Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Patho II > Exam 1: Fluids & Electrolytes > Flashcards

Exam 1: Fluids & Electrolytes Flashcards

1
Q

Cell Properties

A

Molecule: When two of more atoms combine to form substance (pos or neg charge, then is ATOM)

Ion: An atom carries electrical charge bc it has gained or lost electrons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Cation vs Anion

A

Cation: Positive charge bc its LOST electrons

Anion: Negative charge bc it GAINS electrons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Electrolytes

A

Occur when substance dissolved in solution (molecules split into electrically charged atoms or ions)

Think of miliequivalents to balance out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Body Fluid Compartments

A

Fluid in each of the body compartments contain electrolytes

Have to be in the right place and in the right amount with balance of electrolytes

Movement of electrolytes is better when PT is healthy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Body Fluid Compartments Pt. 2

A

Whenever an electrolyte moves out of a cell, another takes its place. Homeostasis has equal number of cations and anions.

Compartments separated by semi-permeable membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Intracellular compartment vs Extracellular compartment

A

Intracellular - IN the cell
Extracellular - OUTSIDE of the cell —Subcategories:

Intravascular compartment
Interstitial Fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Body Fluid

A

Transportation of nutrients to the cells and carries waste from the cells

body fluid is about 60% of body weights

10% loss is serious

20% is fatal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Constituents of Body Fluid

A

Mainly water and dissolved substances

Glucose, urea and creatinine do NOT dissociate into ions, stay in same form

Other substances DO dissociate (NaCl) more likely to move around.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Diffusion

A

Movement of particles in ALL DIRECTIONS though a solution

High to Low concentration

diffusion allows shifting to occur as long as permeable membrane allows for it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Osmosis

A

Movement of WATER (pulling movement)

Draws water from low concentration to High concentration though selective permeable membrane

Goal is to equal concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Filtration

A

movement of solutes and solvents with Hydrostatic pressure.

Pushing pressure, High pressure, to LOW pressure movement

Osmolality - # of active particles per liter/kg

normal osmolality just under 300 mOsm/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hydrostatic Pressure

A

Force of fluid pressing OUTWARD against some surface (water in a balloon)

Different in hydrostatic pressure, filtration moves solutes from High to Low pressure (Capillary Dynamics)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Isotonic Solution

A

Equilibrium on both side of a selectively permeable membrane

0.9%NaCl is isotonic, bc it is isotonic to human cells (very little osmosis)

other isotonic solutions (5% dextrose in 0.225% saline and lactated ringers solution)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hypotonic solution

A

solution contains lower concentration of salt than other solutions

If the cell is dehydrated, we give a hypotonic solution to re-hydrate the cell, the cell then fills up

HYPO - think HIPPO fat swollen cell filling with water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hypertonic solution

A

solution has a higher concentration of solutes than another solution

Think cell shrinkage, movement out of the cell, if blood needs to be diluted

ex: 10% dextrose in water, %5 dextrose in 0/9% saline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Osmotic Pressure

A

Force that draws solvent from solution though a selectively permeable membrane to a solution with less solvent activity.

determined by relative # of particles of solute on side of greater concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Active Transport

A

Moving “against the current” and needs to use energy, or moving from area of low concentration to and area of high concentration

the energy for active transport supplied by metabolic processes in the cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Body Fluid Excretion

A

Fluids leave by skin, lungs, GI tract and kidneys

KIDNEYS excrete largest amount of fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Skin fluid excretion

A

water lost though skin by DIFFUSION up to 300-400 ml per day (perspiration) avg/ per day is 100ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Lungs fluid excretion

A

water is lost from lungs thru expired air which is saturated water vapor

300-400ml/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

GI tract fluid excretion

A

large quantities of water secreted into GI tract, but ALMOST ALL REABSORBED

200ml/day lost in feces. severe diarrhea will result in lost of fluids and electrolytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Kidney Fluid Excretion

A

MAJOR role in regulating fluid and electrolyte balance

normal kidneys can adjust water and electrolytes leaving body

urine output about 1500ml/day, but depends on other factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Body Fluid Replacement

A

2400 ml per day is amount fo fluid excreted

water enters thought drink, food and oxidation of foods

oxidation water gained in foods = amount lost in feces

Electrolytes in food and liquids, EXTRA ones will leave in urine (not needed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Electrolyte Blance / Homeostasis

A

Balance of internal environment

What is lost, needs to be replaced

when there is an excess of electrolytes, we help them, but watch carefully

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Electrolyte Blance / Homeostasis Pt II.
Kidneys - control balance in fluid and electrolytes Adrenal glands - secrete aldosterone, controlling extracellular fluid volume by regulating sodium reabsorbed in kidneys ADH - from pituitary gland, regulates osmotic pressure of extracellular fluid by regulating h2o reabsorbed by kidneys (increased fluid volume)
26
RAAS System
Decreased Kidney perfusion pressure --> Renin release -> Angiotensin I -->converting enzyme in lungs --> Angiotensin II --> increased BP, increased circulating volume, renal auto-regulation Water will follow sodium bc of aldosterone release
27
ADH
Directs kidneys to hold water, increase circulating volume, decrease osmolarity of plasma, helps balance thru negative feedback
28
Best way to determine fluid volume
body weight
29
Fluid Volume Deficit
Dehydration where H2O and electrolytes are lost in same proportion Treat: Fluid Volume restoration, eliminate cause
30
Hypovolemia
FVD (Fluid volume deficit) fluid loss> fluid intake Isotonic: H2O and E.Lytes lost in equal proportions (give isotonic solutions to replace) Hypotonic: decrease in solutes, but not water, fewer electrolytes, total body fluid less than normal. moving from EXTRACELLULAR to INTRACELLULAR Hypertonic: decrease in water, but not solutes, shift INTRA to EXTRA cellular to make blood more dilute.
31
Hypovolemia Etiologies
GI fluid loss: vomiting (GIVE Iso THEN Hypo) Kidneys: Polyuria d/t DKA (GIVE Iso THEN Hypo) Fever (GIVE Hyper) bc cells are getting more fluid than blood, restore circulating volume Third Spacing: fluid stuck in interspicial spaces (ISO to correct circ volume) decreased fluid intake (GIVE Iso THEN Hyper) First fluid is to balance volume, 2nd fluid is to replenish cells or blood
32
Hypovolemia Manifestations
rapid weight loss decreased skin turgor dry mucous membranes decrease urinary output BUN is increased (kidney fail or dehydration) too much nitrogen in blood increased RR and decreased temp orthostatic hypotension (low bp, not enough vol) increased in thirst cold extremities
33
Hypovolemia Treatments
mild: drink water severe: IV Fluids (ISO to expand plasma volume, increase BP ext..) When BP returns to normal, then HYPO to refill cells
34
Fluid Challenge
give fluids, if NO urinary output increase, kidney problems
35
Fluid Volume Excess (HYPERVOLEMIA)
Restore balance is key Peripheral edema: excess fluid btwn cells, normal in cells Cellular edema: excess fluid IN cells, normal btwn cells
36
Hypervolemia
Fluid Volume Excess (FVE) Fluid intake > fluid Loss Isotonic: water and elecyro gained in equal proportion. too much of both in blood and cells Hypotonic: water intoxication (athletes) not enough solutes, Fluid shift from blood to cells, can burst cells. Hypertonic: increase in solutes but not water. Cells shrink. fluid shift TCF to ECF
37
Hypervolemia Etiologies
Excessive intake of sodium and water either PO or IV (not common) happens with renal failure SIADH (inappropriate ADH, too much fluid) Stroke, lesions in brain, chronic liver failure CHF Steroid use (puffyness)
38
Hypervolemia Manifestations
Rapid weight gain Circulatory overload (Heart failure) Interstitial edema (peripheral edema (feet), pulmonary edema - life threatening) Bounding pulses JVD - distended neck veins
39
Hypervolemia treatment
restrict sodium diuretics (lasix - strong) fluid restrictions
40
Hyponatremia
LOW SODIUM Serum sodium level <135 meq/L (normal 135-145) Cause: EXCESSIVE sodium loss (without water) EXCESSIVE water gain (without sodium) Decreased serum osmolality (cell swells from ECF to ICF) Sodium shift ICF to ECF (very common)
41
Hyponatremia Etiologies
Excessive sodium loss -diuretics, GI loss Insufficient sodium intake or absorption Excessive water gain Adrenal insufficiency Adrenal Insufficiency SIADH
42
Hyponatremia Manifestations
>125 - asymptomatic (incase sodium in diet and you good) 120-125 - nausea 115-120 - headache, lethargy <110-115 - seizures, coma, personality changes Lab values: low urine specific gravity low Cl weight gain, but not edema ****FINGERPRINTING OVER STERNUM **** Hallmark of Hyponatremia
43
Hyponatremia Treatment
Sodium replacement PO or IV regular: normal saline for Severe: Na <120 = 3% saline For excessive water gain: restrict fluid intake
44
Hypernatremia
TOO MUCH SODIUM Serum sodium level >145 meq/L Excession sodium gain (without water) Excessive water loss (without sodium) Fluid shift from ICF to ECF (cell shrink) Most often a water problem
45
Hypernatremia Etiologies
Water deprivation Hypertonic tube feeding Inadequately diluted baby formula High Protein Diet Insensible water losses Watery diarrhea Excessive admin of 3% saline Diabetes Insipidus Near Drowning in sea water
46
Hypernatremia Manifestiations
Dry sticky mucous membranes*** HALLMARK CNS abnormalities (neurologic) Neuromuscular (muscle twitching) Extreme Thirst *** HALLMARK
47
Hypernatremia Treatment
SLOW correction with 1/2 NS or 1/4 NS NOT D5W (risk of fluid overload) Drug intervention: Vasporessin (ADH) intranasally SQ or IM
48
Hypokalemia
LOW POSTASSIUM Serum potassium level <3.5 meq/L GENERAL K INFO: major cation in ICF (greater in cell than outside) WE don't store extra K, kidneys excrete
49
Hypokalemia Etiologies
Critical for Heart and GI system function in particular GI loss: vomit and diarrhea Intracellular shifts: DKA Anorexia Nervosa Dialysis (excessive removal) Excessive insulin Rental losses
50
Hypokalemia Manifestations
decreased K levels on labs <2.5 is BAD Cardiac: dysrhythmias Labs: increased pH and bicarbonate. urine specific gravity <1.010 increase serum glucose muscle weakness GI: Anorexia Rental: inability to concentrate urine, DILUTE urine Polyuria - nocturia polydipsia
51
Hypokalemia Treatment
IV replacement: urine output MUST BE adequate ** (Kidney NEEDS TO BE WORKING WELL) Careful NOT > 10mEq/hr - give SLOWLY NEVER IV PUSH = CARDIAC ARREST Mix thoroughly Dietary: foods/supplements Oral supplements (administer with meals or food to lower Gi irritation
52
Hyperkalemia
EXCESSIVE POTASSIUM serum K level > 5.0 mEq/L seldom in pts with normal kidney function MORE dangerous than Hypokalemia - leads to cardiac arrest Iatrogenic causes - OUR faults, this happens more common with older ppl
53
Hyperkalemia Etiologies
Decreased renal excretion Hypoaldosteronism K-sparing diuretics Metabolic acidosis, low pH Tissue injury and lysis of cells Excessive oral or IV intake bowel obstruction
54
Hyperkalemia Manifestations
Cardiac changes***: ``` EKG signs depressed S-T segment peaked T waves wide QRS complex loss of p-waves prolonged PR interval ``` CARDIAC ARRHYTHMIAS ** leading to cardiac arrest, this is major issue Bradycardia CNS - confusion muscle weakness GI - Nausea, diarrhea
55
Hyperkalemia treatement
Kayexalate PO or PR (cation exchange resin) this is a diarrhetic ENEMA usually IV diuretics Emergency - calcium gluconate - slow IV infusion (protects heart, increase threshold, so heart wont fire quickly) Sodium bicarbonate GIK: 500cc 10% glucose, 10u Reg insulin IV Dialysis
56
Hypocalcemia
LOW CALCIUM Serum calcium level < 8.5 mg/dl if calcium levels drop, calcium pulled from bones, phosphorus follows parathyroid pulls: calcium pulled from bones (NOT same process as osteoporosis) Need Vitamin D to absorb calcium Need good kidney function to assist
57
Total Calcium
Total calcium = Unbound + Bound calcium unbound = metabolically active (ionized) BODY REGULATES WITH THIS ONE need to look at MORE than this value to understand calcium loss can be due to low plasma proteins
58
Hypocalcemia Etiologies
Post-Op: Parathyroidectomy thyroidectomy radical neck dissection Renal failure Alkalosis Acute Pancreatitis Drugs Inadequate intake or absorption Excessive elimination Hypoalbuminemia - not enough plasma proteins
59
Hypocalcemia Manifestations
``` Neuromuscular: muscular irritability tingling paresthesias hands and feet muscle spasms ``` ``` CNS: confusion anxiety depression psychosis ``` Cardio: myocardial contractility hypotension dysrhythmias EKG: prolonged QT and DT Hematologic: clotting factors not working, bleeding
60
Trousseau's and Chvostek's Sign
Trousseau's: BP cuff pump up, watch for muscle spasm after 1 min Chvostek's: Twitching face when touched
61
Hypocalcemia Treatment
Acute: Calcium gluconate - SLOW IV INFUSION - too much can cause tissue necrosis Chronic: Oral calcium supplements with vit D and Mg Calcitonin (prevents osteoporosis) Fosamax (inhibits bone resorption) in AM only - empty stomach
62
Hypercalcemia
EXCESSIVE CALCIUM Serum calcium level > 10.5 mg/dl When the rate of calcium entry in the blood is greater than rate of renal calcium excretion
63
Hypercalcemia Etiologies
Excessive supplements Excessive vitamin D intake use of thizaide diuretics HYPERPARATHYROIDISM prolonged immobility Drugs Thyrotoxicosis Hypophosphatemia - decreased phosphorus Milk-alkali syndrome
64
Hypercalcemia Manifestations
Neuromuscular: excessive sedative effect weakness - flaccidity GI: decreased motility constipation anorexia ``` CNS: confusion memory impairment weird behavior LOC to COMA ``` ``` Renal: polyuria polydipsia renal colic renal failure d/t urinary calculi ``` Cardiac: Dysrhythmias EKG: shortened QT increased BP Bone: Soft tissue calcification pathologic fractures
65
Hypercalcemia Treatments
increase fluid intake Eliminate contributing drugs increase mobility Normal Saline IV hourly In and out and breath sounds Etidronate (Didronel) - for malignancies NOT hyperparathyroidism Plicamycin for breast cancer Calcitonin (IM)
66
Magnesium Imbalances
Normal: 1.5-2.3 mEq/L ``` Sources: cereal grains nuts chocolate legumes veggies dairy fruit meat fish water ```
67
Hypomagnesemia
LOW MAGNESIUM decreased serum magnesium level of less thatn 1.5 meq/L
68
Hypomagnesemia Causes
``` decreased intake vomiting diarrhea NG suction GI losses Malabsorption intestinal fistulas excessive loss of calcium and potassium DKA Burns pancreatitis renal disease ```
69
Hypomagnesemia Assesment
``` Neurologic irritability tremors tetany positive chovesteks and trousseas seizures confusion weakness ataxia dysrhythmias ECG abnormalities ```
70
Hypomagnesemia Imprelmentation
Monitor VS and dysrhythmias | same for hypocalcemia
71
Hypermagnesemia
INCREASED magnesium serum level of 2.3 meq/L causes: advanced renal failure*** excessive laxatives antacids
72
Hypermagnesemia Assesment
``` Neurologic depression drowsiness lethargy bradycardia dysrhythmias hypotension weakness too many laxatives areflexia - no reflexes ```
73
Hypermagnesemia implementation
increased renal excretion, but only for healthy kidney mechanical ventilation pacemaker dialysis
74
Phosphorus imbalances
Normal value 3.4-4.5 mg/dl Major Anion (neg charge) 85% in bones in teeth rest in soft tissue <1% in blood
75
Hypophosphatemia
LOW phosphorus serum level below 3.0 in Jejunum
76
Hypophosphatemia Causes
``` decreased intake poor absorption antacids increased renal excretion DKA Steatorrhea fever hepatic disease ``` Ph and CA have INVERSE relationship - with kidney, its one of the other
77
Hyperphosphatemia
TOO MUCH Phosphorus greater than 4.5 mg/dl Causes: excessive intake adrenal insufficiency
78
Hyperphosphatemia Assessment
Neurological excitability seizures conjunctivitis
79
Hyperphosphatemia Implementation
increased fecal excretion of phosphorus by binding phosphorus from food in the GI tract Dialysis

Patho II (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions