CHAPTER 3 Flashcards
Fluids and Electrolytes, Acids and Bases
hyponatremia
most common cause is _____!!!
examples are _____, _____, _____
fluid overload
CHF
ARF SIADH
water excess
parathyroid hormone and calcitonin
PTH:
increases resorption of _____; stimulates _____ reabsorption of _____; inhibits renal reabsorption of _____
calcitonin:
inhibits _____ in bone
bone renal calcium phosphate osteoclasts
alterations in water movement: edema clinical manifestations: -localized vs. generalized -dependent edema -pitting edema -"third space" -swelling and puffiness -tighter fitting clothes and shoes -weight gain
treatment:
- _____ adematous limbs
- use _____ or devices
- avoid _____
- restrict _____ intake
- take _____ agents
elevate compression stockings prolonged standing salt diuretic
aldosterone
-increases renal _____ and _____ reabsorption; increases renal excretion of _____ and _____
sodium
water
potassium
hydrogen ion
acidemia
-_____ pH will initiate the formation of _____ (_____) from _____ (_____) referred to as _____, in the _____ of the _____ of a pH of _____
arterial ammonium (NH4) ammonia (NH3) acidemia tubular lumen kidney 7.25
atrial natriuretic peptide
-increases _____ and _____
renal sodium
water excretion
antidiuretic hormone
increases _____, _____ of the arterioles
renal water reabsorption
vasoconstriction
calcium and phosphate
- regulated by three hormones
1. _____ - _____ plasma _____ levels via kidney reabsorption
2. _____ - is fat-soluble steroid; _____ calcium absorption from the _____
3. _____ - _____ plasma calcium levels
-bottom line point: parathyroid hormone (PTH) so Ca and Phosphate is influenced with PTH, calcitonin and vitamin D
parathyroid hormone (PTH) increases calcium vitamin D increases GI tract calcitonin decreases
hypernatremia
- elevate _____ always implies a _____
- simple dehydration: tx: _____
- failure to produce _____ in the _____ or the _____ are insensitive to _____
- _____ of _____ can cause hypernatrenia
serum sodium free water deficit normal saline replacement AHD brain kidney ADH hypersecretion aldosterone
dehydration decrease sodium (hyponatremia)
-can result in _____, _____, and _____
weak pulse
tachycardia
weight loss
hypernatremia
- serum sodium >147 mEq/L
- related to _____ gain or _____ loss
- water movement from the _____ to the _____
- -_____
- manifestations: _____, _____, _____, _____, and _____
- treatment: _____
sodium water ICF ECF intracellular dehydration intracellular dehydration convulsions pulmonary edema hypotension tachycardia isotonic salt-free fluids
hypokalemia
- potassium level <3.5 mEq/L
- causes:
- reduced potassium intake
- increased potassium entry into cell
- increased potassium loss
- treatment:
- replace potassium orally and/or intravenously
- manifestations:
- decreased _____
- _____ weakness
- _____ atony
- cardiac _____
- _____ on electrocardiogram (ECG)
- causes:
- _____
- _____
neuromuscular excitability skeletal muscle smooth muscle dysrhythmias U wave repeated blood administration pancreatitis
hypermagnesemia
- MCC of hypermagnesemia is _____
- caused by the overuse of magnesium containing _____ or from _____ administration, during premature _____ when it is administered as _____
- it is _____ to have hypermagnesemia without having _____
- leads to _____ and loss of _____ reflexes
renal failure laxatives iatrogenic labor tocolytic rare renal insufficiency muscle weakness deep tendon
hyperkalemia
- 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
- _____ deficiency
- cell trauma
- one important cause of hyperkalemia include _____ and _____
insulin
renal failure
Addison disease
water movement between the ICF and ECF
- osmolality: how much solute in a solution
- _____: water movement between the _____ compartment and the _____ compartment
- –sodium for the ECF
- –potassium for the ICF
- aquaporins: a family of water channel proteins that provide permeability to water
osmotic forces
ICF
ECF
