electrolytes II Flashcards
1
Q
Potassium is responsible for A. building muscle mass B. Building bone structure and strength C. Maintaining heartbeat D. Maintaining weight
A
C. Maintaining the heartbeat; it is vital for proper cardiac function because it plays a key role in cardiac muscle contraction
2
Q
When the hormone aldosterone is secreted the kidneys reabsorb: A. sodium B. Potassium C. Mg D. Ca
A
A. Sodium is reabsorbed & K is excreted
3
Q
Neuromuscular signs and symptoms of hypokalemia include: A. Tourettes syndrome B. confusion & irritability C. Diminished deep tendon reflexes D. Parkinson type tremors
A
C. Diminished DTR’s
4
Q
Medications to help treat severe hyperkalemia inlcude: A. methylprednisolone and mannitol B. Mannitol and regular insulin C. Digoxin and diuretics D. 10% Ca gluconate and regular insulin
A
D. Ca gluconate helps stabilize cardiac cell membranes and insulin given with hypertonic dextrose causes K to move into cells
5
Q
A hallmark ECG characteristic of hyperkalemia is presence of: A. irregular PR intervals B. Narrowed QRS complexes C. Tall, tented T waves D. Peaked P waves
A
C. Tall, tented T waves
6
Q
A major dietary source of K include: A. Chocolate, orange juice, and bananas B. Canned soups, peas, milk C. Apples, whole wheat bread, oatmeal D. Dairy products and whole grains
A
A
7
Q
When administering IV potassium for severe hypokalemia you should:
A. avoid infusing the potassium with all other IV solutions
B. Infuse through a small IV catheter
C. Verify the concentration of solution doesn’t exceed 40 mEq/L
D. Use the drip method to infuse the potassium
A
C.
8
Q
Mg is an important electrolyte because it
A. helps control urine volume
B. Promotes production of growth hormone
C. Promotes bone growth and strength
D. assists in neuromuscular transmission
A
D. Mg is vital to nerve and muscle activity
9
Q
A pt with Crohn's disease develop tremors while receiving TPN. Suspecting she might have hypo-mg you assess the neuromuscular system you should expect to see: A. Homan's signs B. Elevated serum K C. Hyperactive DTR's D. Hypoactive DTR's
A
C. Hyperactive DTR
10
Q
A proper diet for a hypo mg patient should include A. seafood B. fruit C. corn products D. dairy products
A
A. seafood
11
Q
Fluid & electrolyte losses through the skin or lungs are considered _______ (measurable or not measurable) which is also known as ________. (sensible or insensible)
A
Not measurable
Insensible
12
Q
Name some sensible fluid loss locations:
3 kinds
A
Urination, Defecation, wounds
13
Q
3 types of fluid compartments are:
A
Intra cellular
Interstitial
Intra vascular
14
Q
Which type of body fluid makes up the largest percentage of body weight?
A
Intracellular at 40% of BW
15
Q
Within your fluid compartments which of the 3 is outside of the cell and contains the ECF? (intracellular, interstitial, intravascular)
A
The Interstitial & intravascular contains your ecf which is about 20% of your body weight
16
Q
Which fluid is a larger percentage of body weight? Your ICF or ECF?
A
ICF is about 40% (the ECF is about 20%)
17
Q
A fluid that has more solute concentration than another is considered _____.
A
hypertonic
18
Q
Half normal saline solution is an example of ______ solution.
A. Hypotonic
B. Hypertonic
C. Isotonic
A
A. Hypotonic
19
Q
Normal saline solution is considered _____.
A. Hypotonic
B. Hypertonic
C. Isotonic
A
C. Isotonic
20
Q
Dextrose 5% solution is an example of ______.
A. hypotonic
B. hypertonic
C. Isotonic
A
B. Hypertonic
21
Q
If the concentration of solutes in the solution is greater than the concentration of solutes in the blood it is considered?
A. hypotonic
B. Hypertonic
C. Isotonic
A
B. Hypertonic
22
Q
When fluid moves across a membrane from an area of lower solute concentration to an area of higher it is called A. Diffusion B. Osmosis C. Active transport D. Filtration
A
B. Osmosis
23
Q
When solutes move from higher concentrations to lower area of concentration is called: A. Diffusion B. Osmosis C. Active transport D. Filtration
A
A. Diffusion–passive transport mechanism
24
Q
This type of movement occurs in the vascular system; it results from blood pushing against walls of the capillary: A. Diffusion B. Osmosis C. Active transport D. Filtration
A
D. Capillary filtration
25
The pressure that forces fluids and solutes through the capillary wall is called _______ pressure.
hydrostatic pressure
26
```
______ prevents too much fluid from leaving the capillaries no matter how much hydrostatic pressure is present.
A. Diffusion
B. Osmosis
C. Reabsorption
D. Filtration
```
C. Reabsorption
27
A normal plasma colloid osmotic pressure is ___ mmHg.
25 mmHg
28
_______ is a water magnet and causes a pulling force in the intravascular space called ______ _______ _____ pressure.
Albumin
| Plasma colloid osmotic pressure
29
When ______ pressure exceeds _____ pressure than water and solutes leave capillaries & enter the interstitial fluid.
hydrostatic pressure; plasma colloid osmotic pressure
30
```
The type of movement in which solutes move from lower to higher areas of concentration and requires energy:
A. Diffusion
B. Osmosis
C. Active transport
D. Reabsorption
```
C. Active transport
31
The 3 main things that maintain fluid balance are:
Kidneys
Thirst
Hormones
32
```
When blood flow to glomerulus decreases and Na decreases then ______ is secreted.
A. Aldosterone
B. Renin
C. Angiotensin
D. ADH
```
B. Renin
33
```
_____ causes kidneys to retain Na & water to increase their retention.
A. Aldosterone
B. Renin
C. Angiotensin
D. ADH
```
A. Aldosterone- released by adrenal glands
34
Cardiac hormone that is released when there is increased atrial pressure and it counters the renin-angiotensin-aldosterone system?
ANP
35
Where is the thirst mechanism located?
Hypothalamus
36
This electrolyte plays a major role in maintaining osmotic pressure?
Chloride
37
This electrolyte is important to ECF volume as well as nerve and muscle cell interaction.
Na
38
This electrolyte reduces permeability to Na
Ca
39
These 2 electrolytes are important to bone and teeth mineralization:
Phosphorous and Ca
40
These two electrolytes are important to acid base status:
Bicarb and Phosphorous
41
This electrolyte is important to Na & K ion transport:
Mg
42
This electrolyte is important to muscle contraction & myocardial membrane responsiveness
K
43
This electrolyte is a catalyst for enzyme reactions and promotes nervous and Cardiovascular function and protein synthesis
Mg
44
This electrolyte is important to intracellular osmolality
K
45
Electrolytes are measured:
A. Inside & outside the cell
B. Only outside the cell in the blood stream
C. Only inside the cell in the blood stream
B. Only outside the cell in the blood stream
46
What is the difference between dehydration vs hypovolemia?
Dehydration involves the loss of fluid which results in increase in blood solute or osmolality, often Na increases vs hypovolemia is a loss of isotonic fluids which involves loss of both solutes and fluid; bleeding can be an example
47
Name 3 areas where 3rd spacing fluid movement might occur and name the condition that frequently results from this movement.
Abdominal cavity (ascites)
Pleural cavity
Pericardial Sac
It is often a cause of hypovolemia
48
In this condition, a typical manifestation may be pulmonary congestion or edema
A. Hypovolemia
B. Dehydration
C. Hypervolemia
C. Hypervolemia
49
An effective treatment for _____ is diuretics, restriction of fluids, and treatment of heart failure.
A. Hypovolemia
B. Hypokalemia
C. Hypervolemia
C. Hypervolemia
50
```
In this condition excess fluid moves from the ECF to ICF as cells try to balance concentration of fluid:
A. Dehydration
B. Hypovolemia
C. Water intoxication
D. Hypervolemia
```
C. Water intoxication
51
What is the difference between water intoxication & hypervolemia?
In water intoxication fluid moves from ECF to ICF and swelling of cells occurs vs hypervolemia where there is an increase of isotonic fluid in the ECF and moves from interstitial to intravascular
52
One common cause of SIADH is _______.
SIADH; rapid IV infusion of D5W; excessive NG or enema treatment with tap water
53
If your patient is tachycardic, has a rapid bounding pulse and increased BP they most likely have:
A. Hypovolemia
B. Hypervolemia
B. Hypervolemia
54
A common condition seen in ICU; causes include pulmonary disorders, tumors, surgeries or head traumas; Occurs when fluid shifts into cells causing swelling of the cell
SIADH
55
Condition seen when Na is > 125 mEq/L and serum osmolality is
Water Intoxication
56
When you see Na you would expect to see ____.
Water
57
Na will combine with _____ or _____ for sodium acid base status.
Chloride or Bicarb
58
```
This condition can cause swelling of the cells as more fluid moves from ECF to ICF;
A. Hyponatremia
B. Hypernatremia
C. Hyperkalemia
D. Hypokalemia
```
A. Hyponotremia
59
```
This condition causes an increase in solute; fluid will move from inside the cell to outside causing cells to become dehydrated and shrinking results; Often includes neurological signs and symptoms
A. Hyponatremia
B. Hypernatremia
C. Hyperkalemia
D. Hypokalemia
```
B. Hypernatremia
60
```
This condition is often seen with cerebral edema due to swelling of the cells; also hypovolemia may occur
A. Hyponatremia
B. Hypernatremia
C. Hyperkalemia
D. Hypokalemia
```
A. Hyponatremia
61
When looking at Ca levels you should always look at _____ levels as well.
Albumin
62
What is a possible treatment for hypocalcemia?
Calcium gluconate; Ca Chloride; Vit D supplemants, Vit D supplements
63
```
_____ promotes Ca absorption from intestines, reabsorption frm bones & kidneys to increase Ca levels
A. Calcitonin
B. Phosphorous
C. Vit D
D. Albumin
```
C. Vitamin D
64
```
_____ inhibits Ca absorption from intestines; when Ca levels low, kidneys retain Ca & excrete this electrolyte.
A. Calcitonin
B. Phosphorous
C. Vit D
D. Albumin
```
B. Phosphorous
| Inverse relationship to Ca
65
The major cause of hypocalcemia is _____.
hypoalbuminemia
66
Trousseaus's and Chvosteks are tests performed to assess tetany which is a major sign of _____.
hypocalcemia
67
Two major causes of hypercalcemia are?
Cancer & hyperparathyroidism
68
Albumin affects calcium levels by:
A. blocking phosphorous absorption, which prevents Ca excretion
B. Binding with Ca which makes Ca ineffective
C. Inhibiting Mg uptake, which prevents Ca Absorption
D. affecting pH levels
B. Binding with Ca which makes it ineffective
69
```
Hypocalcemia involves a dysfunction of:
A. Calcitonin
B. ADH
C. Growth Hormone
D. PTH
```
D. PTH promotes reabsorption of Ca from the bone to the serum
70
```
If your patient is hypercalcemic, you would expect to
A. Administer IV sodium bicarbonate
B. Administer Vit D
C. Hydrate the patient
D. Administer digoxin
```
C. hydrating the patient with oral or IV fluids increases urine excretion of Ca and helps lower serum Ca levels
71
Hypercalcemia would be most likely to develop in:
A. A 60 year old man who has squamous cell carcinoma of the lung
B. An 80 year old woman who has heart failure and is taking Lasix (furosemide)
C. A 25 year old trauma patient who has received massive blood transfusions
D. A 40 year old man with hypalbumenemia
A. Squamous cell carcinoma of the lung can lead to hypercalcemia
72
You are told during shift report that your patient has a positive Chvostek's sign. You would expect laboratory test results to reveal:
A. Total serum Ca below 8.9 mEq/L
B. A total serum Ca level above 10.1
C. An ionized Ca level above 5.3 mg/dl
D. An ionized Ca level between 4.4 and 5.3 mg/dl
A. below 8.9 mEq/L
