Chapter 3 Flashcards
increases renal _____ and ____ reabsorption; increases renal ______ of _______ and ______ ion
aldosterone sodium, water excretion potassium hydrogen
a test for latent tetany in which _____ spasm is induced by inflating a sphygometer cuff on the upper arm to a pressure exceeding ______ blood pressure for __ mins
trousseau sign hypocalcemia carpal systolic 3
clinical sign of existing nerve hyperexcitability tetany seen in _______. it refers to an abnormal reaciton to the stimulation of the _______
chvostek sign
hypocalcemia
facial nerve
mild attacks
-tingling of ______ and ____, ________, ________ cramping and ______, EKG changes is ________ on the ECG!!!!
severe attacks
-_____ Weakness, loss of _____ tone, ____ paralysis, ________
treatment:
-_________, ______ or ____, _________, _____ exchange _____, ______
tx with insulin
-insulin is used to treat ____ potassium levels because it transports potassium from the _____ to the ____ with ______
hyperkalemia lips fingers restlessness intestinal cramping diarrhea peaked T waves muscle muscle flaccid cardiac arrest calcium gluconate insulin glucose Na+ bicarbonate cation exchange resins dialysis high blood cell glucose
hyponatremia
increases renal water reabsorption
________ of the arterioles
ADH
vasoconstriction
hyponatermia
most common cause is fluid ________
examples are:
____, ________, water ______
overload CHF ARF SIADH water excess
hypernatremia continued
dehydration
-free water deficit
-renal free waterclearance
-manifestations: tachycardia, weak pulse, postural hypotension
-elevated hematocrit and serum sodium levels,
-headache, dry skin, and dry mucuous membrane
treatment: give ____ and stop ____
-________ solutions or ____ in water
pure water free water tachycardia weak pulse postural hypotension hematocrit sodium headache skin mucuous
water, fluid loss
hypotonic saline
5% dextrose
if H+ is high in number, PH is ____
if H+ is low in number, PH is ____
low (acidic)
high (alkaline)
Water movement between the ICF and ECF
______ - water movement between the ICF compartment and the ECF
- sodium for ECF
- potassium for the ICF
aquaporins: family of water channel proteins that provide permeability to water
osmotic forces
sodium
potassium
hyponatremia
____________ decrease sodium
can result in ____ pulse, ______ and _______
dehydration weak tachycardia weight hypovolemic: decrease in Na+ and H2O
elevate serum ______ always implies a free water deficit
- ______ - Tx _______ replacement
-failure to produce _____ in the brain or the _____ is insensitive to it
what does this hormone do?
-hypersecretion of _______ can cause this
why?
serum sodium is >___mEq/l
- related to ____ gain or ___ loss
- water movement from the ____ to ____
- ______ dehydration
- manifestations: _____ dehydration, _______, ______ edema, ________, _________
treatment: __________ fluids
-high sodium in the blood vessels pulls water out of the _____ cells into the blood vessels, causing the cells to _____ which causes _______, ________, ________ and _____
hypernatremia sodium simple dehydration normal saline alderosterone
because aldosterone retains sodium (hypervolemic)
147 sodium, water ICF, ECF intracellular intracellular convulsions pulmonary hypotension tachycardia isotonic salt-free
brain shrink confusion convulsions cerebral hemorrhage coma
hypotonic hyponatremia _______
Water excess
- compulsive water drinking, causing water intoxication
-decreased urine formation
-SIADH
-ADH secretion causes water reabsorption
manifestations: cerebral edema, muscle twitching , ______ and ____ gain
treatment: ___ restriction, may need _______________ IV solution
euvolemic compulsive intoxication (primary polydipsia) urine SIADH reabsorption cerebral twitching headache weight water hypertonic sodium chloride IV
is a deep and labored breathing pattern often associated with severe ________ particularly diabetic _______ but also ______ failure
- it is a form of _________. which is any breathing pattern that reduces _______ in the blood due to increased _____ or ____ of respiration
- ______ measure is needed to correct _________
kussmaul respirations metabolic acidosis ketoacidosis kidney failure hyperventilation carbon dioxide rate depth compensentory metabolic acidosis
alterations in water movement: edema clinical manifestations -localized vs generalized - pitting edema - dependent edema -third space -swelling and puffiness tight fitting clothes and shoes weight
treatment
- ______ edematous limbs
- use _______ or devices
- avoid prolonged ________
- restrict _____ intake
- take _______ agents
localized, generalized pitting dependent third space swelling, puffiness tight weight
elevate compression stockings standing salt diuretic
calcium levels >12 mgdl causes: hyperparathyroidism -bone metastasis -excess vitamin D -immobilization -acidosis manifestations: -decreased neuromusclar excitability -muscle weakness -\_\_\_\_\_\_\_ -\_\_\_\_\_\_\_\_ -\_\_\_\_\_\_\_ constipation heart block
hypercalcemia
kidney stones
lethargy
brachycardia
rate of breathing is chronically decreased below normal level
because of inadequate removal of ____ by the lungs, levels levels of this in the blood increase, leading to _________
_______ is also significantly reduced in more severe incidents
pickwickian syndrome
carbon dioxide
respiratory acidosis
oxygen
increases resorption of ____; stimulates renal reabsorption of _____; inhibits renal reabsorption of ________
PTH
bone
calcium
phosphate
______ and ______
regulated by 3 hormones:
1. __________
-increases plasma _____ levels via kidney ________
2. vitamin __
-is a ______ steroid; increases calcium ____ from the ____
3. ______
-_____ plasma calcium levels
bottom line point:
-_________ so Ca and phosphate is influenced with these 3 things
calcium and phosphate parathyroid hormone (PTH) calcium, reabsorption D fat soluble absorption GI tract calcitonin decreases PTH
___________ peptide: increases renal _____ and water _______
atrial natriuretic peptide
sodium
excretion
arterial pH will initiate the formation of ______ (__) from _____ (__) referred to as ______, in the _______ of the _____ of a pH of ___
academia ammonium NH4 ammonia NH3 academia tubular lumen of the kidney 7.25
in red
the pathophysiological process of edema is related to _______ obstruction, increased __________ results of _____ and _____ retention
lymphatic
capillary hydrostatic pressure
water, sodium
potassium level: >5.5 mEq/L -rare as a result of efficient renal excretion causes: -increased intake -shift of K+ from ICF TO ECF -decreased renal excretion -hypoxia acidosis -\_\_\_\_\_\_ -insulin deficiency -cell trauma -one important cause of this include \_\_\_\_\_\_\_\_ and \_\_\_\_\_\_\_
hyperkalemia
renal failure
Addison disease
metabolic acidosis manifestations: -headache -lethargy -\_\_\_\_\_ respirations treatment: -bicarbonate -lactate solutions: \_\_\_\_\_ converted into \_\_\_\_\_\_ in the liver -treat the underlying causes
headache lethargy kussmaul respirations bicarbonate lactate-containing bicarbonate liver
major intracellular cation
_______, _______, _____ and ______ facilitate this into cells
deficiency of these facilitate it out of cells
is essential for the transmission and conduction of ______ impulses, normal ________, and _____ and ____ muscle contraction
regulates ICF osmolality and deposits _______ in liver and skeletal muscles
-K+ adaptation allows the body to accomodate slowy to increased levels of K+ intake
potassium aldosterone, insulin, epinephrine and alkalosis nerve impulses normal cardiac rhthyms skeletal, smooth glycogen
accumulation of the fluid portion _____ of blood into the extra cellular space
edema
plasma
\_\_\_\_\_\_\_\_ acidosis causes: depression of the respiratory center (brainstem trauma, oversedation) -respiratory muscle paralysis -disorders of the chest wall (kyphoscoliosis, \_\_\_\_\_\_\_, flail chest) disorders of the lung parenchyma pulmonary edema pneumonitis empysema asthma bronchitis
respiratory acidosis
kyphoscoliosis
pickwickian syndrome
flail chest
the pathophysiological process of edema
- is related to an _____ in the forces favoring fluid filtration from the _______ or ______ channels into the _______
- the most common mechanisms are increased __________ pressure, decreased _________ pressure, increased ____________ and _______ obstruction and ______ retention
what each one is:
______________: if there is an increased volume of blood, then fluid will push out to extra cellular space causing sodium and water retention
_________: increase in permeability, occurs in inflammation
-vasculature leaks into extracellular space
__________: lymphatic system collects extra fluid that is in EC, if there is an obstruction due to ex. tumor
________: proteins in plasma act as an osmotic force to pull fluid from extracellular space back into vessel
- if decreased, then build up of edema
increase capillaries lymphatic tissues capillary hydrostatic pressure plasma oncotic pressure capillary membrane permeability lymphatic sodium
increased hydrostatic pressure
increased capillary membrane permeability
lymphatic obstruction
decreased plasma oncotic pressure
causes are repeated ________ and _______
first is a common cause because the ________ in storing whole blood binds with calcium. second one causes a release of _____ into soft tissue spaces; consequently, the free fatty acids that are formed binds to calcium, causing a decrease in ______ calcium
hypocalcemia blood transfusions pancreatitis citrate solutions lipases ionized
treatment:
avoid _______ ; ______ administration or ______
treatment for hypermagnesemia
magnesium
saline
dialysis
potassium level <3.5meq/L causes: reduced potassium intake -increased potassium entry in cell increased potassium loss manifestations - causes: repeated \_\_\_\_\_\_\_ -\_\_\_\_\_\_\_
Low K imbalance causes: - \_\_\_\_\_\_\_\_\_\_ -\_\_\_\_\_\_\_\_\_ -\_\_\_\_\_\_\_\_\_ -weakness of \_\_\_\_\_\_\_\_ muscles -\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
hypokalemia potassium entry into loss blood administration pancreatitis
paralytic ileus sinus bradycardia atrioventricular block skeletal cardiac dysrythmias smooth muscle atony
most common cause is _______ failure
- caused by the overuse of magnesium containing ______ or from _______ administration, during ______ labor when it is administered as a ______
- it is rare to have this without having ____ insufficiency
- leads to muscle ______ and loss of deep _________
hypermagnesemia renal failure laxative iatrogenic premature tocolytic renal weakness tendon reflexes
inhibits osteoclasts in bone
calcitonin
hyponatremia
serum sodium level
manifestations:
lethargy headache confusion apprehension seizures coma
