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Pathophysiology Midterm #2 > Fluid and Electrolyte II > Flashcards

Fluid and Electrolyte II Flashcards

1
Q

Cause: Hypervolemia

A 
Too much blood volume
Too much/too fast  IV fluid 
Organ issues (heart failure, kidney dysfunction, cirrhosis) 
Increase Na intake
Hypertonic solution
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2
Q

Manifestations of Hypervolemia

A 
CNS: lethargic, seizure, coma 
CVS: increase HR (bounding pulse), increase BP, JVD 
Resp: pulmonary edema 
GU: increase U/O (dilute urine) 
Skin: edema
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3
Q

Interventions for Hypervolemia

A
  • diuretics
  • low sodium diet
  • daily in/out
  • check lab value
  • BIPAP
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4
Q

Cause: Hypovolemia

A
  • Decreased blood volume
  • Vomiting, diarrhea
  • Severe dehydration
  • Trauma, burn
  • Medications (diuretics)
  • Third spacing
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5
Q

Manifestations: Hypovolemia

A
  • CNS: thirst, confusion, lethargic, seizure, coma
  • CVS: increased HR (thready pulse), decreased BP, orthostatic hypotension
  • Resp: Increased RR
  • GU: decrease U/O (dark concentrated urine)
  • Skin: decreased skin turgor
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6
Q

Interventions: Hypovolemia

A
  • PO/IV rehydration
  • Daily in/out
  • Daily weight
  • Check lab value
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7
Q

Cause Hypernatremia (MODEL)

A

M - meals
O - osmotic diuresis - increased urination
D - diabetic insipidus - imbalance of fluids. excessive urine
E - excessive water loss
L - low water intake

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8
Q

Manifestations Hypernatremia (FRIENDS)

A 
F - flushed skin 
L - restlessness
I - increased fluid retention 
E - Edema 
N - neuromuscular excitability 
D - decreased urine output 
S - sleepy, lethargy, coma
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9
Q

Interventions: Hypernatremia

A
  • restrict diet sodium intake
  • diuretic to promote sodium loss
  • give free water
  • daily weight
  • IV infusion for fluid loss
  • monitor for CVS, Resp, Neuro, cerebral, renal status
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10
Q

Cause: hyponatremia (SIADH)

A 
S - syndrome of ineffective ADH (SIADH) 
I - intoxication of water 
A - adrenal insufficiency 
D - Diuretic, diarrhea, diaphoresis, drain (NG suction) 
H - Heat exhaustion or high fever
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11
Q

Manifestations: hyponatremia (SALT LOSS)

A 
S - stupor (coma) 
A - anorexia (nausea & vomiting) 
L - lethargy 
T - tendon reflex decrease 
L - limb weakness
O - orthostatic hypotension 
S - seizure 
S - stomach cramping
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12
Q

Interventions: Hyponatremia

A
  • medication antagonize ADH
  • osmotic diuretic
  • increase oral sodium intake
  • IV sodium chloride infusion
  • Monitor for CVSm Resp, neuro, cerebral, renal status
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13
Q

Cause: hyperkalemia (MACHINE)

A 
M - medication - ACE inhibitor, NSAIDS
A - acidosis
C - cellular destruction - burn, traumatic injury
H - hypoaldosteronism 
I - intake (excessive) 
N - Nephrons (renal failure) 
E - Excretion impairment
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14
Q

Hyperkalemia manifestations (MURDER)

A 
M - muscle weakness
U - urine (oliguria, anuria) 
R - respiratory distress
D - Decreased cardiac contractility 
E - EKG changes 
R - reflexes (hyper-reflex, areflexia)
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15
Q

Interventions: Hyperkalemia

A
  • sodium bicarb
  • limit intake of K+
  • dialysis
  • increased elimination (kayexalate, diuretic)
  • Calcium gluconate
  • Cardiac monitoring
  • IV insulin (with glucose)
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16
Q

Cause: hypokalemia (MADOLD)

A 
M - magnesium deficiency (aldosterone increase) 
A - alkalosis
D - diuretic use
O - overdose insulin 
L - laxatives 
D - diarrhea
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17
Q

Manifestations: hypokalemia (LLLLLL)

A 
L - lethargy 
L - leg cramp 
L - limp muscles 
L - Lack of GI motility 
L - lethal cardiac dysrhythmia 
L - lot of urine
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18
Q

Interventions: hypokalemia

A

KCL IV/PO (10-20 mmol/hr)

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19
Q

Cause: hypercalcemia (HAM)

A

H - hyperparathyroidsim
A - antiacid
M - malignancy cancer

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20
Q

Manifestations: hypercalcemia (Groans, moans, bones, stones, overtones)

A
  • Groans - constipation
  • moans - joint pain
  • bones - loss of calcium
  • stones - kidney stones
  • overtones - psychiatric overones (ie confusion, depression)
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21
Q

Intervention: hypercalcemia

A
  • low calcium diet
  • promote excretion of calcium (diuretics, N/S, increase water intake)
  • use calcium reabsorption inhibitor (calcitonin, biphosphate)
  • dialysis
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22
Q

Intervention: Hypocalcemia

A
  • IV/PO caclium
  • calcium-rich diet
  • safety (risk fall and fracture)
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23
Q

Causes: hypocalcium (ABCDLOW)

A 
A - alcoholism 
B - blood transfusion, multiple
C - calcium & vitamin D low intake 
D - diarrhea, or Chron's disease 
L - low parathyroidism 
O - oral meds (laxatives, diuretics, steroids) 
W - wound drainage
24
Q

Manifestations: hypocalcemia (CATTS)

A 
C - convulsion (seizures) 
A - Arrythmia 
T - tetany ( numbness or tingling of muscle) 
T - Trousseaus or chvostek's sign 
S - spasm and stridor
25
Acidic
<7
26
Alkaline
>7
27
Normal blood pH
7.35-7.45
28
Homeostasis
- fluid balance - electrolyte imbalance - acid-base inbalance
29
External Respiration
its what happens when you breathe oxygen into your lungs and breathe out CO2 and H2O (as vapour)
30
Internal Respiration
what happens at the tissue level when the arterial capillary beds allow diffusion of O2 into the cell and the venule capillary beds release CO2 into the plasma for return back to the lungs
31
Acid-Base Regulation
- buffer system (reacts immediately) - respiratory system - responds in minutes; maximum effectiveness reached within hours - renal system - takes 2-3 days to reach maximum response can maintain balance for a long period of time
32
Buffer system
- electrolyte exchange in the cells. K+ is exchanged with H+ - Alkalosis --> hypokalemia - Acidosis --> hyperkalemia (lungs - exhalation of CO2 decreases acidity) (kidneys - excretion and/or retention of acids and bicarbonate)
33
Lungs
- rapid respirations (exhalation of CO2 -> decreased acidity) - slow respirations (retention of CO2 -> increased acidity)
34
Kidneys
- excretion of H+ and reabsorption of HCO3 -> decreased acidity electrolyte exchanges - hypokalemia (alkalosis) - hyperkalemia (acidosis)
35
the lungs ...
"blow off" CO2 to increase pH in response to metabolic acidosis. - kidneys excrete H+ and reabsorb HCO3 to increase pH in response to respiratory acidosis
36
Kidney -> | Respiratory ->
metabolic | respiratory component
37
Respiratory Acidosis: Causes
- anything that causes hypoventilation - COPD - Barbiturate or sedative overdose - severe pneumonia - atelectasis - respiratory muscle weakness - mechanical hypoventilation - sleep apnea - head trauma - post op - pneumonia - asthma
38
Resp Acidosis: Lab values
- increased PCO2 and decreased pH if uncompensated
39
Resp acidosis: Manifestations
- drowsiness, disorientation, dizziness, headache coma - decreased BP, ventricular fib, warm, flushed skin from peripheral vasodilation - seizures - dyspnea, hypoventilation with hypoxia
40
Resp acidosis: interventions
treat the underlying cause: give narcan for opioid antagonist during drug overdose - oxygen therapy (low flow) - respiratory therapy - BiPap
41
Respiratory alk: causes
- anything causing hyperventilaion - 2nd degree to hypoxia, fear/anxiety, fever - stimulated resp center - sepsis, brain injury, salicylate poisoning - mechanical overventilation
42
Lab values: resp alk
- decrease PaCO2 and increased pH if uncompensated
43
Resp alk: manifestations
- lethargy, light-headedness, confusion - increased HR, dysrhythmias - nausea, vomiting, epigastric pain - tetany, numbness, tingling, hyperreflexia, seizures - rapid, shallow breathing (Kussmauls breathing) - fast resps
44
Resp alk: Interventions
- treat the underlying cause - rebreather mask - assist client to slow respirations - decrease anxiety - oxygen therapy if hypoxia is the underlying cause - monitor VS, ABGs and electrolyte imbalances
45
Metabolic acidosis: causes
accumulation of acid - diabetic ketoacidosis, septic shock (lactic acid accumulation), starvation - loss of bicarbonate - diarrhea, renal failure - DKA
46
Met Acidosis: lab values
- decrease HCO3 and decrease in pH if uncompensated. the resp system is going to try and compensate to blow off the CO2 and increase the pH - Kussmauls breathing happens - urine pH is normally 6
47
Met Acidosis: manifestations
- drowsiness, confusion, headache, coma - decreased BP, dysrhythmias, warm, flushed skin (vasodilation) - nausea, vomiting, diarrhea, abdominal pain - deep, rapid respirations (kussmauls resps)
48
Interventions: met acidosis
- treat underlying cause - respiratory support - administer sodium bicarbonate to neutralize acid
49
Metabolic alk: causes
- loss of acid - NG suctioning, prolonged vomiting, loss of K+ to diuretic therapy - gain of bicarbonate - ingestion of baking soda
50
Met alk: lab values
- HCO3 increased and increased pH if uncompensated
51
Met alk: Manifestations
- dizziness, irritability, nervousness, confusion - tachycardia, dysrhythmias - anxorexia, nausea, vomiting - tremors, hypertonic muscles, muscle cramps, tetany, tingling, - hypoventilation
52
Met alk; interventions
- treat underlying cause - replace lost fluids and electrolytes - support renal function (dialysis) - administer acetazolamide - promotes loss of bicarb in urine (diuretic)
53
Mixed
- two or more simple disorders present at the same time - pH will depend on type, severity and acuity - respiratory acidosis and metabolic alkalosis - mixed acidosis - mixed alkalosis
54
Normal ABG values
pH - 7.35-7.45 PaO2 - 80-100 mmHg PaCO2 - 35-45 mmHg HCO3 - 22-26 mEq/L
55
vomiting and diarrhea
vomiting will decrease acidity because of the stomach acid being lost stool contains bicarbonate so when you have diarrhea- you will become acidic
56
Fully Compensated
- pH returned to normal despite the presence of abnormalities in both resp and/or metabolic systems - acidosis because it is more leading towards acidosis

Pathophysiology Midterm #2 (9 decks)

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