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
2
Q
Intracellular fluid makes up
A
70% of fluid within cells
3
Q
Extracellular fluid makes up
A
30% of fluid outside cells
4
Q
Who has less body water?
A
women and obese
5
Q
healthy people have a total body water of:
A
50-60% of their body weight
6
Q
Cations:
A
positive
7
Q
Anions
A
Negative
8
Q
Osmosis is when
A
water passes from an area of lesser solute to greater concentration
9
Q
Diffusion is when
A
solutes more freely throughout a solvent (“downhill”)
10
Q
Active transport:
A
requires energy for movement from lesser solute concentration to higher solute concentration
11
Q
Filtration:
A
passage of fluid through permeable membrane from higher to lower.
12
Q
Isotonic solutions:
A
same concentration of particles as there is plasma. Remains in intravascular compartment without net flow
I-SO-PERFECT
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)
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
15
Q
which system pumps and carries nutrients and water in the body..
A
cardiovascular
16
Q
what regulates carbon and oxygen levels in the blood
A
lungs
17
Q
What helps conserve sodium, save chloride and water and excrete potassium
A
Adrenal Glands
18
Q
What stores and releases ADH
A
pituitary gland
19
Q
What increases blood flow in the body and increases renal circulation:
A
thyroid gland
20
Q
What inhibits and stimulates mechanism of influencing fluid balance
A
nervous system
21
Q
What regulates the level of calcium in ECF
A
parathyroid gland
22
Q
What absorbs water and nutrients that enter the body through this route
A
GI tract
23
Q
hypovolemia
A
deficiency in the amount of water and electrolytes in ECF with near-normal water and electrolyte proportions
24
Q
Dehydration
A
decrease volume of water and electrolyte change
25
Hypervolemia
excessive retention of water and sodium in ECF
26
overhydration
above normal amounts of water in extracellular spaces
27
Edema
excessive ECF accumulates in tissue spaces
28
Interstitial to plasma shift
movement of fluid from the space surrounding cells to blood
29
BUN level
5-25
30
CREAT. CLEARANCE LEVEL
1-2mgs/dl
31
SERUM OSMOLARITY LEVEL
280-295
32
URINE SG LEVEL
1.005 TO 1.050
33
Phosphorus level
2.5-4.5
34
Magnesium level
1.5-2.5
35
potassium level
3.5-5
36
a loss or gain of equal amount of Na and H2O is..
isotonic
Remember no net change!
37
loss or gain of Na in excess of H20 or H20 in excess of Na:
Hypotonic or Hypertonic
38
Isotonic loss causes:
Fluid volume deficit
renal disease with polyuria, excess diuretic use, aldosterone deficiency (addisons), hemorrhage, vomiting, diarrhea, burns, excess sweating, 3rd spacing
39
Fluid volume deficit S/S:
tachycardia, hypotension, dry mucus membranes, tenting skin
40
Fluid volume deficit labs:
increased Hct (due to loss of plasma), BUN and NORMAL SERUM OSMO!!!
41
Treatment for fluid volume deficit:
give isotonic solution, replace blood loss and remove 3rd spacing fluid
42
Isotonic gain of Na &H20 :
Fluid Volume Excess!
decreased Na and H20 elimination by kidneys
43
Causes of Fluid volume excess
renal failure, heart failure, increased aldosterone (cushings syndrome)
44
S/S of fluid volume excess
edema, weight gain, JVD, crackles in lungs
45
labs indicating fluid volume excess:
Decreased Hct and BUN, NORMAL SERUM OSMO
46
Treatment for fluid volume excess
diuretics, decrease fluid intake
47
Hyponatremia:
Less Na and more H20 (hypoosmolar)
48
Hyponatremia causes:
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
S/S of hyponatremia:
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
Nursing interventions for hyponatremia:
3% hypertonic solution, decrease water intake, consume sodium rich foods or Na supplements
51
Hypernatremia:
More Na than H20--hypertonic
52
Causes of Hypernatremia:
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
S/S of hypernatremia:
Think: "no fried foods for you model:
```
F-Fever, flushed
R-restless
I-irritability
E-excessive thirst
D-dry mucus membranes, dehydrated
```
54
Which type of solution would you give for hypernatremia:
hypotonic solution
55
What is the key electrolyte for cell excitability and muscle function (contraction)
Potassium
56
S/S of BOTH hypokalemia and hyperkalemia
muscle weakness, spasms, paralysis, paresthesia, orthostatic hypotension, arrhythmia, nausea, vomiting, cramping
57
Hypokalemia causes:
Excess urine loss, diabetes insipidus, high aldosterone, excess GI loss through vomiting, GI suction and inadequate intake of K
58
Treatment for Hypokalemia:
give K foods or K supplements
Give through IV slowly and carefully but NEVER IV PUSH
59
When giving potassium replacement you can give up to..
40meq/hr if severe
Check serum every 4-6 horus
60
What function must you check before administering potassium supplements
Kidney function
61
Should IV solution of potassium be diluted?
YES 10ml IV solution per 1meq
62
Hyperkalemia causes:
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
Hyperkalemia treatment
Insulin & Dextrose or sodium bicarb to shift into cells
Dialysis, sodium polystyrene (Kavexalate), and exchange resin (diarrhea)
Stabilize cell excitability with Calcium iv
64
ECF includes large amounts of___ and small amounts of___
Large amounds of NA and Cl
| Small amounts of K,Ca, Mg, phosphate
65
ICF includes large amounts of ___ and small amounts of__
Large amounts of K and small amounts of Ca, Mg, phostphage, Na and Cl and bicarb
66
Total body water is lower or higher in adults?
LOWER (45-47%)
67
Average urine output should be
60ml/hr (
68
List of Cations:
Na, K, Ca, Mg, H
69
List of Anions
Cl, P04, HC03
70
What is the key function of electrolytes?
water balance,
nerve impulses & muscle contraction (NA, K, Ca)
Acid based balance (H, HC03, K)
Blood clotting (Ca)
71
What is the movement of water from lower concentration to higher concentration through semi-permeable membrane
Osmosis
72
Tonicity
tension or effect that osmotic pressure of solution with impermeable solutes exerts on cell size because of H20 movements across the cell membrane
73
Give an example of a hypertonic solution..
Powerade
74
Give an example of an isotonic solution
Gatorade
75
If a client is admitted with CHF what tonicity might they have?
Hypotonic-- more dilute since there is less fluid in the cell
76
capillary colloidal osmotic pressure
pulls fluid into the capillaries (prevent too much fluid from being lost)
generated by plasma proteins too large to pass through pores
77
Capillary filtration pressure-capillary hydrostatic pressure (HP)
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
If there is a hydrostatic pressure that is higher at the COP of an aterial end, the net flux goes out to..
the tissues
79
If there is a hydrostatic pressure that is lower at the COP of a venous end, the net flux goes into
plasma
80
Edema can be caused by
increased capillary filtration pressure, decreased capillary colloidal osmotic pressure, increased capillary permeability and obstuction to lymph flow
81
Capillary filtration pressure is increased by...
decrease in resistance to outflow, an increase in venous pressure
82
Magnesium- how does this react in related to K and Ca
maintains homeostasis bewteen K and Ca
83
Hypomagnesemia
similar to hypocalcemia- increase in neuromuscular excitability, tachycardia, hypertension, ventricular dysrhythmias
84
hypermagnesemia
muscle weakness, decreased reflexes, lethargy, confusion, no DTR and low RR
85
Creatinine is used to estimate
GFR
86
Creatinine is increased with
decreased renal function and BUN increase
87
What causes there to be a slight age related increase in creatinine
the decreased muscle mass
88
if you are dehydrated it does not affect the serum creatinine levels. True or false?
True
89
name inverse relationships with calcium
hyperphosphatemia and hypocalcemia
hypophosphatemia and hypercalcemia
90
calcium
blocks Na gates in nerve and muscle cells
91
Calcium is important for..
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
Calcium actions are opposite of that of...
K--low calcium makes more cells excitable whereas high calcium makes cells less excitable.
93
What is calcium regulated by
PTH and Vitamin D
94
Calcium has an inverse relationship with..
Phosphate
95
hypercalcemia
Causes: increased bone release of Ca due to immobility, neoplasms, hyperparathyroidism, renal disease
Increased calcium gains: excessive Ca or Vit D in diet
96
Hypercalcemia manifestations:
decreased neuromuscular activity, weakness, lethargy, nausea, vomiting, coma, pain, kidney stones, fractures
97
How to treat hypercalcemia:
correct cause, weight bearing activities, loop diuretics, phosphate meds to bind PO4 and Ca and lower Ca
98
Hypocalcemia is caused ffrom:
increased bone resorption (bones holding onto more calcium), hypoparathyroidism
99
Manifestations of hypocalcemia are:
increased n-m activity, tetany, twitching, hyperreflexia, parasthesias, CV arrhythmias
+chovsteks sign
+Trusseaus sign
100
Treating hypocalcemia:
give calcium or vit d supplement, decrease the use of phosphate containing antacids and laxatives.
101
Chloride is a major key role in...
osmotic balance with Na and acid base balance.
102
Low sodium levels will also have low..
chloride levels
103
Hypochloremia S/S:
same as hyponatremia
104
Phosphorus is a key role in
acid base balance and ATP relationship with calcium
