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Adult health 2 > Exam 1: Fluid and Electrolytes imbalance > Flashcards

Exam 1: Fluid and Electrolytes imbalance Flashcards

1
Q

Total body fluid depends on what 4 things

A

muscle mass
electrolytes
body fat
age

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2
Q

In the newborn infant more than half of total body fluid is ________

A

extracellular

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3
Q

For adults what is the % of TBW for each:

Intracellular
Extracellular
Interstitial
Intravascular
Transcellular

A

66%
34%: extracellular
– 75%
–25%
–1%

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4
Q

Serum levels indicate _______ concentration

A

extracellular

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5
Q

Osmolality/osmolarity

A

measurement of number of particles in a solution or the concentration of the solution

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6
Q

Normal osmolarity

A

275-290 mOsm/kg

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7
Q

Osmolality and osmolarity are regulated by

A

ADH release

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8
Q

Osmolality (concentration of solutes in water) exert osmotic pressure causing…

A

osmosis

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9
Q

_____: measurement of osmotic pressure of a solution–osmalality

A

tonicity

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10
Q

Isotonic

A

same osmolality of serum blood

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11
Q

hypertonic

A

osmolality higher than that of serum, causing ICF to shrink

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12
Q

hypotonic

A

osmolality lower than that of serum, causing ICF to swell

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13
Q

__________ pressure: pulling pressure exerted by proteins colloids in the blood

A

colloid oncotic pressure

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14
Q

Colloid oncotic pressure ____ or ____ fluid from the interstitial

A

pulls/absorbs

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15
Q

_________ pressure: created by the weight of fluid pressing against the wall of blood vessels

A

hydrostatic

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16
Q

hydrostatic pressure forces molecules through a

A

capillary membrane

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17
Q

_________ movement of water and solutes from highly hydrostatic pressure to low hydrostatic pressure

A

filtration

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18
Q

What factors regulate water in the body

A

ADH and thirst

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19
Q

ADH is stimulated by ____________ or ________ and cause increased water resorption in the kidney tubules

A

decreased blood volume or increased serum osmolality

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20
Q

What is ANP

A

amino acid peptide synthesized, stored, and released by atria cells

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21
Q

What does ANP do to blood pressure

A

decreases blood pressure and volume

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22
Q

T/F isotonic fluid deficit (hypovolemia) has a proportional loss of both sodium and water from ICF?

A

yes but there will be no change in osmolality –> no fluid shift

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23
Q

isotonic fluid excess can cause ECF to become

A

hypotonic

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24
Q

What is the most predominant electrolyte in the ECF??

A

sodium

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25
Q

What is sodiums normal level

A

135 to 145

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26
Q

sodium imbalance is usually associated with parallel changes in water ____ or _____

A

loss or gain

27
Q

Sodium is important for what

A

transmission of nerve impulses and muscle contraction

28
Q

Hypernatremia etiology

A

water loss is greater than sodium loss

29
Q

Hypernatremia clinical presentation

A

dehydration, thirst, dry mucous membranes, decrease LOC, seizures

30
Q

Hypernatremia treatment

A

free water boluses
hypotonic fluid replacement
treat cause
if due to excessive Na, diuretics

31
Q

Hyponatremia etiology

A

excessvie water intake (SIADH

32
Q

hyponatremia clinical presentation

A

s/s fluid overload, neuro impairment, changes in LOC, muscle weakness, seizures

33
Q

Sodium loss can be caused by

A

GI loss, diuretics, diaphoresis

34
Q

Treatment for hyponatremia

A

excessive water: fluid restrict, diuretics

sodium deficits: replace sodium

35
Q

What is the main cation in ICF

A

potassium

36
Q

What is potassium responsible for

A

transmission of nerve fibers

Contraction of skeletal, smooth, and cardiac muscles

37
Q

Hyperkalemia treatment

A

glucose and insulin
sodium bicarb
calcium chloride
kayexalate (not fast)
sorbitol

treat cause (e.g. dialysis)

38
Q

S/S of hyperkalemia

GI
CNS
Muscles
Cardiac
Urine

A

GI: N/V/diarrhea

CNS: numbness, paresthesias

Muscles: irritability (early) and weakness (late) –> flaccid paralysis

Cardiac: ventricular fibrillation and cardiac arrest

Urine: oliguria –> anuria

39
Q

S/S of hypokalemia

GI
CNS
Muscles
Cardiac
Kidneys

A

GI: anorexia, N/V, abdominal distention –> paralytic ileus

CNS: lethargy, diminished deep tendon reflex, confusion, mental depression

Muscles: weakness –> flaccid paralysis, weakened respiratory muscles –> respiratory arrest

Cardiovascular system: decrease in standing BP, ECG changes, Cardiac arrest, Myocardial damage

Kidney’s: decreased capacity to concentrate waste –> water loss –> thirst –> kidney damage

40
Q

Treatment of hypokalemia

A

Potassium replacement and treat the cause

41
Q

Normal calcium levels

A

9.0-10.2 mg/dL

42
Q

What 3 things regulate Ca

A

PTH
Vitamin D
Calcitonin

43
Q

What is calcium responsible for doing

A

transmission of nerve impulses
contraction of cardiac muscles
formation of bones and teeth
coagulation process

44
Q

Calcium is bound to _____ so if that is low, calcium is generally low as well

A

albumin

45
Q

S/S of hypocalcemia

GI
CNS
Muscles
Cardiac
Bones

A

GI increased peristalsis –> N/V/D

CNS: tingling –> convulsions

Muscles: spasms –> tetany

Cardiac: dysrhythmias –> cardiac arrest

Bones: osteoporosis

46
Q

What can cause hypocalcemia

A

decreased ionized calcium: large tranfussion with citrated blood

excess loss: kidney disease, draining fistulas

inadequate intake

decreased GI and bone absorption: decreased vit d, PTH; increased mg, calcitonin

47
Q

What are the treatments for hypocalcemia

A

calcium replacement: IV 10% calcium gluconate or cholride slowly

Vitamin D replacement

oral calcium for chronic

treat cause

48
Q

What are 2 signs of low calcium

A

trousseau sign

chvostek sign

49
Q

Trousseau sign:

how can you check for it

what is a positive signs of it

A

you can check while monitoring vital signs –> triggered by placing a BP cuff on an arm and inflating it to a pressure greater than systolic BP for 2 to 3 minutes

If you have it, your arm muscles will activate involuntarily and have flexion of the wrist, thumb, and joints with extension of the fingers

50
Q

Chvostek signs

A

abnormal twitching of muscles that are activated by the facial nerve –> when it is tapped in front of the ear, the muscles on the same side will contract

51
Q

What are causes of hypercalemia

A

loss from bones: metastases, multiple myeloma, immobilization

excess intake

increase in factors causing mobilization from bone: increased PTH, Vit D

52
Q

S/S of hypercalcemia

Kidneys
CNS
Muscles
Cardiac
Bones

A

Kidneys: stones –> damage

CNS: decreased reflex –> lethargy –> coma

Bones: pain –> osteoporosis –> fractures

muscles: fatigue –> decreased GI motility

Cardiac: depressed activity –> dysrhythmias –> cardiac arrest

53
Q

What is the treatment for hypercalcemia

A

Normal saline infusions
corticosteroids to decrease GI absorption
mithramycin
phosphate administration
treat cause

54
Q

What does your body look like with hypercalcemia?

A

slow movements

55
Q

What is a normal magnesium level

A

1.3-2.2

56
Q

What does magnesium do

A

contract myocardium and influence transportation of Na/K across cells

57
Q

S/S hypomagnesemia

mental changes

CNS

Muscles

Cardiac

A

mental: agitation, depression, confusion

CNS: convulsions, paresthesias, tremor, ataxia

Muscles: cramps, spasticity, tetany

Cardiac: tachy, hypotension, dysrhytmias

58
Q

Causes of hypomagnesemia

A

decreased in

impaired absorption: alcohol withdrawal, hypercalcemia, diarrhea

Excessive excretion: increased aldosterone, conditions with large losses of urine

59
Q

Treatment of hypomagnesemia

A

magnesium replacement

treat the cause (hypomagnesemia caused dig toxicity)

60
Q

What is a rule of thumb when replacing K and Mg

A

don’t replace potassium until you replace magnesium first

61
Q

What are causes of hypermagnesemia

A

increased in
decreased out: renal failure, adrenocortical insufficiency

62
Q

S/S hypermagnesemia

Muscle

CNS

Cardaic

A

Muscle: weakness, paralysis, hyporeflexia, resp paralysis

CNS: drowsiness, confusion, coma

Cardaic: hypotension, flushing, T-wave changes, brady

63
Q

Treatment of hypermagnesemia

A

fluids
dialysis
calcium gluconate
treat underlying cause

64
Q
A

Adult health 2 (8 decks)

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