resulting in fluid overload, or in some cases hypernatremia if there is more sodium than water reabsorption

33
Q

What is an effect of increased antidiuretic hormone (ADH) secretion?

A

Decreased plasma osmolarity

Increased ADH secretion (i.e., syndrome of inappropriate ADH) results in pure water reabsorption (retention) by the kidneys. This excess water dilutes the electrolytes in the plasm resulting in hyponatremia and low plasma osmolarity.

34
Q

How does the body immediately attempt to reestablish equilibrium when sodium is added to extracellular fluid making it hypertonic?

A

Water is drawn from the intracellular space to the extracellular space.

An increase in the concentration of sodium in the ECF increases the osmotic pressure. Intracellular water is attracted to the region of higher sodium concentrations. Water from the intracellular space has moves to the extracellular space until the osmotic pressures are equal. The consequence is a decrease in ICF water volume and cellular dehydration.

35
Q

Which conditions are common causes of hyponatremia?

A

Excessive oral water intake
Vomiting

Gastric fluid has a significant amount of sodium in it therefore protracted vomiting or gastric suction has the potential to cause hyponatremia. Rapid, excessive water intake can dilute the sodium in the plasma resulting in hyponatremia. Inadequate dietary sodium intake is not a common cause of hyponatremia in North America since salt is a common additive in most prepared foods.

36
Q

Hypokalemia causes the cell membrane to become more negative (hyperpolarized), thus delaying the action potential (firing) of the cell.

A

True

A deficit in potassium in the cells causes a decrease in the cell’s resting membrane potential (RMP) since a decrease in this positively charged ion means that the potential in the cell becomes more negative than normal. When the RMP becomes more negative, it requires a greater trigger to bring the membrane to threshold. Hypokalemia can therefore can delay or stop the generation of an action potential.

37
Q

Which clinical manifestation occur with dehydration due to insufficient water intake?

A

decreased urine output.
decreased skin turgor.
decreased blood pressure.

38
Q

Why is severe hyponatremia immediately life threatening?

A

Due to neuronal swelling in the brain.

39
Q

Which of the following conditions has the potential to cause hypokalemia?

A

Severe, prolonged diarrhea

Normally, electrolytes such as potassium are absorbed in the large intestine. Diarrhea is the loss of large volumes watery stool and a corresponding decrease in potassium absorption.

40
Q

Which conditions have the potential to cause hyperkalemia?

A

Renal failure
Crushed limb trauma
Insulin deficiency in a type 1 diabetic

41
Q

A person with severe dehydration will also generally present with

A

Hypernatremia

42
Q

A client is admitted to the unit with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which electrolyte abnormality would the nurse be sure to monitor for?

A

Hyponatremia

SIADH is a disease characterized by the secretion of too much antidiuretic hormone (ADH) by the posterior pituitary gland. A normal physiological effect of ADH is the reabsorption (i.e., retention) of pure water by the kidneys. Therefore increased ADH secretion in SIADH results in the dilution of sodium concentrations in the blood/plasma, resulting in hyponatremia.

43
Q

The assistive personnel (AP) reports to the nurse that a client’s blood pressure is low. Which of the following assessment findings would indicate that the patient is dehydrated?

A

Low urine output (80 ml over the past 4 hours)

44
Q

Which statement by a client (i.e., patient) with hypernatremia related to dehydration is the best indicator to the nurse of the need for additional education?

A

I will be sure to add salt to my food.”

45
Q

A patient has chronic renal failure and is being evaluated in the hospital. The nurse’s morning assessment reveals edema in the lower extremities, evidence of pulmonary edema, bounding peripheral pulses, and other signs of fluid overload. Which of the following should be in the patient’s plan of care?

A

Maintain accurate intake and output records
Daily weights

46
Q

A patient has a potassium level of 7.5 mEq/L, which is critically elevated. After notifying the primary health care provider (i.e., the physician or nurse practitioner), which nursing intervention is the priority?

A

Place the patient on cardiac monitoring

Pathophysiology (14 decks)

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