Fluid and electrolyte balance and disturbances

Question 1

K+ is the major determinant what r/t cell excitability

Answer 1

RMP

Question 2

Ca++ is the major determinant of what r/t cell excitability

Answer 2

threshold potential

Question 3

Normal Ionic balance:

what is the normal rmp? and what controls it

Answer 3

-90

K+

Question 4

Normal Ionic balance:

what is the normal threshold? and what controls it

Answer 4

-60

Ca++

Question 5

point to the RMP

Answer 5

Question 6

Normal Ionic balance:

clearify

Muscle rmp is -90

Nerve is -70

Answer 6

just so i dont get confused

Question 7

Normal Ionic balance:

point to the Threshold line

Answer 7

Question 8

Normal Ionic balance:

what one is HYPOkalemia

Answer 8

Question 9

Normal Ionic balance:

explain how you know it is hypokalemia and what it all means.

Answer 9

• RMP HYPERpolarized (more negative)
• making it LESS excitable
  
  • Moves away from threshold
• ​​More of a stimulus if needed to exert an action

Question 10

Normal Ionic balance:

Point to HYPERkalemia

Answer 10

Question 11

Normal Ionic balance:

explain how you know it is hyperkalemia and what it all means.

Answer 11

• HYPOpolarized (less negative/closer to 0)
• RMP moves closer the threshold
  
  • MORE excitable
• Less of a stimulus is needed to evoke a response

Question 12

Normal Ionic balance:

what the hell can cause D? and what is going on?

Answer 12

• the RMP has past the threshold
• Cardioplegia solution
• Hyperkalemia
• Na+ channel snaps open
  
  • causes absolut refractory period b/c Na+ channels can’t fire
• K+ levles = 15-40 mEq

Question 13

Normal Ionic balance:

point to Hyper calcemia

Answer 13

Question 14

Normal Ionic balance:

explain how you know it is hypercalemia and what it all means.

Answer 14

• Threshold is hypopolarzed
  
  • moves closer to 0
• ​​Decreased excitability
  
  • bigger gap b/t rmp and threshold
• More stimulus is needed to elict a response

Question 15

Normal Ionic balance:

what the hell if F showing?

Answer 15

• hyperkalemia treated with Ca++
• the RMP is hypopolarized (hyperkalemia)
• the threshold is increased to decrease the excitability
  
  • threshold increased

Question 16

Normal Ionic balance:

what is G showing explain how you know and what it all means.

Answer 16

• first a nerve cell b/c it says so and the RMP is at -70 (normal for nerve cell)
• hypocalcemia is shown
  
  • threshold is decreased
• Increased excitability
  
  • smaller gap between RMP and Threshold
• Smaller stimulus will be neede to elict a response

Question 17

can s/s of hypocalcemia be elicited when the pt is hyperventilated?

Answer 17

yes, hyperventilation can cause resp alkolosis. ionzied Ca++ decreases

Question 18

therapies and mechanisms for treating HYPERkalemia:

what is the fastest treatment, but does not correct the hyperkalemia

Answer 18

Give Ca++

Question 19

therapies and mechanisms for treating HYPERkalemia:

why administer HCO3-

Answer 19

H+ concentraions in the plasma decrease and metabolic alkolosis ensues.

H+ shifts out of cell to to buffer the alkolosis and in exchane K+ shfts into the cell

Question 20

therapies and mechanisms for treating HYPERkalemia:

what does hyperventilation do?

Answer 20

H+ concentration in plasma decreases causing resp alkolosis occurs.

H+ shifts out of the cell to buffer the alkolosis and in exchange K+ shifts into the cell

Question 21

for each 10mmHg decrease in PaCO2 serum K+ decreaseshow much?

Answer 21

0.5 mEq/L

Question 22

therapies and mechanisms for treating HYPERkalemia:

what does giving insulin-glucose do?

Answer 22

insulin stimulates Na+K+ pump, drives K+ into the cells

Insulin also opens glucose channels

Glucose is administered along with insulin to prevent hypogylcemia

Question 23

therapies and mechanisms for treating HYPERkalemia:

what do Beta-2 agonist do?

Answer 23

stimulates Na+K+ pump, drives K+ into the cells

Question 24

insulin stimulates Na+K+ pump, drives K+ into the cells

2 additional treatments

Answer 24

kayexalate

Dialysis