CH 42 Electrolyte/ Acid base

Question 1

What fraction of total body fluid is intracellular/ extracellular fluid?

Answer 1

Intracellular fluid - 2/3 of body water

Extracellular fluid - 1/3 of body water

Question 2

Interstitial fluids

Answer 2

the fluids between cells and outside the blood vessels. These include lymph (fluid in the lymphatic channels).

Question 3

What are the 3 divisions of interstitial fluids?

Answer 3

Interstitial
Intravascular
Transcellular

Question 4

Intravascular fluid

Answer 4

blood plasma found in the vascular system

Question 5

Transcellular fluids

Answer 5

secreted by epithelial cells and include cerebrospinal, pleural, peritoneal, and synovial fluids

Question 6

Osmolality

Answer 6

Osmolality of a fluid is a measure of the number of particles per kilogram of water.

Question 7

Isotonic solutions

Answer 7

have the same osmolarity as blood, similar to normal saline (0.9% sodium chloride).

Question 8

A hypertonic solution such as 3% sodium pulls fluid from or moves fluid into cells?

Answer 8

pulls fluid from cells, causing them to shrink.

Question 9

A hypotonic solution such as 0.45% sodium chloride pulls fluid from or moves fluid into cells?

Answer 9

moves fluids into cells, causing them to enlarge.

Question 10

nonpermeant particles

Answer 10

Particles that cannot cross cell membranes easily that determine the tonicity of a fluid

Question 11

Filtration

Answer 11

Movement across a membrane, under pressure, from higher pressure to lower pressure

Question 12

Diffusion

Answer 12

passive movement of electrolytes or other particles down the concentration gradient

Question 13

Osmoreceptors

Answer 13

continually monitor plasma osmolality; when it increases, they cause thirst by stimulating neurons in the hypothalamus

Question 14

Insensible water loss

Answer 14

through the skin and the lungs - not visible measurable

Question 15

regulate ECF volume by influencing how much sodium AND water is excreted in urine

Answer 15

ADH

RAAS (Renin angiotensin aldosterone system

ANP (Atrial Natiuretic Peptide)

Question 16

About what should daily fluid intake be?

Answer 16

2300 mL/day

Question 17

What is the pH of blood?

Answer 17

7.35 - 7.45

Question 18

Metabolic Acids

Answer 18

any acids besides carbonic acid - citric acid, lactic acid

Question 19

True or False? People who have kidney disease often have difficulty with normal excretion of metabolic acids.

Answer 19

true

Question 20

Respiratory alkalosis

Answer 20

Arises from alveolar hyperventilation

Lungs excrete too much CO2

Deficit of carbonic acid in the blood increases pH

Question 21

Respiratory acidosis

Answer 21

Arises from alveolar hypoventilation

Lungs unable to excrete enough CO2

Excess carbonic acid in the blood decreases pH.

Question 22

Metabolic alkalosis

Answer 22

Arises from direct increase in base (bicarbonate) or decrease in metabolic acid

Results in increased blood bicarbonate

Question 23

Metabolic acidosis

Answer 23

Arises from increase in metabolic acid or decrease in base (bicarbonate)

Kidneys unable to excrete enough metabolic acids, which accumulate in the blood

Results in decreased level of consciousness

Question 24

D5W

Answer 24

5% dextrose in water is hypotonic so it moves fluid into the cells out of the circulation

Question 25

D5NS

Answer 25

5% dextrose in normal saline. Is hypertonic so it moves fluid out of the cells and into the circulation.

Question 26

Why do you initiate a blood transfusion slowly and stay with the patient for the first 15 minutes?

Answer 26

To watch for transfusion reactions and catch them early

Question 27

sodium

Answer 27

regulates water in and out of cell, muscle and nerve function 135-145 mEq/L

Question 28

hyponatremia

Answer 28

Lethargy Tendon reflexes diminished Shallow respirations

Question 29

hypernatremia

Answer 29

Restless, really agitated | Edema

Question 30

Potassium

Answer 30

Watch heart | 3.5-5.0 mEq/L

Question 31

hypokalemia

Answer 31

Caused by extreme fluid loss/diuretics flat or inverted T wave prominent U wave Lethal cardiac dysrhythmias may be sign of digoxin toxicity

Question 32

furosemide/ thiazide diuretics

Answer 32

waste potassium

Question 33

``` P O T A S S I U M ```

Answer 33

``` Potatoes Oranges Tomatoes Avocados Strawberries Spinach fIsh mUshrooms Musk melons, cantaloupe ```

Question 34

hyperkalemia

Answer 34

Spironolactone K sparing diuretics ACE inhibitors renal failure Decreased cardiac contractility Tall peaked T waves widened QRS and prolonged PR

Question 35

calcium

Answer 35

8.6-10.5 mg/dL

Question 36

hypocalcemia

Answer 36

low parathyroid hormone Laryngospasm Trousseaus signs - hand Chvosteks signs - face

Question 37

``` young sally’s calcium serum continues to randomly mess-up ```

Answer 37

``` Yogurt Sardines Cheese Spinach Collard greens Tofu Rhubarb Milk ```

Question 38

hypercalcemia

Answer 38

increase risk for kidney stones

Question 39

Magnesium

Answer 39

1.5-2.5 mg/dL supplement with during pregnancy

Question 40

hypomagnesemia

Answer 40

hypocalcemia twitching everything is hyperexcitable seizure precautions

Question 41

hypermagnesemia

Answer 41

lethargy bradycardia impaired breathing monitor respiratory, cardiac, renal, neuro

Question 42

Phosphorus

Answer 42

Calcium and phosphorus inversely related 2.5-4.5 mg/dL

Question 43

hypophosphatemia

Answer 43

alcoholism malnutrition rhabdo risk of bone fractures

Question 44

hyperphosphatemia

Answer 44

main cause is renal failure Trousseau/Chvostek signs seizures confusion