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NUE 325: Pathopharm I > Electrolytes > Flashcards

Electrolytes Flashcards

1
Q

Function of fluid

A
  • transports nutrients and waste to and from cells
  • acts as solvent for electrolytes/non electrolytes
  • helps maintain body temp, digestion/elimination, acid-base balance, lubrication of joints and body tissue
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2
Q

Composition of body fluid

A

Water that contains dissolved or suspended substances
- 50-60% of body wt is water

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3
Q

Fluid compartments

A
  • intracellular: inside the cells
  • extracellular: outside the cell
  • interstitial fluid: between the cells
  • intravascular fluid: plasma (part of blood)
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4
Q

Movement of fluid and electrolytes

A
  • diffusion
  • facilitated diffusion
  • active transport
  • osmosis
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5
Q

Osmosis

A

Movement of water down its concentration gradient
- from low solute env to high solute env across a semipermeable membrane
- stops when conc differences disappear or hydrostatic pressure builds and opposes further movement

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6
Q

Diffusion

A

Movement of molecules from an area of high conc to low conc
- movement stops when conc are equal

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7
Q

Osmotic pressure

A

Amount of pressure needed to prevent the movement of water across a cell membrane

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8
Q

Colloids

A

Substances that inc colloid oncotic pressure
- move fluid from interstitial compartments to plasma compartment

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9
Q

3 primary colloids

A
  • albumin
  • globulin
  • fibrinogen
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10
Q

How to measure colloids

A

Total protein level
-not an indicator of protein nutrition

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11
Q

Colloid oncotic pressure dec w

A

Age
Overall malnutrition
- can be replaces with colloid replacements

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12
Q

Hydrostatic pressure

A

Force of fluid in compartment pushing against the cell membrane (or vessel wall)
- generated by bp
- at capillary level—> major force that pushes water out of vascular into interstitial

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13
Q

Oncotic pressure

A

Aka colloid oncotic pressure
Caused by plasma colloids in solution
- plasma has lots of colloids and the interstitial space has few so plasma proteins attract water and pull fluid from tissues into vascular space

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14
Q

Hydrostatic and oncotic

A

Hydro pushes fluid out of capillaries
Oncotic pulls fluid into capillary

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15
Q

Electrolyte influence

A

Fluid balance, acid base balance, nerve impulses, muscle contractions, heart rhythm, other cell functions
- function collaboratively so a change in one is going to influence changes in others

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16
Q

Electrolytes

A

Substances that are electrically charged when in solution

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17
Q

Conc of electrolytes depend on

A
  • intake
  • absorption
  • distribution
  • excretion
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18
Q

Where do we find electrolytes

A

Intracellular
- K, Mg, Ph
Extracellular
- Na, Cl, bicarbonate

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19
Q

What happens if electrolyte imbalance occurs

A

We replace abnormal losses with a fluid and electrolyte similar to that which was lost

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20
Q

Normal Na level

A

136-145 med/L

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21
Q

K levels

A

3.5-5.0 meq/L

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22
Q

Mg levels

A

1.7-2.2 mg/dl

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23
Q

Ca levels

A

9-11 mg/dL

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24
Q

Ph levels

A

3.2-4.3 mg/dL

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25
Hypo/hypernatremia
-below 136 and above 145
26
Sodium key points
Main ECF cation which governs osmolality and influences water distribution - sodium sucks water towards it - activates muscle and nerve cells —> important for AP
27
Causes of hyponatremia
- GI loss: vomiting/etc. fistulas, NG suction - renal losses: diuretics, adrenal insufficiency - skin loss: burn skin, wounds - fasting diets or polydipsia - excess hypotonic fluid
28
S/s of hyponatremia
- confusion/ altered LOC - anorexia, muscle weakness - can lead seizure
29
Hyponatremia altered LOC explained
Cells in the brain swell - more solutes in the cells than vascular space
30
Dilutional hyponatremia
hypervolemic: too much volume in the vascular space - extra fluid dilutes the Na down - increase bp, wt gain, bounding/rapid pulse, inc urine sp gravity
31
Depletion hyponatremia
Hypovolemic: Low Na - hypovolemia, dec bp, tachy pulse, dry skin, wt loss, dec urine sp gravity
32
Treatment of hyponatremia
- slow Na replacement PO/IV - can do normal saline - fluid restrictions - treating underlying problem
33
Why is Na replacement slow
Too much Na too fast will in Na in vascular space, so fluid moves out of cells (specifically brain) and dehydrate the cell causing the altered LOC
34
Causes of hypernatremia
-IV fluids, tube feeds, near drownings in salt water—> excess Na intake - not enough water intake or too much water loss due to cog impairment, diarrhea, high fever, heatstroke - profound dieresis
35
S/s of hypernatremia
- altered LOC, confusion, seizure, coma - extreme thirst (hyperosmolaity) - dry, sticky mucous membranes - muscle cramps
36
Hypernatremia treatment
If water is lost to quickly, then add water If na is in excess, then remove na - gradually adjust over 48 hr period to avoid edema of cerebral cells
37
Potassium
Intracellular ion that helps regulate the excitability and electrical status - helps control intracellular osmolality - diet is main source - kidneys main source of loss
38
Normal values of k
3.5-5 mEq/L
39
Causes of hypokalemia
Renal or GI losses like diuresis Acid base disorders —> k leaves ECF into ICF
40
S/s of hypokalemia
- cardiac rhythm disturbance (heart attack) - muscle weakness, leg cramps - dec bowel motility, constipation, nausea, lieu’s * potassium and ATP pump *
41
Hypokalemia treatment
Potassium chloride
42
Hyperkalemia cause
- dec potassium output (renal failure, not peeing) - burns, crash, injuries, sepsis (K lives in cells, so when many die they release K into blood) - drugs (K sparing, ACE, ARBS, NSAIDS)
43
Hyperkalemia s/s
Cardiac rhythm disturbance - muscle weakness, cramps - abdominal cramping
44
Hyperkalemia treatment
Diuretics or drugs
45
Magnesium
Helps stabilize cardiac muscle cells by blocking/controlling movement of K OUT of cardiac muscles - also helps stabilize smooth muscles
46
Hypomagnesium causes
- diuresis - GI or renal losses - limited intake (fasting/starvation) - alc abuse - pancreatitis - hyperglycemia
47
Hypomagnesium treatment
- Treat cause - replacement oral or IV
48
Hypomagnesium s/s
- hyperactive reflexes - confusion - cramps - tremors - seizures - nystagmus
49
Hyper magnesium cause
Increased intake accompanies with renal failure - renal failure and OB pts - healthy ppl pee it out
50
Why can OB pts get hyper magnesium
Given mg sulfate to prevent pre eclampsia, eclampsia and seizures
51
Hyper magnesium s/s
- lethargic - floppiness - muscle weakness - dec reflexes - flushed/warm skin - dec pulse/BP
52
Hyper magnesium treatment
Stop replacement - if chronic, then dialysis
53
Calcium
Hormones released from thyroid and parathyroid glands control amount of Ca absorbed/released from bone
54
When is majority of Ca
Bone
55
Ca functions
- enzyme rxns - effects membrane potentials and nerve excitability - helps in release of hormones, NTs, and chemical mediators - influences cardiac contractility and automaticity - necessary for blood clotting
56
Hypocalcemia cause
- unable to mobilize Ca from bone - hypoparathyroidism - hypomagnesium - increase renal loss - inc binding - dec intake of absorption, dec vitamin D - acute pancreatitis - thyroid/parathyroid surgery
57
Hypocalcemia s/s
Increased neuromuscular excitability - parasthesias (numbness/tingling) - muscle cramps, bone pain, tetany, laryngeal spasms, hyperactive reflexes - prolonged QT interval - positive Chvostek’s and Trousseau
58
Chovsteks
Ipsilateral twitching of the circumoral muscles in response to gentle tapping of the facial nerve just anterior of the ear
59
Trousseau
Carpal spasm upon inflation of BP cuff to 20 mmHg Obote pts sbp for 3 mins
60
Treatment of hypocalcemia
IV: ca chloride/ca gluconate., given through central line typically Oral: elemental Ca, Ca carbonate (tums), may also need vitamin D (active form in impaired liver and or kidney function)
61
Hypercalcemia causes
Hyperparathyroidism Cancer (breast, lung, hemotological)
62
S/s of Hypercalcemia
Calcium acts like a sediative, fatigue, lethargic, confusion, weakness, leading to seizure/coma, kidney stones - dec excitability
63
Treatment of hypercalcemia
Adequate hydration - inc urine output - diuretics and NaCl (na excretion accompanied w Ca) - dialysis in renal failure
64
Phosphorus location
Mostly found in bone, some intracellular - tiny amount in blood
65
Forms of P
Organic: intracellular Inorganic: circulating and measured
66
Function of P
- role in bone formation - essential for ATP formation and enzymes need for glucose, protein, fat metabolism - part of RNA, DNA - acid base buffer - normal function of WBC and platelet
67
Hypophsophatemia cause
- dec absorption - antacids OD - severe diarrhea - inc kidney elimination - malnutrition (alcoholism, TPN, recovery)
68
Hypophosphatemia s/s
Tremor, parasthesia, confusion to coma, seizure, muscle weakness, joint stiff, hemolytic anemia, platelet dysfunction, impaired WBC
69
Causes of hyperphosphatemia
Kidney failure - laxative/enemas with P - shift form intracellular to extracellular due to trauma or heat stroke - hypoparathyroidism
70
S/s hyperphosphatemia
Usually asymptomatic - usually the symptoms of hypocalcemia: muscle spasms, parathesia, tetany
71
Treatment for p imbalance
Hypophosphatemia: oral or IV replacement given over a long period of time, inc risk of calcification Hyperphosphatemia: treat cause, ca based p binders, hemodialysis

NUE 325: Pathopharm I (23 decks)

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