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Pathophysiology > Chapter 6: electrolytes > Flashcards

Chapter 6: electrolytes Flashcards

1
Q

What percentage of body weight does the intracellular fluid compartment make up?

A

40%

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2
Q

What percentage of body weight does the extracellular fluid compartment make up?

A

20%
tissue - 14
plasma (vascular)- 5
transcellular- 1

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3
Q

What is tonicity?

A

osmotic pressure of two solutions separated by a semipermeable membrane

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4
Q

How is the thirst mechanism triggered?

A

Triggered by decreased blood volume and increased osmolarity

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5
Q

What does ADH promote?

A

Promotes reabsorption of water in the kidneys

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6
Q

What does aldosterone do?

A

Increases reabsorption of sodium and water in the kidneys

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7
Q

What does atrial natriuretic peptide do?

A

Stimulates renal vasodilation and suppresses aldosterone, increasing urinary output

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8
Q

What is edema?

A

Excess fluid in the interstitial space

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9
Q

What is hypervolemia?

A

Excess fluid in the intravascular space

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10
Q

What is water intoxication?

A

Excess fluid in the intracellular space

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11
Q

How much is interstitial fluid increased with edema?

A

2.5 liters

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12
Q

What does edema do to capillary filtration pressure?

A

Increased

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13
Q

What happens when capillary filtration pressure is increased?

A

increased volume, heart failure, gravity, venous obstruction

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14
Q

What does edema do to colloid osmotic pressure?

A

decreased

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15
Q

What happens when colloid osmotic pressure is decreased?

A

liver disease, starvation

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16
Q

What does edema do to capillary permability?

A

Increase

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17
Q

What happens when capillary permeability is increased?

A

immune response, shock, sepsis

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18
Q

What does edema do to lymph flow?

A

Obstructs it

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19
Q

What causes an excessive sodium or water intake?

A 
High-sodium diet
Psychogenic polydipsia
Hypertonic fluid administration
Free water
Enteral feedings
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20
Q

What causes an inadequate sodium or water elimination?

A 
Hyperaldosteronism
Syndrome of inappropriate antidiuretic hormone
Renal failure
Liver failure
Heart failure
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21
Q

What are the manifestations of fluid excess?

A

peripheral edema, periorbital edema, pulmonary edema, bounding pulse, tachycardia, jugular vein distension, hypertension, polyuria, rapid weight gain

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22
Q

What is decreased with hypovolemia or fluid volume deficit?

A

Decreased fluid in the intravascular space

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23
Q

Does fluid deficit have to occur with electrolyte defects?

A

No

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24
Q

What happens with a fluid deficit?

A
  • Decrease in fluid level leads to increase in level of blood solutes
  • Cell shrinkage
  • Hypotension
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25
Q

What causes an excessive fluid or sodium loss?

A
  • Gastrointestinal losses
  • Excessive diaphoresis
  • Hemorrhage
  • Diuresis
  • Surgery
  • Open wounds
  • Third spacing – transcellular c-ompartment ex. burns
  • Excessive use of diuretics
  • Osmotic diuresis
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26
Q

What are the manifestations of fluid deficit?

A

thirst, altered level of consciousness, hypotension, tachycardia, weak pulse, flat jugular veins, dry mucous membranes, decreased skin turgor, decreased urine output, weight loss

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27
Q

What is the treatment for fluid deficit?

A

identify and manage underlying cause along with fluid replacement

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28
Q

What is the normal range of sodium?

A

135–145 mEq/L.

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29
Q

Facts about sodium

A

Most significant cation and prevalent electrolyte of extracellular fluid.

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30
Q

What does sodium control?

A

Controls serum osmolality and water balance.

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31
Q

Does sodium play a role in acid-base balance?

A

yes

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32
Q

What does sodium facilitate

A

Facilitates muscles and nerve impulses.

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33
Q

What is the main source of sodium?

A

Main source is dietary intake.

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34
Q

Where is sodium excreted?

A

Excreted through the kidneys and gastrointestinal tract.

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35
Q

What is hyponatremia?

A

Sodium < 135 mEq/L

Serum osmolarity decreases

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36
Q

What is hypertramia?

A

Sodium > 145 mEq/L

Serum osmolarity increases

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37
Q

What are the causes of hypernatremia due to excessive sodium?

A

-Excessive sodium ingestion
-Hypertonic IV saline
administration
-Oversecretion of
aldosterone

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38
Q

What are the causes of hypernatremia due to deficient water?

A
  • Decreased water ingestion
  • Loss of thirst sensation
  • Inability to drink water
  • Third spacing
  • Vomiting
  • Diarrhea
  • Excessive sweating
  • Diuretic use
  • Diabetes insipidus
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39
Q

What are the manifestations of hypernatremia?

A

increased temperature, warm and flushed skin, dysphagia, increased thirst, agitation, weakness, headache, seizures, lethargy, coma, hypotension, tachycardia, weak pulse, edema, and decreased urine output

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40
Q

What is the treatment for hypernatremia?

A

fluid replacement

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41
Q

What are the causes of hyponatremia due to deficient sodium?

A
  • Diuretic use
  • Gastrointestinal losses
  • Excessive sweating
  • Dietary sodium restrictions: rare
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42
Q

What are the causes of hyponatremia due to excessive water?

A
  • Hyperglycemia
  • Excessive water ingestion
  • Syndrome of inappropriate antidiuretic hormone
43
Q

What are the manifestations of hyponatremia?

A

gastrointestinal upset, blood pressure changes, pulse changes, edema, headache, lethargy, confusion, diminished deep tendon reflexes, muscle weakness, seizures, and coma

44
Q

What happens with sodium and ECF loss?

A

hypotension, tachycardia, decreased urine output, poor skin turgor, dry mucous membranes
Dilutional hyponatremia

45
Q

What is dilutional hyponatremia?

A

weight gain and edema

46
Q

What is the treatment for hyponatremia?

A

treat the cause

47
Q

What is the normal range of potassium?

A

3.5–5 mEq/L.

48
Q

fact about potassium

A

The primary intracellular cation.

49
Q

What does potassium play a role in?

A

Plays a role in electrical conduction, acid–base balance, and metabolism.

50
Q

What is the main source of potassium?

A

Main source is dietary intake.

51
Q

Where is potassium excreted?

A

Excreted through the kidneys and gastrointestinal tract.

52
Q

What happens with potassium fluctuation?

A

Serum potassium cannot fluctuate much without causing serious issue.

53
Q

What is hyperkalemia?

A

Potassium > 5 mEq/L

54
Q

What are the causes of hyperkalemia?

A

Deficient excretion: renal failure, Addison’s disease, certain medications
Excessive intake: oral potassium supplements, salt substitutes, and rapid intravenous administration of diluted potassium
Increased release from cells: acidosis, blood transfusions, and burns or any other cellular injuries
Insulin deficit

55
Q

What are the manifestations of hyperkalemia?

A

paresthesia, muscle weakness, dysrhythmias, cardiac arrest, abdominal cramping, nausea, and diarrhea

56
Q

What is the treatment for hyperkalemia?

A

treat the cause. Calcium gluconate, insulin, cation exchange resins (oral or rectal).

57
Q

What is hypokalemia?

A

Potassium < 3.5 mEq/L

58
Q

What are the causes of hypokalemia?

A

Excessive loss: vomiting, diarrhea, nasogastric suctioning, fistulas, laxatives, potassium-losing diuretics, increased mineralcorticoids
Deficient intake: malnutrition, extreme dieting, and alcoholism
Increased shift into the cell: alkalosis and insulin excess

59
Q

What are the manifestations of hypokalemia?

A

muscle weakness, paresthesia, hyporeflexia, leg cramps, weak and irregular pulse, hypotension, dysrhythmias, decreased bowel sounds, abdominal distension, constipation, and cardiac arrest

60
Q

What are the treatments for hypokalemia?

A

identify and manage underlying cause along with potassium replacement

61
Q

What is the normal range of calcium?

A

Normal range: 8.5 -10.5 mg/dL

62
Q

Where is calcium mostly found?

A

Mostly found in the bone and teeth

63
Q

What does calcium play a role in?

A

Plays a role in blood clotting, hormone secretion, receptor functions, nerve transmission, and muscular contraction

64
Q

What does calcium have an inverse relationship with?

A

Has inverse relationship with phosphorus

65
Q

What is the main source of calcium?

A

Main source is dietary intake.

66
Q

What aids absorption of calcium?

A

Vitamin D aids absorption.

67
Q

Where is calcium absorbed?

A

Absorbed through the gastrointestinal tract (small intestine).

68
Q

Where is calcium excreted?

A

Excreted in urine and stool

69
Q

What is calcium regulated bY?

A

Vitamin K
Parathyroid hormone
Calcitonin

70
Q

What is hypercalcemia?

A

Calcium > 10.5 mg/dL

71
Q

What are the causes of hypercalcemia?

A
  • Increased intake or release: calcium supplements, cancer, immobilization, corticosteroids, vitamin D excess
  • Deficient excretion: thiazide diuretics, and hyperparathyroidism
72
Q

What are the manifestations of hypercalcemia?

A

dysrhythmias, headache, fatigue, muscle weakness, decreased deep tendon reflexes, anorexia, nausea, vomiting, constipation, high blood pressure, bone resorption

73
Q

What is the treatment for hypercalcemia?

A

treat cause, increase excretion or mobility

74
Q

What is hypocalcemia?

A

Calcium < 8.5 mg/dL

75
Q

What are the causes of hypocalcemia?

A

Excessive losses: hypoparathyroidism, alkalosis, laxatives, diarrhea
Deficient intake: decreased dietary intake, alcoholism, absorption disorders

76
Q

What are the manifestations of hypocalcemia?

A

dysrhythmias, increased bleeding tendencies, confusion, fatigue, increased deep tendon reflexes, increased bowel sounds, abdominal cramping, and positive Trousseau’s and Chvostek’s signs

77
Q

What is the treatment for hypocalcemia?

A
  • Identify and manage underlying cause
  • Calcium replacement (oral or intravenous)
  • Vitamin D
  • Decrease phosphorus
78
Q

What is the normal range of phosporus?

A

Normal range: 2.5–4.5 mg/dL.

79
Q

Where is phosphorus mainly found?

A

Mostly found in the bones; small amounts are in the bloodstream.

80
Q

What does phosphorus play a role in?

A

Plays a role in bone and tooth mineralization, cellular metabolism, acid–base balance, and cell membrane formation.

81
Q

What is the main source of phosphorus?

A

Main source is dietary intake.

82
Q

Where is phosphorus excreted?

A

Excreted through the kidneys.

83
Q

What is hyperphosphatemia?

A

Phosphorus > 4.5 mg/dL

84
Q

What are the causes of hyperphosphatemia?

A

Deficient excretion: hypoparathyroidism and phosphate containing laxatives
Excessive intake or cellular exchange: cellular damage, hypocalcemia, and cell destruction

85
Q

What are the manifestations of hyperphosphatemia?

A

rarely seen alone, related to low calcium levels

86
Q

What is the treatment for hyperphosphatemia?

A

Identify and manage underlying cause
Aluminum hydroxide binds with phosphate
Treat hypocalcemia

87
Q

What is hypophosphatemia?

A

Phosphorus < 2.5 mg/dL

88
Q

What are the causes of hypophosphatemia?

A

Excessive excretion or cellular exchange: hyperparathyroidism, and alkalosis
Deficient intake: malabsorption, vitamin D deficiency, magnesium and aluminum antacids, alcoholism, and decreased dietary intake

89
Q

What are the manifestations of hypophosphatemia?

A

similar to hypercalcemia. Muscle weakness, irritability, confusion, bone resorption.
Treatment:

90
Q

What is the treatment for hypophosphatemia?

A 
Identify and manage the underlying cause
Phosphorus replacement (oral or intravenous)
91
Q

What is the normal range of magnesium?

A

Normal range: 1.8–2.4 mEq/L.

92
Q

What kind of cation is magnesium?

A

An intracellular cation.

93
Q

Where is magnesium mainly stored?

A

Mostly stored in the bone and muscle.

94
Q

What does magnesium play a role in?

A

Plays a role in muscle and nerve function, cardiac rhythm, immune function, bone strength, blood glucose management, blood pressure, energy metabolism, and protein synthesis.

95
Q

What is the main source of magnesium?

A

Main source is dietary intake.

96
Q

Where is magnesium excreted?

A

Excreted through the kidneys.

97
Q

What is hypermagnesemia?

A

Magnesium > 2.5 mEq/L (rare)

98
Q

What are the causes of hypermagnesemia?

A

Causes: renal failure, excessive laxative and antacid use

99
Q

What are the manifestations of hypermagnesemia?

A

muscle weakness, fatigue, dysrhythmias, hypotension, nausea

100
Q

What is the treatment for hypermagnesemia?

A

diuretics and intravenous calcium

101
Q

What is hypomagnesemia?

A

Magnesium < 1.8 mEq/L

102
Q

What are the causes of hypomagnesemia?

A

inadequate intake, chronic alcoholism, malnutrition, pregnancy, diarrhea, diuretics, and stress

103
Q

What are the manifestations of hypomagnesemia?

A

similar to hypocalcemia, confusion, increased reflexes, hypertension

104
Q

What is the treatment for hypomagnesemia?

A

magnesium replacement (oral or intravenous)

Pathophysiology (11 decks)

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