Fluid And Electrolyte Flashcards

Question

Hypernatremia: Manifestations

Answer 1

``` Thirst Tachycardia Decreased urine output Fever Flush warm skin Dry skin and mucous membranes Decreased salivation and lacrimation Decreased reflexes Agitation Headache Restlessness Seizure Coma ```

Answer 2

Limit intake | Replace fluid oral or IV D5W

Answer 3

CO2 >50 = acidosis CO2 <35 = alkalosis PH <7.35 = acidosis PH >7.45 = alkalosis Bicarbonate <22 = acidosis Bicarbonate >36 = alkalosis Ph serum levels are not directly proportionate to CO2 levels Arterial blood gases - indicate respiratory and metabolic function

Answer 4

Intake oral urine output (aldosterone eliminates and hydrogen reabsorption eliminates) transcompartmental shifts in ICF and ECF Serum osmolality - water moves out of cell into ECF = increase in potassium concentration Acid base balance - cation shift for buffering pH = (alkalosis = hydrogen excreted; hypokalemia and acidosis = hydrogen reabsorbed; hyperkalemia) Insulin - temporary shift into cells; hypokalemia Sympathetic NS - epinephrine = increase in uptake; hypokalemia

Answer 5

Serum potassium below 3.5 Inadequate intake - low potassium diet or inability to obtain or ingest food Burns and capillary injury Excessive renal losses - diuretic, alkalosis, magnesium depletion, increased aldosterone Insulin Beta adrenergic agonist drugs

Answer 6

``` Increased urine output - polyuria Nocturia Thirst Anorexia Nausea and vomiting Constipation Weakness Fatigue Muscle cramps ECG changes Arrhythmias and digitalis toxicity Alkalosis and renal chloride wasting ```

Answer 7

Increasing intake Oral supplement IV potassium and magnesium replacement

Answer 8

Potassium above 5 Decreased renal elimination - chronic kidney disease, nephropathy, aldosterone deficiency, potassium sparing diuretics, ace inhibitors Shift from ICF to ECF - acidosis, tissue injury, decreased insulin, beta blockers Increased intake

Answer 9

``` Bradycardia Cardiac arrests ECG changes Weakness Paralysis Paresthesia Cramps Diarrhea Nausea and vomiting ```

Answer 10

``` Calcium Sodium bicarbonate Beta agonists Insulin Hemodialysis or peritoneal dialysis Restrict intake ```

Answer 11

Below 8.5 ``` Decreased intake Renal failure Hypoparathyroidism Vitamin D deficiency Respiratory alkalosis Loop diuretic PPI H2 blockers Citrate ```

Answer 12

``` Tetany Bone pain Carpopedal spasm Trousseau sign Chvoskek sign Twitching facial muscle Parestheisa Confusion Lethargy Anxiety Cardiac arrhythmia Resistance to digitalis Hypotension ```

Answer 13

Above 10.5 ``` Neoplasms of the parathyroid gland Hyperparathyroidism Immobilization Increased absorption in intestine Excess vitamin D Lithium Thiazide drugs ```

Answer 14

``` Muscle weakness Lethargy Ataxia Personality changes Stupor Coma HTN ECG changes Anorexia Nausea and vomiting Constipation Thirst and dilute urine ```

Answer 15

Bicarbonate - plasma RBC, CA converts CO2 and H20 into H2CO3 that dissociates into H and HCO3 (bicarbonate) where HC03 is exchanged for Cl- Hemoglobin - combination of C02 and Hgb loose reversible for exchange in lungs Plasma - dissolved in plasma that forms carbonic acid from hydration of dissolved CO2

Answer 16

Chemical buffer - bicarbonate (weak acid H2C03 and weak base NaHC03) AND potassium hydrogen exchange AND body proteins Bone buffering - leading to demineralization Respiratory - ventilation to increase CO2 exchange; monitored by chemoreceptors in brain, carotid, and aortic bodies Renal - reabsorption of HCO3 and Regulation of H+ secretion and generation of new bicarbonate; phosphate buffer system

Answer 17

Value furthest from norm is primary | If values of predicted compensatory values fall outside range it is mixed

Answer 18

Increasing respiratory rate HCO3 <22 and pH <7.35 Lactic acid buildup and production of ketoacids Inadequate o2 deliver - shock, cardiac arrest, intense exercise, cancers, liver failure Poorly controlled diabetes Kidney disease Diarrhea

Answer 19

``` Lethargy Stupor Fatigue and malaise Kussmauls respirations Hyperventilation Hypotension Arrhythmia Tachycardia Anorexia Nausea and vomiting Abdominal pain ```

Answer 20

Correcting underlying cause Restoring lost fluid and electrolytes Insulin and fluid replacement in diabetic ketosis

Answer 21

Hypoventilation HCO3 >26 ph >7.45 ``` Vomiting Gastric suctioning Ingestion of alkali - calcium carbonate, antacids IV bicarbonate Hyperaldosteronism Diuretics Abrupt acidosis correction ```

Answer 22

``` Hyperactive reflexes Tetany Confusion Seizures Carpopedal spasm Trosseau signs Bradypnea Shallow respirations Hypoxemia Respiratory acidosis Hypotension Arrhythmia Nausea and vomiting ```

Answer 23

Correcting underlying cause | Chloride Deficit requires correction (potassium chloride)

Answer 24

Renal adaptation PaCO2 >45 pH <7.35 ``` Acute respiratory failure Narcotic overdose Lung disease Chest injury or obstruction Pneumothorax Enervation COPD Timor Exercise Fever - Hyperthermia Sepsis Burns Carbohydrate rich diet Accidental inspiration of CO2 ```

Answer 25

``` Restlessness Confusion Depressed reflexes Somnolence Coma Blurred vision Psychological disturbances Dyspnea Tachypnea Hypoxemia Tachycardia Arrhythmia HTN or Hypotension Warm flush skin and weakness ```

Answer 26

Improve ventilation | Mechanical ventilation

Answer 27

Hydrogen pulled from cells to produce carbonic acid PaCO2 <35 and pH >7.45 Hyperventilation Medullary stimulation Mechanical ventilation Disease processes

Answer 28

``` Dizzzy, Agitated Circumoral and peripheral paresthsia Tetany Twitching Muscle weakness Light headed Deep rapid respirations Dyspnea Palpitations Tachycardia ```

Answer 29

Correct underlying cause Rebreathe into a paper bag Supplemental o2 and changing ventilator settings