Exam3- Fluids, electrolytes, and acid-base balance

Question 1

hypovolemia or isotonic FVD

Answer 1

loss of h2o AND electrolytes from the ECF

Question 2

dehydration

Answer 2

loss of h2o without the loss of electrolytes

Question 3

risk factors for hypovolemia

Answer 3

• excessive GI loss: vomiting, diarrhea, nasogastric suctioning
• sweating
• excessive urination (DI, kidney disease, AI, osmotic diuresis)
• third spacing (peritonitis, ascites, burns, intestinal obstruction
• poor intake (anorexia, nausea, NPO)

Question 4

risk factors for dehydration

Answer 4

• hyperventilation
• DKA
• prolonged fever
• enteral feeding with poor water intake

Question 5

S/S for both dehydration and hypovolemia (FVD)

Answer 5

• hypothermia
• hypotension
• tachycardia
• tachypnea
• dizziness, syncope, confusion, fatigue
• weight loss
• dry mucous membranes
• oliguria (decreased urine output)
• nonelastic skin turgor
• no tears

Question 6

hypervolemia (FVE)

Answer 6

excess water AND sodium

increased blood volume

Question 7

overhydration (hypoosmolar fluid imbalance)

Answer 7

• retention of more water than electrolytes

- causes hemodilation

Question 8

risk factors for hypervolemia

Answer 8

• heart failure
• poor kidney function
• plasma fluid shifts (hypertonic fluid, burns)
• excessive sodium intake

Question 9

risk factors for overhydration

Answer 9

• head injuries
• anesthetics
• SIADH (excess secretion of ADH)
• water replacement without electrolytes replacement (strenuous exercise with profuse diaphoresis)

Question 10

S/S for FVE

Answer 10

• hypertension
• bounding pulse
• tachycardia
• confusion
• muscle weakness
• weight gain
• edema/ascites
• JVD
• dyspnea
• crackles

Question 11

sodium range

Answer 11

135-145

in the ECF

Question 12

potassium range

Answer 12

3.5-5.0

in the ICF

Question 13

calcium range

Answer 13

9-10.5

Question 14

magnesium range

Answer 14

1.3-2.1

Question 15

• excess of water in the plasma or loss of sodium-rich fluids
• water moves IN to the cell, causing cellular swelling (cerebral edema)

Answer 15

hyponatremia

Question 16

• serious electrolyte imbalance: can cause significant neurological, endocrine, and cardiac disturbances
• water moves OUT of the cell, making the cell dehydrated

Answer 16

hypernatremia

Question 17

• tachycardia
• hypotension
• headache, confusion
• decreased deep tendon reflexes
• hyperactive bowel sounds
• abdominal cramps
• N/V

Answer 17

S/S for both hyponatremia and hypernatremia

Question 18

• weak irregular pulse
• hypotension
• muscle cramping
• mental confusion
• premature ventricular contractions
• bradycardia
• flattened T waves
• ST depression
• hypoactive bowels
• n/v/

Answer 18

hypokalemia S/S

Question 19

• slow irregular pulse
• hypotension
• mental confusion
• lack of reflexes
• v-fib
• peaked T waves
• widened QRS, cardiac arrest
• hyperactive bowels
• diarrhea

Answer 19

hyperkalemia S/S

Question 20

• numbness and tingling
• muscle spasms
• hyperactive DTR
• +chvostek’s sign (facial twitching)
• +trousseau’s sign (hand/finger spasms with BP cuff)
• laryngospasm
• prolonged QT interval and ST segment
• hyperactive bowels, diarrhea
• seizures

Answer 20

hypocalcemia S/S

Question 21

• decreased reflexes
• bone pain
• dysrhythmias
• increased risk of blood clots
• weakness, lethargy
• decreased LOC

Answer 21

hypercalcemia S/S

Question 22

• hyperactive DTR
• muscle tetany
• +chvostek
• +trousseau
• tetany
• seizures
• hypoactive bowels
• constipation
• tachycardia
• hypertension

Answer 22

hypomagnesemia S/S

Question 23

• diminished DTR
• muscle paralysis
• shallow respirations (decreased RR)
• bradycardia, hypotension
• lethargy

Answer 23

hypermagnesemia S/S

Question 24

chloride

Answer 24

• other electrolytes
• in the ECF
• bound to other ions (CaCl2)

Question 25

phosphate (phosphorus)

Answer 25

-ICF anion -bound with calcium in teeth and bones -inverse relationship with calcium (increased phosphate= decreased calcium)

Question 26

bicarbonate

Answer 26

- in the ICF and ECF - acid-base balance - regulated by the kidneys - produced by body to act as buffer

Question 27

normal blood pH

Answer 27

7.35-7.45

Question 28

<7.35

Answer 28

acidosis

Question 29

>7.45

Answer 29

alkalosis

Question 30

normal pCO2

Answer 30

33-45 mmHG

Question 31

repiratory

Answer 31

pertaining to CO2 (acid) | -affected by ability to adequately exchange oxygen and carbon dioxide

Question 32

respiratory acidosis

Answer 32

pCO2 > 45mmHg | retaining CO2

Question 33

respiratory alkalosis

Answer 33

pCO2 < 35mmHg | excessive ventilation

Question 34

metabolic

Answer 34

pertaining to HCO3- (base) | -kidneys control by retaining or excreting HCO3- in response to body's pH

Question 35

normal HCO3-

Answer 35

22-26

Question 36

metabolic acidosis

Answer 36

HCO3 < 22 | too much acid in the body or body unable to excrete enough acid

Question 37

metabolic alkalosis

Answer 37

HCO3 > 26 | acid loss or too much base

Question 38

practice: ``` pH= 7.27 pCO2= 36 HCO3-= 19 ```

Answer 38

metabolic acidosis pH is acidic (7.27) pCO2 is within range (36) HCO3- level is below normal (acidic) (19) pH 7.35-7.45 pCO2= 35-45 HCO3= 22-26

Question 39

practice: ``` pH= 7.52 pCO2= 28 HCO3-= 23 ```

Answer 39

respiratory alkalosis pH is alkalotic (7.52) pCO2 is alkalotic (28) HCO3 is within range (23) pH 7.35-7.45 pCO2= 35-45 HCO3= 22-26