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Exam 1 > Concepts: Electrolyte and Acid-Base Balance > Flashcards

Concepts: Electrolyte and Acid-Base Balance Flashcards

1
Q

What is included in the History/Interview for electrolytes and acid-base

A
  1. Acute and chronic illnesses (e.g., diabetes, congestive heart failure, renal failure)
  2. Abnormal losses of body fluids (e.g., prolonged or severe vomiting or diarrhea, draining wounds, fistulas)
  3. Burns
  4. Trauma
  5. Surgery
  6. Therapies that may disrupt fluid and electrolyte balance, for example, medications such as diuretics and steroids, and treatments such as IV therapy and parenteral nutrition (PN)
  7. Usual patterns of fluid intake/output
  8. Signs of dehydration
  9. Medication
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2
Q

What is included in the Focused assessment for electrolytes and acid-base

A
  1. Fluid intake and output
  2. Daily weight
  3. Skin turgor = sternum, inner thigh and forehead (kids abdominal and medial thigh) looking for tinting \
  4. Tongue turgor = normal has one long cut deficit causes multiple cuts, excesses salt looks swollen and red
  5. Moisture and oral cavity (dry =FVD, salt = sticky)
  6. Tearing and salivation (less tears with age, no tear in kids is a sign of FVD)
  7. Skin appearance and temp (metabolic acidosis cause warm flushed skin)
  8. Facial appearance (pinched and drawn facial expression, sunken eye fell soft to touch)
  9. Edema (not seen until retention on 5-10)
  10. Body temp (fever increase loss of fluids, increase fluids 500ml if temp is 101-103, 103 to 1,000)
  11. Pulse (tachy sign of FVD, Irregular a potassium imbalance) (quality increase FVE and VS versa)
  12. Respiratory (Deep and rapids trying to compensate metabolic acidosis/respiratory alkalosis) crackles sign of FVE
  13. BP (FVD lower BP and EVD raises it)
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3
Q

What are the daignostic to for ABG

A

CBC, serum electrolytes, blood urea nitrogen, and creatinine levels
Urine pH and specify gravity, ABG

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4
Q

Identify therapeutic interventions related to electrolyte and acid-base

A
  1. Mineral–electrolyte preparations are frequently prescribed to correct electrolyte imbalances.
  2. Diuretics are drugs that increase renal excretion of water, sodium, and other electrolytes.
  3. intravenous (IV) solutions may be prescribed to address fluid and/or electrolyte disturbances. Isotonic (0,9% NaCl and Lactated Ringer), Hypertonic (0.33% & 0.45% Strength normal saline) and Hypertonic (5% dextrose)
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5
Q

How is pH regulation concepts related to electrolyte and acid-base concepts

A

Electrolytes like bicarbonate (HCO3-) play a critical role in maintaining pH balance. The kidneys regulate bicarbonate concentration, which helps control blood pH.

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6
Q

How are Buffer systems related to electrolyte and acid-base concepts

A

The bicarbonate buffering system is essential in regulating acid-base balance. When there is an excess of hydrogen ions (H+), bicarbonate (HCO3-) can neutralize them, forming carbonic acid (H2CO3), which can then be converted to CO2 and exhaled. (protein and phosphate, and hemoglobin buffers but lesser)

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7
Q

How is Electrolyte Shifts elated to electrolyte and acid-base concepts

A

Changes in electrolyte levels can influence acid-base balance. For example, hyperkalemia (high potassium levels) can occur in acidosis (a condition where there is too much acid in the body).

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8
Q

How is Renal Function related to electrolyte and acid-base concepts

A

The kidneys regulate both electrolyte levels and acid-base balance. They reabsorb bicarbonate from urine and excrete hydrogen ions to maintain pH balance.

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9
Q

How is Respiratory Function related to electrolyte and acid-base concepts

A

The respiratory system helps regulate pH by controlling the levels of carbon dioxide (CO2) in the blood. CO2 is a byproduct of metabolism and can combine with water to form carbonic acid.

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10
Q

What is the range of pH in blood

A

7.35-7.35

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11
Q

What is the CO2 base range to acids is normal

A

35-45

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12
Q

What is the HCO3 range in acid to base

A

22-26

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13
Q

What is the relationship of Na+ and K+

A

Inverse high Na+ = Low K+

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14
Q

What is the relationship of Ca+ and PO4

A

Inverse High Ca+ = Low PO4

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15
Q

What is the relationship of Ca+ and Vit. D

A

Similar High Ca+ = High Vit. D

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16
Q

What is the relationship of Mg and calcium

A

High Mg = High Ca+

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17
Q

What is the relationship of Mg and Potassium

A

Similar Low Mg = Low K+

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18
Q

What is the relationship of Mg and PO4

A

Inverse Low Mg = High PO4

19
Q

Sodium range

A

135- 145mEq/L

20
Q

Potassium range

A

3.5 - 5.0 mmol/L

21
Q

Calcium range

A

9-11

22
Q

Magnesium range

A

1.5 - 2.5mEq/L

23
Q

Phosphate range

A

2.5 - 4.5 mg/dL

24
Q

What is metabolic acidosis

A

It is acid in your body cause by a loss of bicarbonate less than 22 mEa/L

25
Q

What Are the signs of acidosis

A

Headache, confusion, drowsiness, increased respiratory rate and depth, nausea, and vomiting. Peripheral vasodilation and decreased cardiac output occur when the pH drops to less than 7. Additional physical assessment findings include decreased blood pressure, cold and clammy skin, arrhythmias, and shock. Chronic metabolic acidosis is primarily caused by chronic kidney disease because dysfunctional kidneys do not excrete acid

26
Q

What causes a loss of bicarbonate

A

As in diarrhea, lower intestinal fistulas, ureterostomies, use of diuretics, early renal insufficiency, excessive administration of chloride, and the administration of parenteral nutrition without bicarbonate or bicarbonate-producing solutes, CKD

27
Q

How do you treatment metabolic acidosis

A

in acute, excessive chloride is the problem, given bicarbonate and monitor potassium levels. Chronic low calcium levels are treated, alkalizing agent and dialysis

28
Q

What is Metabolic alkalosis

A

Your body is based has a bicarbonate greater than 26 mEq/L

29
Q

What are the signs and symptoms of metabolic alkalosis

A

related to hypocalcemia, such as tingling of the fingers and toes, dizziness, and tetany (cramping muscles). Because it is the ionized fraction of calcium that is diminished in metabolic alkalosis, neuromuscular symptoms due to hypocalcemia are often the predominant symptoms

30
Q

What cause metabolic alkalosis

A

severe vomiting or gastric suction that causes loss of stomach HCl (hydrogen and chloride ions). pyloric stenosis, loss of potassium, ACTH secretion (as in hyperaldosteronism and Cushing’s syndrome, antacids containing bicarbonate or from the use of sodium bicarbonate,

31
Q

What is treatment for metabolic acidosis

A

Restoring normal fluid volume, Proton pump inhibitors (reduce HCL production), Carbonic anhydrase inhibitors (for patient with heart failure)

32
Q

What is respiratory acidosis

A

Your body is acidic caused by PCO2 great then 45 mm Hg

33
Q

What causes respiratory acidosis

A

hypoventilation, acute pulmonary edema, aspiration of a foreign object, atelectasis, pneumothorax, and overdose of sedatives, obstructive pulmonary disease (COPD)

34
Q

What is the treatment for respiratory acidosis

A

improve ventilation by bronchodilators, antibiotics, Mechanical ventilation, Pulmonary physiotherapy and nebulizer treatment

35
Q

What cause Respiratory acidosis

A

sudden hypercapnia (elevated PaCO2) that will increase pulse, blood pressure, and respiratory rate. The patient may complain of confusion, disorientation, or may exhibit diminished level of consciousness

36
Q

What is respiratory alkalosis?

A

Your body is based caused by PCO2 less 35 mm Hg

37
Q

What are the clinical signs of respiratory alkalosis

A

of lightheadedness and inability to concentrate due to cerebral artery vasoconstriction and decreased cerebral blood flow, numbness and tingling from decreased calcium ionization in the bloodstream, tinnitus, and sometimes loss of consciousness. Cardiac effects of respiratory alkalosis include tachycardia and ventricular and atrial arrhythmias

38
Q

What causes respiratory alkalosis

A

hyperventilation anxiety such as panic disorder, hypoxemia, salicylate intoxication, gram-negative sepsis, and inappropriate ventilator settings.

39
Q

What is the treatment for respiratory alkalosis

A

underlying cause breathe more slowly, antianxiety agent, paper bag or CO2 rebreather mask)

40
Q

What is the Dx, S/S, TX metabolic acidosis

A

Dx=DKA, shock, renal failure, diarrhea, starvation
S/S: Weakness fatigue, headache, dysrhythmia, Kussumal breathing, SOB,
Tx: Bicarbonate, fluids, Insulin, normal, K+, & D50

41
Q

What is the Dx, S/S, TX metabolic Alkalosis

A

Dx: Vomiting, hypokalemia, suctioning, TPN food, Tums
S/S: Dizziness, decreased RR, Numb toe and finger
Tx: fluid and electrolytes repletion, decrease N/V

42
Q

What is the Dx, S/S, TX Respiratory acidosis

A

Dx: Respiratory failure, COPD, Hypoventilation, PNA, sedatives, coma, thoracic injury
S/S: anxiety, confusion, headache, restless, blurry vision
Tx: Bronchodilators, antibiotic, fluids, ventilation

43
Q

What is the Dx, S/S, TX metabolic Alkalosis

A

Dx: Hyperventilation, increase altitude, PNA, anxiety attack, PTX, Blood transfusion
S/S: dizziness, dry mouth, Numb toes and finger
Tx: Paper bag, O2, sedative/antianxiety meds

44
Q

Chloride

A

98-108

Exam 1 (5 decks)

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