Exam 2 Flashcards
1
Q
What is PMN
A
A white blood cell
2
Q
What is opsonization
A
Cell is altered in a way that makes it easy to be killed
3
Q
What is Pyrexia
A
Something that causes fever
4
Q
What is insensible perspiration
A
You can’t measure how much sweat is being lost
5
Q
What are the 3 purposes of inflammatory response
A
Neutralize harmful agents/bacteria. Limit the spread of damage/wall-off injury. Prepare damaged tissue for repair
6
Q
What are the 5 cardinal signs of inflammation
A
Redness, swelling, heat, pain, and loss of function
7
Q
Describe acute inflammation
A
Usually a defined starting point (bee sting e.g.) IT is short, lasts 2 weeks or less. Trigger is identifiable
8
Q
Describe chronic inflammation
A
Lasts longer than 2 weeks. More “diffuse” usually can’t identify the reason for the inflammation. Causes scar tissue to form and deformity to set in.
9
Q
Describe 3 steps in inflammation
A
Increased vascular permeability and vasodilation. Recruitment of emigration and WBCs (chemotaxis). Phagocytosis of antigens and debris.
10
Q
Give 5 step pathway for inflammation response
A
Injury - Vasoactive chemicals - vasodilation - Emigration of neutrophils and macrophages into tissue - Phagocytosis
11
Q
Describe the vascular stage of inflammation
A
Momentary vasoconstriction followed by vasodilation and capillary leakage. Increases the volume of blood delivered to the damaged tissue thus delivering the necessary components of the blood to handle the issue
12
Q
Describe the effects of increased vascular permeability
A
Histamine-prostaglandin-leukotrines released from mast cells. Vasodilation, capillarity permeability and blood volume are all increased
13
Q
Increased blood volume increases hydrostatic pressure resulting in what
A
Pain, heat, redness, and swelling (edema)
14
Q
Describe granulocytes in the cellular stage of inflammation
A
Neutrophils arrive first and engulf/phagocytize and eliminate bacterial invaders. Left shift of excess immature neutrophils (bands) are released into the blood stream. Eosinophils release substances causing vasodilation. Basophils also release vasodilation substances
15
Q
Describe monocytes in the cellular stage of inflammation
A
Actions similar to neutrophils but have a longer life span and mature into macrophages they are released once the neutrophils are exhausted.
16
Q
Describe lymphocytes in the cellular stage of inflammation
A
Locate and destroy viral pathogens
17
Q
What does it mean if you have more macrophages than other wbc’s
A
The inflammation is likely chronic because the monocytes are hanging around and maturing into macrophages
18
Q
Name 4 steps of cells in inflammation response
A
Margination - emigration - chemotaxis - Phagocytosis
19
Q
Describe margination
A
WBCs and platelets stick to the walls of blood vessels
20
Q
Describe emigration
A
cells move through the capillary spaces
21
Q
What do bradykinins, histamines, and prostaglandins lead to
A
The capillary leak that increases hydrostatic pressure and thus pain
22
Q
What is C-reactive protein indicative of
A
That there is an inflammatory response going on
23
Q
Describe local manifestations of inflammation
A
Exudates: serous drainage, hemorrhagic/sanguinous drainage, serosanguinous drainage, fibrinous drainage, purulent or suppurative drainage. Also ulceration or wound
24
Q
What does serous drainage look like
A
Pale urine
25
What is serosanguinous drainage
A combination of sanguinous (blood) and serous (pale urine color) fluids
26
What is fibrinous drainage
The drainage has fibrin products in it so it's clear yellow and consistency is like jello (congealed serous fluid it seems to look like)
27
What are some systemic manifestations of inflammation
Leukocytosis, fever, elevated C-reactive protein. Lymphadenopathy (due to rapid increase in lymphocytes), lethargy, anemia, weight loss, sleepiness, ESR
28
What is an ESR
Erythrocyte sedimentation rate: How fast are red blood cells falling through fibrin to get to the bottom of the tube
29
Name 3 chronic inflammation etiology
Certain pathogens, environmental exposure and autoimmune disorders
30
Describe macrophages and granulomas in chronic inflammation
Macrophages release factors both promoting healing and re-injuring. Granulomas composed of macrophages, fibroblasts, and connective tissue
31
Describe fibroblasts in healing
Synthesize CT, can migrate where needed, and facilitate normal cell growth. Fibrin is like the framework for healing a wound.
32
Describe endothelial cells in the healing process
Develop new capillary beds from existing vessels, they bring in nutrients to promote healing.
33
Describe myofibroblast in the healing process
Develop a wound edge, promotes wound contracture (closure)
34
Which cells are constantly regenerating
Labile cells such as skin, mucous membranes, and bone marrow
35
Which cells regenerate only "when needed"
stable cells such as liver, pancreas, endocrine glands, and renal tubules
36
Which cells have poor regeneration
Permanent cells such as neurons and muscle cells
37
Describe connective tissue replacement in the formation of granulation tissue
Fibroblasts initiate healing, collagen develops from fibroblasts, contraction pulls the wound edges together leading to closure and then scar formation occurs - scars do not function like the parent tissue its essentially just a patch
38
What is primary healing
Healed by like cells such as in a very clean cut
39
What is secondary healing
granulation tissue is required because tissues aren't lined up.
40
What is tertiary healing
granulation forms and delayed closing is required. It's essentially just delayed secondary, often times it is due to a contaminated wound.
41
Name 7 complications of wound healing
Keloid formation, contractures, dehiscence, evisceration, stricture formation, fistula formation, and adhesions
42
Name 10 things that delay healing
Malnutrition, oxygen delivery, Impaired inflammatory/immune response, infection/contamination, foreign bodies, dehiscence, evisceration, circulation, obesity, and age
43
What is a contracture
An injury over a joint, as the the fibroblasts contract to heal the wound the joint is also constricted in so you lose rom
44
What is a stricture
A band of scarring around a pipe (around the trachea with chronic smoking e.g.)
45
What is a fistula
An opening between two body parts that do not normally open to each other
46
What is an adhesion
Scar tissue in which two body parts are stuck together that normally don't stick together
47
Give 6 things involved with temp regulation
Vascular response, skin response, positioning, shivering, epinephrine, and thyroid hormone
48
Name the four stages of fever
Prodromal, chill, flush, and Defervescence
49
Describe the prodromal stage
A general feeling of unwell but no identifiable specific signs and symptoms that would point to a certain disease
50
Describe fever in the elderly
Fever response is diminished so a temp of 99 is similar to for example a 102 in children. Also elderly people can often have errors in measurement with what they're telling you
51
Compare antigen vs antibodies
antigen would be like the foreign invader. It's the thing that antibodies recognize and respond to
52
What is seroconversion
The point in time that you can measure antibodies in a person's bloodstream to know if they've been exposed to whatever you're looking for. Usually referred to HIV. It's when you can determine that they do have HIV
53
What is myalgia
General muscle aches and pains
54
What is gammaglobulin
Same thing as both immunoglobulin and antibodies. 3 words for the same thing
55
What is pyrogenic
Things that cause fever
56
What is autoimmunity
When you break down organs in your own body due to an immune response
57
Name 3 of the skin and mucous membranes
Physical barriers, chemical barriers - peptides, and normal flora
58
What is the mononuclear phagocyte system
Monocytes, macrophages, and dendritic cells destroy or present antigens
59
What is involved with the lymphoid system
spleen, lymph nodes, thymus - filters
60
How is bone marrow involved in the immune system
It creates stem cells
61
What does bone marrow primarily do as a lymphoidal structure
cell growth and differentiation. T and B stem cell development and B cell maturation. T cells stay in the thymus while B cells stay in the bone
62
Describe what the 3 granulocytes are involved in
Neutrophils - 1st WBCs to appear at injury/infection - phagocytosis. Eosinophils - allergic reactions and parasitic response. Basophils and mast cells - allergic reactions, chronic inflammation and wound healing.
63
What do mast cells release
Histamine
64
What is the other big job of macrophages besides phagocytic activity
The presentation of antigens to T cells.
65
What do NK cells do
Destroy tumor cells and viruses without prior exposure required. They are pre-programmed to take care of certain abnormalities
66
What do T cells do
Direct the immune system's function. It tells the B cells to turn into certain antibodies. They determine how many neutrophils get released and how many eosinophils get released.
67
What is the only job of the B cell
To become an antibody
68
Describe the innate immunity
Responds primarily to microbes. Composed of skin, phagocytic cells, NK cells, monocytes - macrophages and cytokines.
69
What is passive immunity
Immunity that is given to an individual through antibodies. It doesn't last very long. Two main ways are from mother to infant and through antibody injections
70
Describe the adaptive/active immunity
Requires exposure to antigen for development such as vaccines or diseases. Acquired over time. Composed of WBCs and their products. More specific than innate immunity. It has a memory.
71
What are the two types of adaptive/active immunity
Humoral and cell-mediated
72
What are major histocompatibility complexes (MHC)
Proteins that identify self and present antigens to the attacker cells of the immune system. Very important in tissue transplantation.
73
What's another name for MHC
human leukocyte antigens (HLAs)
74
Describe cell mediated immunity
Composed of T cells. T cells develop from stem cells in bone marrow and move to thymus gland to mature. T4 cells with CD4+ are helper cells. T8 cells with CD8+ which are cytotoxic cells. Cytokines are also involved
75
What does IgG antibody do
Bacteria, toxins, viruses - second responder to antigens
76
What does IgM antibody do
First responder to an antigen. elevated levels indicate a recent infection
77
Describe primary response of humoral immunity
First exposure to an antigen that stimulates the development of antibodies. Vaccines are a great example
78
Describe secondary response of humoral immunity
Occurs when a person is subsequently exposed to the antigen
79
Describe the development of the immune system
Begins at 5-6 in utero
Secondary lymph organs are small at birth
IgG is the only Ig to cross the placenta
The presence of other Ig at birth indicates intrauterine infection
IgA is transferred in breast milk & colostrum
80
Describe a type I hypersensitivity response
It's immediate. IgE receptor stimulation on mast cells and basophils. Causes vasodilation, increased capillary permeability, and smooth and bronchial muscle constriction
81
Describe an anaphylactic reaction
They're life threatening such as hives, bronchoconstriction, tachycardia, and vasodilation
82
Describe a type II cytotoxic Hypersensitivity
Antibody mediated (immediate and tissue specific). Activation of IgG and IgM. Respond to antigens on cell surfaces and some drugs and binds to the surface
83
Give type O antigen and antibodies
No antigen. Anti-A and anti-B
84
Describe type III hypersensitivity reaction
It's an immune complex reaction. insoluble antigen-antibody complexes deposit in the glomeruli, skin vessels, and joints and activates complement.
85
What can type III hyper-sensitivity lead to
Kidney damage - glomerulonephritis. Serum sickness from certain drugs. Systemic lupus erythematosus (SLE)
86
Describe a type IV hypersensitivity reaction and give 6 examples
It is delayed and not antibody mediated it's cell mediated involving T lymphocytes:
TB skin test– delayed result
Fungi
Protoza
Parasites
Contact dermatitis
Pneumonitis
87
How are autoimmune disorders treated and diagnosed
Diagnosed via Ig. Treated via Immunosuppression, plasma exchange, and cytokines
88
What are host vs graft transplant immunopathology
Hyperacute, acute, chronic, local S&S
89
What is graft versus host transplantation immunopathology
Acute, chronic, systemic S&S
90
What happens when you have an inability to pruduce Ig
Recurrent pyrogenic infections (extracellular infections)
91
Give two deficiencies involved with antibody specific immunodeficiency disorders
IgA deficiency
IgG deficiency
92
Give an example of an all antibody immunodeficiency disorder
X Linked Agammaglo
93
What happens when cell-mediated immunity does not function correctly
Increases susceptibility to Increases susceptibility to
Fungi
Viruses
Intracellular bacteria
Cancer
94
What is severe combined immunodeficiency disease
Lack both humoral and cell-mediated immunity
Severe Combined Immunodeficiency Disease
95
Describe HIV pathophysiology
It's a retrovirus so it carries genetic information in RNA instead of DNA. HIV attaches to CD4+ (T helpers). HIV RNA enters the cells and converts its RNA to DNA in the cell, therefore the body's cells begin producing the virus. This process kills the CD4+ cells and releases more HIV
96
How do we measure HIV
CD4+ count is an indication of the effectiveness of the immune response. Less than 200 cells/uL leads to opportunistic diseases. Viral load is a measure of how much of the virus is in the bloodstream.
97
Give a list of High risk groups for HIV
Homosexual males, heterosexual females. History of an STI. IV drug users. Persons who require frequent blood transfusions. Transplant recipients. Those who contact contaminated instruments.
98
Describe primary infection phase of HIV
2-4 weeks post exposure
Viral loading
Flu like S&S
Fever and night sweats
Fatigue
Myalgias (muscle pain)
Sore throat
GI disturbances
Rash
HA (headache)
Swollen lymph nodes
99
Describe latency phase of HIV
can last for a few to 10-15 years. S&S free except for enlarged nodes. Continued decrease in CD4+ Increasing viral load.
100
Describe overt disease phase of HIV (AIDS phase)
By definition, CD4+ count of less than 200 cells/uL and an AIDS defining illness: fever, weight loos and wasting, diarrhea, Generalized lymphadenopathy
Opportunistic infections – lungs, skin
Cancers – Kaposi sarcoma, cervical
101
What are some nervous system infections associated with HIV
Retinopathy and ocular malignancies
AIDS dementia
Toxoplasmosis
Cryptococcus
Encephalopathy
102
Name 3 malignancies that are more common with HIV
Kaposi sarcoma
Non-Hodgkins lymphoma
Cervical cancer
Pap test every 6 months
103
How do we diagnose HIV
Test for antibodies IgG to HIV using EIA, ELISA, and western blot
104
Describe treatment for HIV
Antiretroviral therapy: Works to slow replication of the virus. Increase CD4+ count, converted HIV to a chronic disease. Preexpose prophylaxis leading to 92% decrease in transmission
105
Name some childbearing factors of HIV
HIV crosses the placenta
HIV antibodies cross the placenta
Blood transmission at birth
HIV is present in breast milk
Infants testing negative for 6 months without opportunistic dz are said to be HIV free
Viral loads <1000copies/mL have decreased chance of being positive
106
Describe children with AIDS
Failure to thrive. CNS abnormalities. Developmental delays. PCP in the first 3-6 months of life
107
Give type A antigen and antibodies
A antigen, anti-B antibody
108
Give type B antigen and antibodies
B antigen, anti-A antibody
109
Give type AB antigen and antibodies
A and B antigens, no antibodies
110
Compare positive and negative blood types
If you're positive your blood cells have the Rh protein, if you're negative your cells lack the Rh protein
111
Name four symptoms of wasting
Diarrhea
Chronic weakness
Fever
Lipodystrophies
112
What are microflora
harmless, helpful organisms
113
What is a host
organism where the pathogen lives
114
What is virulence
disease producing capacity
115
What is immunocompetence
ability to ward off infection
116
Describe 3 underlying infection premises
All living things seek to survive and reproduce.
Must extract from the environment or host everything necessary to live and reproduce.
Humans are constantly exposed to microorganisms some of which are pathogens.
117
List 9 infectious agents in order of descending virulence
Prions (most virulent)
Viruses
Bacteria
Spirochetes
Mycoplasmas
Rickettsiae
Chlamydiae
Fungi
Parasites (least virulent)
118
Describe prions
Transformed protein structures that are not broken down by proteases and accumulate in neuronal tissue.
Transmitted via injection, transplantation of contaminated tissue, contact with contaminated medical equipment, and ingestion of contaminated food.
Do not elicit an immune response.
Antimicrobials are ineffective
119
Describe viruses
Intracellular organisms with no organized cell structure and have either a protein or lipoprotein coat or a genome (DNA or RNA) but not both.
Can only reproduce within a living cell.
Have latent and reactivation periods.
Do not respond to antimicrobials very well.
120
Describe bacteria
Largely asexual replicating non nucleated cells with a cell wall.
Gram stain
May be aerobic or anaerobic.
Varying sensitivity to antimicrobials.
May develop resistance.
May be protective or pathogenic
Name = Genus then species
121
Describe fungi
Free living eukaryotic (nucleus, DNA & cell wall) saphrophytes (feeds on dead and dying material).
Infections are called mycoses
122
Describe parasites
Members of the animal kingdom that cause infection in humans – helminths, protozoa & arthropods.
123
Describe chlamydiae and what are they considered
They are considered parasitic. Similar to rickettsiae but are transmitted from vertebrate to vertebrate
124
Describe Rickettsiae and what are they considered
Combine characteristics of viruses and bacteria; intracellular, have cell walls, asexual reproduction, have DNA and RNA.
Infect arthropods without causing disease but victims of arthropods develop disease
125
Name the 5 ingredients for infection
Source
Portal of entry
Site of Infection
Symptomatology
Exit portal
126
Describe the 5 stages of infection progression
Incubation period – replication of the organism without overt S&S
Prodromal stage – vague S&S
Acute stage – Maximum impact and expression of the infection. More severe and specific S&S
Convalescent stage – containment, repair and resolution of S&S.
Resolution –complete recovery
127
Describe factors impacting severity of infection
Site
Virulence:
Toxins
Adhesion factors
Invasive factors
Evasive factors
128
Describe four global infection diseases
West Nile Virus (WNV) – mosquito vectors and travel
Severe Acute Respiratory Syndrome (SARS) – 29 countries via travel
Ebola – hemorraghic dz – infected blood (animals) and body fluids
Zika – Flu like S&S in adults; microcephaly, visual abnormalities, and joint deformity and muscle deformity
129
What is the intracellular space
fluid inside cell
-water can diffuse out and cause cell shrinkage
-water can enter and cause cell swelling (edema)
130
What is the extracellular space
fluid outside cells and mostly in vascular space
-bp control
-found in blood vessels containing electrolytes, oxygen, glucose and nutrients to be delivered to cells or waste products for excretion
131
What is the interstitial space
fluid surrounding cells outside vascular space
-tissues, between cells and capillaries
-lacks proteins because to large to diffuse out of blood vessels into interstitial space unless theres inflammation
132
What is the third space
localization of a large collection of fluid neither intra or extra cellular
133
Describe hydrostatic pressure (movement of fluid and electrolytes)
the pressure created by water in the bloodstream against capillaries. Hydrostatic pressure creates a pushing motion of fluid. Anything that increases the amount of water in a container (cell, vascular space) increases the flow of !water out! of the container. Hydrostatic pressure is increased by adding water to the vascular space via IV for example.
-pushes water out of vascular space through capillary membrane pores into interstitial and intracellular compartments
134
Describe colloidal (protein) or oncotic pressures (movement of fluid and electrolytes)
-exerted by protein (mainly albumin)
-keeps hydrostatic pressure in by pulling fluid into capillaries
-pulling from ICF into ECF (capillary)
-albumin attracts water and helps keep it inside the blood vessel
135
Describe how capillary permeability works
artery and vein meet, fluid leaks out with increased capillary permeability, fluid leaks in with decreased capillary permeability
136
What is isotonic fluid
same concentration of sodium particles/tonicity as human blood
137
What is the impact of isotonic fluid on fluid shifts and cell size
-does not cause fluid shifts
-does not alter cell size
138
where does isotonic fluid have the prosperity to go/stay
no push or pull effects
-stays in vascular space
139
Give two examples of isotonic solutions
- 0.9% normal saline (NS)
-ringers lactate
140
Describe hypotonic fluids
have fewer sodium particles/lower tonicity than human blood
-more water than human blood
-dont give if bleeding because it stays in vascular space
141
What is the impact of hypotonic fluid on fluid shifts and cell size
- water is added to bloodstream causing a fluid shift from extracellular fluid to intracellular fluid to deliver water to blood stream
-causes cellular swelling, treats dehydration
142
Where does hypotonic fluid have the prosperity to go/stay
it pushes fluid out of vascular space into interstitial and cellular space
-leads to edema if not carefully monitored
143
Give examples of hypotonic fluids
- 0.9% or less means hypotonic solution
-0.45% NS
-0.225% NS
-D5 0.9% NS
-D5 0.45% NS
-D5W
-free water
144
Describe hypertonic fluids
higher concentration of sodium particles/tonicity than human blood
-less water than blood
-give for swelling or burns
145
What is the impact of hypertonic fluid on fluid shifts and cell size
-solutes are added to bloodstream causing fluids to shift from intracellular fluid to extracellular fluid
-causes cellular shrinkage
-treats edema
146
Where does hypertonic fluid have the prosperity to go/stay
pulls fluid into vascular space from interstitial and cellular spaces
-leads to dehydration if not closely monitored
147
Give examples of hypertonic fluids
-3% NS
-5% NS
-5% albumin
-25% albumin
-mannitol
148
What do hypertonic fluids cause
decreased hydrostatic pressure and increased colloidal pressure
149
Describe 5% and 25% albumin
protein
-salt follows water, sucked out of cells into vascular space
150
Describe mannitol
osmotic diuretic
-sucks fluid from cells in brain (give for brain swelling)
151
What are some causes of dehydration
-low water intake
-diarrhea and vomiting
-diuretics
-burns
-fevers
-uncontrolled diabetes
152
Describe the signs and symptoms of dehydration
-hemoconcentrated (increased lab values from blood draw)
-decreased vascular and cell volume
-UOP <30mL
-rapid thready pulse (hard to tell when one pulse ends and starts)
-poor skin turgor
-weight loss
-tachycardia (increased HR, not enough blood volume)
-hypotension
-dark urine
153
Describe what fluids we would give to a dehydrated patient
-isotonic: equal parts H2O and Na, slowly corrects, best option
- hypotonic: more water less sodium, corrects quickly
-never hypertonic (pt basically hypertonic)
154
What are some causes of overload
-Increased intake of hypotonic fluid
-Liver failure
-Renal failure (kidneys arent excreting water)
-Heart disease/failure
155
What are signs and symptoms of overload
-hemodilution (decreased lab values from blood draw, water is diluting lab values)
-excess vascular volume
-edema
-crackles!: fluid in interstitial space in lung increases hydrostatic pressure, decreased colloidal/oncotic pressure
-full bounding pulse
-weight gain
-bulging eyes
-dyspnea: SOB
-Jugular vein distention
-swollen/puffy
-dilute urine
156
What fluid types should we give to patients with overload
-isotonic, works slowly over time
-hypertonic (more sodium less water): sends in more fluid from cells and interstitial fluid, reduces overload quicker
-never hypotonic (pt is almost hypotonic)
157
How does low antidiuretic hormone (ADH) effect fluid balance
diabetes insipidus: low ADH leads to large amounts of water loss via urine
158
how does high (excess secretion) of antidiuretic hormone (ADH) effect fluid balance
syndrome of inappropriate ADH (SIADH): high ADH leads to water retention
159
What should daily fluid intake be
1.5-3L
160
What does 1L of water weight
1kg or 2.2 pounds of weight
161
What is obligatory urine output
the minimum amount of urine per day needed to excrete toxic waste products
-0.5mL/kg per hour
162
What is the best indicator of fluid balance/volume status
daily weights at same time, same scale, same amount of clothing
163
What influences Na movement/levels
H2O follows sodium in fluid and electrolyte movement
-sodium follows protein
164
Describe how Na and Cl move
together usually
165
What is the sodium normal value range
135-145 mEq/L
166
Where is sodium normally reabsorbed
kidney tubules under control of the sympathetic nervous system and renin
167
What do angiotensin II and aldosterone cause
increased sodium and reabsorption from tubules
168
Describe ADH effects on hypernatremia
increased H2O retention (concentration of urine)
169
What is sodium controlled by
-thirst regulating H2O intake
-thirst is controlled via hypothalamus in response to dehydration, hypovolemia (low fluid), and angiotensin II
170
Describe the causes of hypernatremia
-results from fluid loss or excess sodium
-fever
-vomiting/diarrhea
-concentrated tube feedings
-thirst defect
-strenuous exercise
-excessive diaphoresis (sweating)
171
What is hypernatremia
too much sodium in the blood
172
What are the signs and symptoms of hypernatremia
Thirst: first
*Superficial: Dry skin, mucous membranes, ↓tears, & saliva
*Vascular space: Weight loss, tachycardia, thready pulse, & hemoconcentration.
*CNS : ↓reflexes, agitation, HA, restlessness, coma &, seizures
-Sodium imbalance: confusion, lethargic, aggrivated
173
What are the causes of hyponatremia
-same as volume overload
-ingestion of too much water (low sodium) or hypotonic fluids
-too little aldosterone
-too little cortisol
-too much ADH
-need normal saline or hypertonic saline
174
What are the signs and symptoms of hyponatremia
-low sodium (excess water dilutes sodium levels)
-same as volume overload
-superficial: edema, nausea/vomiting, abdominal cramps
-vascular: CHF, full bounding pulse, weight gain, hemodilution
-CNS: lethargy, HA, disorientation, confusion, motor weakness, decreased reflexes, seizures, coma
175
What is potassium controlled by
Na+/K+ ATPase pump
176
What is the normal value range of potassium
3.5-5 mEq/L
177
Where is potassium excreted
-majority: kidneys
-minority: stool and sweat
178
How is potassium controlled
-renal excretion
-intracellular-extracellular shifts
179
intracellular-extracellular shifts in potassium: increases H+ causes
increased K+ and visa versa
180
intracellular-extracellular shifts in potassium: increased Na+ causes
decreased K+ and visa versa
181
intracellular-extracellular shifts in potassium: increased insulin and catecholamines causes
increased potassium movement into cells
182
What are some causes of hypokalemia
-low potassium intake
-high UOP from diuretics
-vomiting and GI suction
-alkalosis (decreased hydrogen)
-burns
-hyperinsulinemia
183
What results from alkalosis (decreased hydrogen)
low potassium, high pH
184
What are some signs and symptoms of hypokalemia
-look at heart first with potassium
-renal: increased UOP, thirst, orthostatic hypotension (muscles arent contracting)
-GI: constipation, nausea/vomiting, constipation
-muscular: weakness, fatigue, cramps
-cardiac!!! dysrhythmias (heart conduction is abnormal)
185
What are some causes of hyperkalemia
-decreased urinary excretion (renal failure)
-increased ingestion
-intra-extra cellular shifts
-diarrhea: ASSidosis
186
What are some signs and symptoms of hyperkalemia
*Paresthesia (burning or prickling sensation)
*Muscle weakness
*Respiratory depression
*Changes in the electrical activity of the heart!!! (bradycardia: slow heart rate, irregular heart rate, cardiac arrest)
187
What would we give with low volume due to blood loss or dehydration
normal saline
188
What type of shock causes low fluid volume
hypovolemic shock
189
What are some signs and symptoms of low fluid volume
-dehydration
- hypothalamus osmoreceptors activate thirst
-dry mucous membrane
-poor skin turgor (skin stays tented)
-hypotension
-low UOP
-dark color urine
190
What happens with greater hydrostatic pressures
fluid will leave capillaries and go into intracellular
191
What happens when oncotic pressure is greater
fluid enters capillaries and go into vascular space/ extracellular fluid
192
What condition may result in a "false hyperkalemia"
acidosis
193
Reduced sodium concentration accompanied by fluid deficit is also known as
hypovolemic hyponatremia.
194
What are hyper and hypokalemia
too much or too little potassium in the blood
