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NR 351 Final A > Chapter 40 > Flashcards

Chapter 40 Flashcards

1
Q

Intracellular fluid (ICF)

A

fluid within the cell

70%

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2
Q

Extracellular fluid (ECF)

A

fluid outside the cell 30%;

responsible for transport of nutrients and wastes

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3
Q

Intravascular fluid

A

plasma

Fluid within the vascular system

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4
Q

Interstitial fluid

A

interstitial space

Around the cells, includes lymph

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5
Q

Transcellular fluids

A

Transform into everywhere

CSF, Pericardial, Synovial joints, interocular, pleural, sweat, digestive juices.

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6
Q

Healthy person: Total body water is

A

50% to 60% of body weight
Decreases with age

Infant has more bodily fluid and ECF than an adult

More prone to fluid volume deficits

Women and obese people have less body water

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7
Q

Sources of fluid

A
  • Ingested liquids
  • Food
  • Byproduct of metabolism
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8
Q

Fluid intake

A

1,300 mL (from ingested water)
1,000 mL (from ingested food)
300 mL (from metabolic oxidation)
= 2,600 mL (total fluid intake per day)

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9
Q

Sensible Losses

A

can be measured, fluid lost during urination, defecation and wounds

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10
Q

Insensible Losses

A

can’t be measured or seen, such as perspiration and water vapor from lungs during respiration

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11
Q

Fluid output

A 
1,500 mL urine (from kidneys)
600 mL (fluid loss from skin)
300 mL (from lungs)
200 mL (from feces via the GI tract)
= 2,500 to 2,900 mL (total per day)
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12
Q

Solvents

A

Liquid that holds a substance in solution (water)

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13
Q

Solutes

A

Substance that is dissolved in a solution

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14
Q

Charged particles are necessary for

A

metabolism

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15
Q

For Homeostasis to occur

A

Total cations = Total anions

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16
Q

Primary Organs for Homeostasis

A

Kidneys, cardiovascular system, adrenal glands, pituitary gland, thyroid gland, nervous system, GI tract

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17
Q

Kidneys

A

filter 170 L of plasma and excrete 1.5 L of urine

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18
Q

Cardiovascular system

A

pumps and carries nutrients and water in the body

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19
Q

Lungs

A

regulate oxygen & carbon dioxide levels of the blood

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20
Q

Adrenal Gland

A

help the body conserve sodium, save water and chloride and excrete potassium

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21
Q

Pituitary gland

A

stores and releases ADH.

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22
Q

Thyroid gland

A

increase blood flow in the body and increases renal circulation

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23
Q

Nervous system

A

inhibits and stimulates mechanisms influencing fluid imbalance

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24
Q

GI tract

A

absorbs water and nutrients that enter the body

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25
Q

Osmosis

A

water (solvent) passes from area of LOW concentration to HIGH concentration

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26
Q

Diffusion

A

HIGH concentration to LOW concentration

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27
Q

Active Transport

A

requires energy for movement of substances through the cell membrane from a low solute concentration to a high solute concentration

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28
Q

Filtration

A

passage of fluid through permeable membrane HIGH TO LOW PRESSURE.

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29
Q

Hydrostatic Pressure

A

(“Pushing Force”) Fluids are pushed through the semipermeable membrane of capillaries (IVS) interstitial fluid

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30
Q

Colloid Osmotic pressure

A

(“Pulling Force”) Plasma proteins (albumin) pulls the fluid from interstitial space back into capillaries

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31
Q

Sodium (Na+)

A
  • Value- 135-145 mEq/L
  • Maintains water imbalance, transmits nerve impulses, contracts muscles
  • Controls and regulates volume of body fluids
  • Most abundant in the ECF
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32
Q

Potassium (K+)

A
  • Value- 3.5-5.0 mEq/L
  • Regulates neuromuscular excitability, muscular contraction
  • Regulates cellular enzyme activity ad water content
  • Major ICF cation
  • Chief regulator of cellular enzyme activity and water content
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33
Q

Calcium (Ca2+)

A
  • Value- TOTAL serum calcium level 8.6- 10.2 mg/dL
  • Value Ionized- 4.5-5.1 mg/dL
     Cardiac conduction, blood coagulation, bone growth and formation and muscular relaxation
     Nerve impulse, Blood clotting, Muscle contraction, B12 Absorption
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34
Q

Magnesium (Mg2+)

A

 Value- 1.3- 2.3 mEq/L
 Muscular excitability
 Metabolism of carbohydrates and proteins, Enzyme activity
 Second most important of ICF

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35
Q

Chloride (Cl-)

A

 Value- 97- 107 mEq/L
 Major component of Gastric and pancreatic juices
 Maintains osmotic pressure in the blood and produces hydrochloric acid
 Role in body’s acid/base balance

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36
Q

Bicarbonate (HCO3-)

A

 Value- 22-26 mEq/L
 Regulates body’s acid / base balance
 Body’s primary buffer system

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37
Q

Phosphate (PO4-)

A

 Value- 2.5- 4.5 mg/dL
 Element in all of the body’s tissue
 Involved in important chemical reactions in the body such as cell division & Hereditary traits

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38
Q

Hyponatremia

A

(<135mEq/L)
 Causes: GI losses, fistulas, sweating, & diuretics
 S/S: Vomiting, Abdominal cramps, confusion, hypotension, edema, muscle cramps, can lead to seizures

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39
Q

Hypernatremia

A

(>145mEq/L)
 Causes: Ingestion of large amounts of sodium, fluid deprivation, lack of fluid intake, hyperventilation, burns
 S/S: Dry tongue, neurological impairment (restlessness, weakness, disorientation delusion, hallucinations), thirst, dry skin

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40
Q

Hypokalemia

A

(<3.5mEq/L)
 Causes: K+ wasting diuretics, Gi losses, poor dietary intake
 S/S: Fatigue, irregular pulse, hypotension, muscle weakness, leg cramps, paresthesia’s and dysrhythmias

41
Q

Hyperkalemia

A

(>5mEq/L)
 Causes: renal failure, hypoaldosteronism
 Meds: potassium chloride, heparin, ACE inhibitors, NSAIDS, potassium sparing diuretics
 S/S: Nerve conduction, muscle contractility, skeletal weakness, paralysis, cardiac irregularities, irregular slow pulse, can lead to cardiac arrest

42
Q

Hypocalcemia

A

 Causes: Vitamin D deficiency, impaired calcium absorption, excessive calcium loss, renal failure
 S/S: Tetany, circumoral numbness, muscle cramps, Trousseau’s & Chvostek’s sign, seizures, dyspnea, laryngospasm

43
Q

Hypercalcemia

A

(total serum calcium >10.2 mg/dL)
Serum calcium >equal to 17mg/dL is an emergency = cardiac arrest
 Causes: Cancer, hyperparathyroidism, osteoporosis, prolonged immobilization
 S/S: Constipation, bone pain, excessive urination, thirst, confusion, lethargy, slurred speech, muscle weakness, kidney stones, incoordination

44
Q

Hypomagnesemia

A

(<1.3mEq/L)
 Causes: Malnutrition, GI losses, sepsis, burns and withdrawal from alcohol
 S/S: Muscle tremors, hyperactive deep tendon reflexes, seizures, heart block, dysrhythmias, change in mental status, respiratory paralysis

45
Q

Hypermagnesemia

A

(>2.3 mEq/L)
 Causes: Renal failure, excessive administration of magnesium
 S/S: Weakness, flushing, lethargy, hypoactive DTRs, slow respirations, coma

46
Q

Hypophosphatemia

A

(<2.5 mg/dL or 1.8 mg/dL)
 Causes: Administration of calories to malnourished patients, alcohol withdrawal, hyper ventilation, insulin release
 S/S: irritability, fatigue, weakness, confusion, seizures, coma

47
Q

Hyperphosphatemia

A

(>4.5mg/dL)
 Causes: renal failure, hypoparathyroidism, chemo
 S/S: Tetany, anorexia, nausea, weakness, tachycardia

48
Q

Hypochloremia

A

(<97 mEq/L)
 Causes: Gi losses, sweating or high fevers, burns, drugs (bicarbonate, corticosteroids, diuretics, laxatives)
 S/S: tetany, hyperactive DTRs, weakness and muscle cramps, dysrhythmias, seizures, coma

49
Q

Hyperchloremia

A

(>107 mEq/L)
 Causes: increase sodium level in blood, hyperparathyroidism, metabolic acidosis, head trauma, increase perspiration
 S/S: Tachypnea, weakness, lethargy, decreased cognitive ability, dysrhythmias

50
Q

Acid

A

substance containing hydrogen ions (H+) that can be liberated or release to a base, like carbonic acid (H2CO3)

51
Q

Base

A

“alkali” substance that can trap, accept or bind hydrogen (H+) ions, like bicarbonate acid (HCO3)

52
Q

pH reflects the overall ____ concentration in bodily fluids

A

H+

53
Q

Alkaline

A

greater than 7 (pancreatic secretions)

54
Q

most important buffer system

A

Carbonic acid sodium bicarbonate

55
Q

Phosphate buffer system

A

actives in intracellular fluids, n renal tubules.

• Converts alkaline sodium phosphate (Na2HPO4) in kidneys

56
Q

Protein buffer system

A

mixture of plasma proteins and the globin portion of hemoglobin in RBC’S.

57
Q

Respiratory mechanism

A

CO2 is produced by cellular metabolism and excreted by exhalation
• More CO2 that is exhaled the H2CO3 level in the blood decreases, the pH of the blood becomes alkaline

58
Q

Renal mechanism

A

long term adjustment

59
Q

Acidosis

A

the kidneys excrete H+ ions and conserve the bicarbonate ions, raising the pH to normal

60
Q

Alkalosis

A

kidneys retain hydrogen ions and excrete bicarbonate ions to return to balance.

61
Q

Normal pH of urine

A

4.6-8.2

62
Q

Respiratory acidosis

A
  • carbonic acid excess
     pH< 7.35
     paCO2 > 45 mm Hg
     Causes: respiratory failure, Hypoventilation, airway obstruction
     S/S: Rapid shallow respirations, headache, muscle weakness, dyspnea, Hyperkalemia
63
Q

Respiratory alkalosis

A

carbonic acid deficit
 pH>7.45
 paco2< 35 mm Hg
 Causes: excessive exhalation of CO2- Hyperventilation
 S/S: Seizures, deep rapid breathing, nausea, vomiting, Hypokalemia

64
Q

Metabolic acidosis

A

bicarbonate deficit
 pH< 7.35 (increase H+)
 Bicarbonate - < 22 mEq/L
 Causes: starvation, DKA, renal failure, diarrhea, drug use, shock
 S/S: headache, lethargy, nausea, coma, abdominal discomfort, impaired kidney function

65
Q

Metabolic alkalosis

A

bicarbonate excess
 pH> 7.45 (decrease H+)
 Bicarbonate - >26 mEq/L
 Causes: excessive vomiting, prolonged gastric
 S/S: Tetany, confusion, muscle cramping

66
Q

Fluid volume deflect (FVD)

A

Hypovolemia: isotonic fluid loss, deficiency of electrolytes in the ECF

Third space fluid shift

67
Q

Fluid volume excess (FVE)

A 
Hypervolemia 
	Edema
	Interstitial to plasma shift 
	Bounding pulse
	Headache
	Seizures
68
Q

Compete Blood Count (CBC)

A

total number of RBC’s and values for hemoglobin (HGB) and hematocrit (HCT)

69
Q

Increase HGB

A

hem concentrated, blood diseases/cancers, lung diseases, congenital heart disease

70
Q

Decrease HGB

A

Anemia, severe hemorrhage, after hemolytic rection

71
Q

Increase HCT

A

In severe fluid volume deficit and shock

72
Q

Decease HCT

A

with massive blood loss, hemolytic reaction after transfusion of incompatible blood, fluid overload

73
Q

Increase BUN

A

impaired renal function, heart failure, salt and water depletion, dehydration, diabetic ketoacidosis, burns

74
Q

Increase creatinine

A

found with impaired renal function, heart failure, shock and dehydration

75
Q

low pH

A

metabolic acidosis, diabetic ketosis, and diarrhea

76
Q

High pH

A

respiratory alkalosis, potassium depletion, and chronic renal failure

77
Q

Specific gravity

A
  • (normal 1.005-1.030)
    • (concentrated urine >equal to 1.025)
    • (diluted urine
78
Q

Increase Urine specific gravity

A

dehydration, vomiting, diarrhea and heart failure

79
Q

Decrease Urine specific gravity

A

renal damage

80
Q

Low PaO2

A

HGB carries less than normal levels of O2, carbonic acid leaves the body in excessive amount

81
Q

High PaO2

A

HBG carries more oxygen; influenced by respiratory activity, excessive carbonic acid in the body

82
Q

Arterial Blood Gases (ABGs)

A

determine adequacy of oxygenation and ventilation, as a well assessment and treatment of acid base. Obtained by arterial blood sample

83
Q

Partial Pressure (P)

A

the chemical and physical activities of 2 gases
• Partial pressure of carbon dioxide= paCO2
• Partial pressure of oxygen= PaO2

84
Q

hypernatremia avoid __________ foods

A

high sodium

85
Q

IV __ is never administer IV bolus

A

K+

86
Q

infusion rate for IV KCL

A

10/mEq/hr

87
Q

Isotonic

A

same concentration particles of as plasma
(between 275-295)
• Normal cell

88
Q

Hypertonic

A

greater concentration of particles than plasma
(>295)
• Cell shrinks

89
Q

Hypotonic

A

lesser concentration of particles than plasma
(<275)
• Cell expands

90
Q

Isotonic solution

A

 0.9% NaCl (normal saline-NS)

 Lactated ringers

91
Q

Hypotonic solutions

A

 0.33% NaCl (1/3 NS)

 0.45% NaCl (1/2 NS)

92
Q

Hypertonic solutions:

A

D5

3% NaCl

93
Q

IV complications

A 
	Infiltration
	Phlebitis scale 
	Phlebitis
	Speed shock - too much fluid
	Fluid overload
	Air embolus
94
Q

Blood Types

A

Inherited trait determined by type of antigens and antibodies present in the blood.

95
Q

Antigen

A 
substances that causes formation of antibodies 
A blood has A Antigen on RBC’s
B has B antigens on RBC’S 
AB have both A&B 
O blood has neither.
96
Q

Hemolytic transfusion reaction

A

incompatibility (blood)

 Immediate onset, flushing, fever, chills, shock

97
Q

Circulatory overload

A

overwhelming volume

 Dyspnea, cough, pulmonary edema

98
Q

Bacterial reaction

A

bacteria in blood

 Fever, hypertension, abdominal pain

NR 351 Final A (13 decks)

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