Ch 45. Agents Affecting the Volume and Ion Content of Body Fluids Flashcards

1
Q

What is the decrease in total body water?

A

vol contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the increase in total body water?

A

volume expansion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the causes of isotonic contraction?

A

vomiting, diarrhea, kidney disease, and misuse of diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is isotonic contraction?

A

Volume contraction in which Na and H2O are lost in isotonic proportions

Decrease in total volume but no change in osmolarity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Treatment for isotonic contraction?

A

fluids isotonic to plasma
.9% NS
give fluids slowly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is hypertonic contraction?

A
  • loss of water exceeds loss of Na
  • reduced ECF volume and increase in osmolarity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the causes of hypertonic contraction?

A
  • excessive sweating, osmotic diuresis.
  • secondary to extensive burns or CNS disorders that interfere with thirst.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Treatment for hypertonic contraction?

A

hypotonic fluids (.45% NaCl) or fluids that contain no solutes

intial therapy: drink water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is hypotonic contraction?

A

= loss of Na exceeds loss of H2O
= both volume and osmorality of ECF are reduced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Causes of hypotonic contraction?

A

excessive loss of Na through kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tx for hypotonic contraction?

A

Mild: infusing isotonic NaCl solution for injection
Severe: hypertonic solution 3% NaCl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the cause of volume expansion?

A
  • overdose with therapeutic fluids
  • disease states
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are acid-base disturbances?

A
  • respiratory alkalosis
  • respiratory acidosis
  • metabolic alkalosis
  • metabolic acidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Tx for volume expansion

A

diuretics and agents used for heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the cause of respiratory alkalosis?

A

hyperventilation causes decrease in CO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment for respiratory alkalosis?

A

Mild: none
Severe: rebreathe CO2 laden expired breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the cause of respiratory acidosis?

A

retention of CO2 secondary to hypoventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Tx for respiratory acidosis?

A
  • correction of respiratory impairment
  • infusion of NaHCO3 if severe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the cause of metabolic akalosis?

A
  • excessive loss of gastric acid
  • administration of alkalinizing salts.
20
Q

Tx for metabolic alkalosis?

A

solution of NaCl + KCl

21
Q

What are the causes of metabolic acidosis?

A
  • chronic renal failure
  • loss of bicarbonate during severe diarrhea
  • metabolic disorders
  • poisoning by methanol and certain medications.
22
Q

Tx of metabolic acidosis?

A

correction of the underlying cause of acidosis
alkalinizing salt if severe

23
Q

What is the most abundant intracellular cation?

A

Potassium

24
Q

What are the major role of K+?

A

conduction nerve impulses
maintaining the electrical excitability of muscle
regulating acid-base balance

25
Q

What is HYPOkalemia?

A

serum potassium levels are less than 3.5

26
Q

Tx for hypokalemia?

A

thiazide or loop diuretic

27
Q

Consequences of hypokalemia?

A

adverse effects on skeletal & smooth muscles, b.p. and heart

28
Q

Hypokalemia increases risk for ______ and ______

A

hypertension and stroke

29
Q

___ Deficiency frequently coexists with hypokalemia?

A

Chloride

30
Q

What is the tx for mild hypokalemia?

A

oral potassium chloride (KCl)

31
Q

What is the tx for severe hypokalemia or if client cannot take oral meds?

A

IV potassium chloride

32
Q

What is hyperkalemia?

A

excessive elevation of serum potassium

33
Q

What causes hyperkalemia?

A
  • severe tissue trauma, untreated Addison’s disease
  • acute acidosis
  • potassium-sparing diuretics or OD with oral or IV potassium
34
Q

What are some consequences of hyperkalemia?

A
  • disruption of electrical activity of the heart
35
Q

What is the mild elevation of hyperkalemia?

A

5-7 mmol/L

36
Q

What is the consequence of mild elevation hyperkalemia?

A

T wave heightens; PR prolonged

37
Q

What is the severe elevation for hyperkalemia?

A

8-9 mmol/L

38
Q

What is the consequence of severe elevation hyperkalemia?

A

cardiac arrest

39
Q

What are the noncardiac signs consequences for hyperkalemia?

A
  • confusion, anxiety, dyspnea, weakness or heaviness of legs, numbness/tingling of hands/feet/lips
40
Q

Tx for hyperkalemia?

A
  • withholds foods that contain potassium
  • withholds meds that promote potassium accumulation: potassium supplements, potassium- sparing diuretics
  • lower extracellular levels of potassium
41
Q

Causes of hypomagnesemia?

A
  • diarrhea
  • hemodialysis
  • kidney disease
  • prolonged IV feeding
  • chronic alcoholism
  • hypermagnesemia
42
Q

What are the adverse effects for hypomagnesemia?

A
  • respiratory paralysis at 12-15 mEq/L
  • cardiac arrest when Mg levels exceed 25 mEq/L
43
Q

Prevention & Tx for hypomagnesemia?

A
  • magnesium oxide
  • magnesium sulfate
  • IM o r Iv
44
Q

Who are susceptible to hypermagnesemia?

A

pts with renal insufficiency esp when pt uses magnesium- containing antacids or cathartics

45
Q

What are the symptoms of mild intoxication for hypermagnesemia?

A

muscle weakness, hypotension, sedation and ECG changes

46
Q

What is the consequence for higher magnesium concentrations?

A

risk of cardiac arrest.