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Mary's Tests - Spring 2016 > Electrolytes. Patho and Adult Exam > Flashcards

Electrolytes. Patho and Adult Exam Flashcards

1
Q

functions of water in the body:

A

transport nutrients to cells

transport hormones enzymes, blood (red and white blood cells),

cellular metabolism

acts as a solvent for both non electrolytes and electrolytes

Maintains normal body temp

facilitates digestion and promotes elimination

acts as a tissue lube

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2
Q

Intracellular fluid makes up

A

70% of fluid within cells

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3
Q

Extracellular fluid makes up

A

30% of fluid outside cells

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4
Q

Who has less body water?

A

women and obese

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5
Q

healthy people have a total body water of:

A

50-60% of their body weight

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6
Q

Cations:

A

positive

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7
Q

Anions

A

Negative

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8
Q

Osmosis is when

A

water passes from an area of lesser solute to greater concentration

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9
Q

Diffusion is when

A

solutes more freely throughout a solvent (“downhill”)

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10
Q

Active transport:

A

requires energy for movement from lesser solute concentration to higher solute concentration

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11
Q

Filtration:

A

passage of fluid through permeable membrane from higher to lower.

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12
Q

Isotonic solutions:

A

same concentration of particles as there is plasma. Remains in intravascular compartment without net flow

I-SO-PERFECT

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13
Q

Hypertonic solutions:

A

greater concentrations are in the plasma (extracellular)

water moves out of the cell and drawn intravascular causing cells to SHRINK

HYPER people skinny (SHRINK)

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14
Q

Hypotonic solutions

A

lesser concentration of particles than plasma.

Fluid in intravascular space move into intracellular fluid causing cells to SWELL

HIPPO SWOLLEN

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15
Q

which system pumps and carries nutrients and water in the body..

A

cardiovascular

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16
Q

what regulates carbon and oxygen levels in the blood

A

lungs

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17
Q

What helps conserve sodium, save chloride and water and excrete potassium

A

Adrenal Glands

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18
Q

What stores and releases ADH

A

pituitary gland

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19
Q

What increases blood flow in the body and increases renal circulation:

A

thyroid gland

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20
Q

What inhibits and stimulates mechanism of influencing fluid balance

A

nervous system

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21
Q

What regulates the level of calcium in ECF

A

parathyroid gland

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22
Q

What absorbs water and nutrients that enter the body through this route

A

GI tract

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23
Q

hypovolemia

A

deficiency in the amount of water and electrolytes in ECF with near-normal water and electrolyte proportions

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24
Q

Dehydration

A

decrease volume of water and electrolyte change

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25
Q

Hypervolemia

A

excessive retention of water and sodium in ECF

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26
Q

overhydration

A

above normal amounts of water in extracellular spaces

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27
Q

Edema

A

excessive ECF accumulates in tissue spaces

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28
Q

Interstitial to plasma shift

A

movement of fluid from the space surrounding cells to blood

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29
Q

BUN level

A

5-25

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30
Q

CREAT. CLEARANCE LEVEL

A

1-2mgs/dl

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31
Q

SERUM OSMOLARITY LEVEL

A

280-295

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32
Q

URINE SG LEVEL

A

1.005 TO 1.050

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33
Q

Phosphorus level

A

2.5-4.5

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34
Q

Magnesium level

A

1.5-2.5

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35
Q

potassium level

A

3.5-5

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36
Q

a loss or gain of equal amount of Na and H2O is..

A

isotonic

Remember no net change!

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37
Q

loss or gain of Na in excess of H20 or H20 in excess of Na:

A

Hypotonic or Hypertonic

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38
Q

Isotonic loss causes:

Fluid volume deficit

A

renal disease with polyuria, excess diuretic use, aldosterone deficiency (addisons), hemorrhage, vomiting, diarrhea, burns, excess sweating, 3rd spacing

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39
Q

Fluid volume deficit S/S:

A

tachycardia, hypotension, dry mucus membranes, tenting skin

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40
Q

Fluid volume deficit labs:

A

increased Hct (due to loss of plasma), BUN and NORMAL SERUM OSMO!!!

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41
Q

Treatment for fluid volume deficit:

A

give isotonic solution, replace blood loss and remove 3rd spacing fluid

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42
Q

Isotonic gain of Na &H20 :

Fluid Volume Excess!

A

decreased Na and H20 elimination by kidneys

43
Q

Causes of Fluid volume excess

A

renal failure, heart failure, increased aldosterone (cushings syndrome)

44
Q

S/S of fluid volume excess

A

edema, weight gain, JVD, crackles in lungs

45
Q

labs indicating fluid volume excess:

A

Decreased Hct and BUN, NORMAL SERUM OSMO

46
Q

Treatment for fluid volume excess

A

diuretics, decrease fluid intake

47
Q

Hyponatremia:

A

Less Na and more H20 (hypoosmolar)

48
Q

Hyponatremia causes:

A

loss of sodium: GI losses like vomiting, diarrhea, GI suction, Excess diuretics, Decreased aldosterone levels (addisons)

Gain of water: renal and heart failure, excess hypotonic solutions, SIADH (too much ADH) increase H20 intake

49
Q

S/S of hyponatremia:

A

neuromuscular:
think salt loss

S- seizures
A- abdominal cramping
L- LOC decreased
T- tachycardia 
L- lab Na and serum osmo decreased
O- orthostatic hypotension
S- swollen cell
S-
50
Q

Nursing interventions for hyponatremia:

A

3% hypertonic solution, decrease water intake, consume sodium rich foods or Na supplements

51
Q

Hypernatremia:

A

More Na than H20–hypertonic

52
Q

Causes of Hypernatremia:

A

Gain of Na: IV fluids with Na, excess tube feedings

Not enough water: insufficient intake or excess loss from skin, renal (DIABETES INSIPIDUS, OSMOTIC DIURESIS) and diarrhea

53
Q

S/S of hypernatremia:

A

Think: “no fried foods for you model:

F-Fever, flushed
R-restless
I-irritability
E-excessive thirst
D-dry mucus membranes, dehydrated
54
Q

Which type of solution would you give for hypernatremia:

A

hypotonic solution

55
Q

What is the key electrolyte for cell excitability and muscle function (contraction)

A

Potassium

56
Q

S/S of BOTH hypokalemia and hyperkalemia

A

muscle weakness, spasms, paralysis, paresthesia, orthostatic hypotension, arrhythmia, nausea, vomiting, cramping

57
Q

Hypokalemia causes:

A

Excess urine loss, diabetes insipidus, high aldosterone, excess GI loss through vomiting, GI suction and inadequate intake of K

58
Q

Treatment for Hypokalemia:

A

give K foods or K supplements

Give through IV slowly and carefully but NEVER IV PUSH

59
Q

When giving potassium replacement you can give up to..

A

40meq/hr if severe

Check serum every 4-6 horus

60
Q

What function must you check before administering potassium supplements

A

Kidney function

61
Q

Should IV solution of potassium be diluted?

A

YES 10ml IV solution per 1meq

62
Q

Hyperkalemia causes:

A

increased K intake through po source, IV or meds, decreased loss of K through renal failure and decreased aldosterone (addisons) and cell destruction through trauma or burns

63
Q

Hyperkalemia treatment

A

Insulin & Dextrose or sodium bicarb to shift into cells

Dialysis, sodium polystyrene (Kavexalate), and exchange resin (diarrhea)

Stabilize cell excitability with Calcium iv

64
Q

ECF includes large amounts of___ and small amounts of___

A

Large amounds of NA and Cl

Small amounts of K,Ca, Mg, phosphate

65
Q

ICF includes large amounts of ___ and small amounts of__

A

Large amounts of K and small amounts of Ca, Mg, phostphage, Na and Cl and bicarb

66
Q

Total body water is lower or higher in adults?

A

LOWER (45-47%)

67
Q

Average urine output should be

A

60ml/hr (

68
Q

List of Cations:

A

Na, K, Ca, Mg, H

69
Q

List of Anions

A

Cl, P04, HC03

70
Q

What is the key function of electrolytes?

A

water balance,
nerve impulses & muscle contraction (NA, K, Ca)
Acid based balance (H, HC03, K)
Blood clotting (Ca)

71
Q

What is the movement of water from lower concentration to higher concentration through semi-permeable membrane

A

Osmosis

72
Q

Tonicity

A

tension or effect that osmotic pressure of solution with impermeable solutes exerts on cell size because of H20 movements across the cell membrane

73
Q

Give an example of a hypertonic solution..

A

Powerade

74
Q

Give an example of an isotonic solution

A

Gatorade

75
Q

If a client is admitted with CHF what tonicity might they have?

A

Hypotonic– more dilute since there is less fluid in the cell

76
Q

capillary colloidal osmotic pressure

A

pulls fluid into the capillaries (prevent too much fluid from being lost)

generated by plasma proteins too large to pass through pores

77
Q

Capillary filtration pressure-capillary hydrostatic pressure (HP)

A

reflects BP,
pressure pushes water out of the capillary into the interstitial spaces
higher at the arterial end and lower at venous end
Water moves out of the capillaries at the arterial end and into the venous end

78
Q

If there is a hydrostatic pressure that is higher at the COP of an aterial end, the net flux goes out to..

A

the tissues

79
Q

If there is a hydrostatic pressure that is lower at the COP of a venous end, the net flux goes into

A

plasma

80
Q

Edema can be caused by

A

increased capillary filtration pressure, decreased capillary colloidal osmotic pressure, increased capillary permeability and obstuction to lymph flow

81
Q

Capillary filtration pressure is increased by…

A

decrease in resistance to outflow, an increase in venous pressure

82
Q

Magnesium- how does this react in related to K and Ca

A

maintains homeostasis bewteen K and Ca

83
Q

Hypomagnesemia

A

similar to hypocalcemia- increase in neuromuscular excitability, tachycardia, hypertension, ventricular dysrhythmias

84
Q

hypermagnesemia

A

muscle weakness, decreased reflexes, lethargy, confusion, no DTR and low RR

85
Q

Creatinine is used to estimate

A

GFR

86
Q

Creatinine is increased with

A

decreased renal function and BUN increase

87
Q

What causes there to be a slight age related increase in creatinine

A

the decreased muscle mass

88
Q

if you are dehydrated it does not affect the serum creatinine levels. True or false?

A

True

89
Q

name inverse relationships with calcium

A

hyperphosphatemia and hypocalcemia

hypophosphatemia and hypercalcemia

90
Q

calcium

A

blocks Na gates in nerve and muscle cells

91
Q

Calcium is important for..

A

Extracellular: clotting– there may be a problem if there is a lack of calcium

Intracellular: needed for all muscle contraction and acts as a second messenger in many hormone and neurotransmitter pathways.

92
Q

Calcium actions are opposite of that of…

A

K–low calcium makes more cells excitable whereas high calcium makes cells less excitable.

93
Q

What is calcium regulated by

A

PTH and Vitamin D

94
Q

Calcium has an inverse relationship with..

A

Phosphate

95
Q

hypercalcemia

A

Causes: increased bone release of Ca due to immobility, neoplasms, hyperparathyroidism, renal disease

Increased calcium gains: excessive Ca or Vit D in diet

96
Q

Hypercalcemia manifestations:

A

decreased neuromuscular activity, weakness, lethargy, nausea, vomiting, coma, pain, kidney stones, fractures

97
Q

How to treat hypercalcemia:

A

correct cause, weight bearing activities, loop diuretics, phosphate meds to bind PO4 and Ca and lower Ca

98
Q

Hypocalcemia is caused ffrom:

A

increased bone resorption (bones holding onto more calcium), hypoparathyroidism

99
Q

Manifestations of hypocalcemia are:

A

increased n-m activity, tetany, twitching, hyperreflexia, parasthesias, CV arrhythmias

+chovsteks sign
+Trusseaus sign

100
Q

Treating hypocalcemia:

A

give calcium or vit d supplement, decrease the use of phosphate containing antacids and laxatives.

101
Q

Chloride is a major key role in…

A

osmotic balance with Na and acid base balance.

102
Q

Low sodium levels will also have low..

A

chloride levels

103
Q

Hypochloremia S/S:

A

same as hyponatremia

104
Q

Phosphorus is a key role in

A

acid base balance and ATP relationship with calcium

Mary's Tests - Spring 2016 (10 decks)

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