Fluid And Electrolytes Flashcards

1
Q

What are the primary ECF ions?

There are two

A

Sodium and Chloride

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2
Q

What are the primary ICF ions?

There are two. P&P

A

Potassium and Phosphate?

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3
Q

What are the ways of movement for facilitation?

There are four; eight advanced

A

Diffusion (Passive and Facilitated), Active Transport, Osmotic, Pressure (Hydrostatic and Oncotic)

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4
Q

(T/F) The cell swells during hypotonic ECF

A

True

Think opposite; hypotonic causes swelling, hyper causes shrinking

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5
Q

(T/F) The cell swells for hypertonic ECF?

A

False, the cell shrinks

Think opposite, hypertonic causes shrinking and hypo causes swelling

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6
Q

What is Hydrostatic Pressure? What is an example

A

PUSHES force of fluid against cell wall. Ex: Blood pressure

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7
Q

What is oncotic pressure?

A

PULL force of proteins, attracting water from one space to another

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8
Q

(T/F) The first spacing is normal ICF and ECF

A

True

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9
Q

What and where is second spacing? Give an example of what second spacing would look like.

A

Abnormal increase located in INTERSTITIAL FLUID. Example: edema

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10
Q

What and where is third spacing? Give an example.

A

Excess fluid in NON-FUNCTION spaces around CELLS. Example is ascites and edema from burns.

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11
Q

(T/F) It is easy to move third spacing fluid back to ICF or plasma

A

False, fluid is trapped and difficult to move back to ICF or plasma.

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12
Q

What are the three processes that help keep water and electrolyte balance?

There are four

A

Intake and Absorption
Distribution
Output

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13
Q

(T/F) The antidiuretic hormone (ADH) regulates water excretion only

A

True, the ADH encourages kidneys to hold onto water

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14
Q

(T/F) The RAAS system (Renin-Angiotensin-ALDOSTERONE-System) regulates water and sodium.

A

True, Aldosterone encourages kidneys to hold onto water and sodium

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15
Q

What is the difference between dehydration and hypovolemia?

Hint: What cation moves with water?

A

Dehydration is loss of water alone while hypovolemia is loss of water and sodium

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16
Q

What causes hypovolemia?

There are four causes

A

Abnormal loss, Inadequate intake, Shift from plasma to interstitial fluid, Third Spacing

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17
Q

What are interventions for hypovolemia?

There are two

A

Replace water and electrolytes with options like isotonic fluids and blood transfusions.

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18
Q

(T/F) 1kg of weight equals 1 liter of fluid retention

A

True, this is why it’s important to do daily weights for patients with fluid imbalances.

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19
Q

What is the lab value for Hct?

A

37-52%

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20
Q

What is the lab value for BUN?

A

10-20mg/dL

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21
Q

What is the lab value for Urine Specific Gravity:

A

1.010-1.025

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22
Q

What is the normal range for sodium?

A

136-145 mEq/L

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23
Q

(T/F) Water follows sodium

A

True, this is why sodium imbalances are closely related to water imbalances

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24
Q

What are the causes for hypernatremia?

There are two

A

Low water intake, excess water loss

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25
Q

What are some symptoms associated with hypernatremia?

FRIED and SALTED acronyms

A

Fever (low grade)
Restlessness and agitation
Increased fluid retention
Edema (peripheral and pitting)
Dry mouth

Skin flushed
Altered LOC and confusion
Low urinary output
Thirst
Elevated Blood pressure
Decreased energy

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26
Q

What is the management for hypernatremia?

There are five things to manage it

Think what you want to do to manage excess sodium

A

Water deficit (replace isotonic fluids)
Sodium excess: replace with sodium free fluids
Sodium restrictions
Monitor lab levels
Safety (seizure precautions)

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27
Q

What causes hyponatremia?

There are two causes

A

Loss of sodium-rich fluids (ex: wounds, diarrhea, vomiting), and water excess

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28
Q

What are symptoms of hypocalcemia?

Acronyms: SALT LOSS

A

Stupor/coma
Anorexia
Lethargy
Tendon reflexes go down

Limp muscles
Orthostatic Hypotension
Seizures
Stomach Cramping

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29
Q

What is management for hyponatremia?

There are five

A

Isotonic or sodium containing fluids
PO intake
Water excess: restrict fluids
Monitor labs
Monitor I&Os

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30
Q

What is the range for hyponatremia?

A

Less than (<) 136

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31
Q

What is the range for hypernatremia?

A

More than (>) 145

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32
Q

What is the normal range for potassium?

A

3.5-5.0 mEq/L

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33
Q

What is the function for potassium?

There are two

A

Neuromusclar and cardiac

34
Q

(T/F) Potassium is inversely related to sodium regulation

A

True; When sodium goes up, potassium goes down and vice-versa.

35
Q

What is the range for hyperkalemia?

A

More than (>) 5.0

If the range is 3.5-5.0, then anything above it is hyper.

36
Q

What are the causes for hyperkalemia?

There are four

A

Impaired ouput (ex: kidney failure)
Increased intake
Shift from ICF to ECF
Certain medications (ex: Digoxin, Propranolol, Hydrocholride)

37
Q

What are the clinical manifestations for hyperkalemia?

There are eight

A

Cell excitability
Electrocardiac changes
Dysrhythmia
Muscle cramps; tetany numbness/tingling
Diarrhea, cramping, vomiting

38
Q

What are managements for hyperkalemia?

There are five

A

Stop potassium intake
Increase potassium excretion (ex: diuretics)
Calcium gluconate–reverses effects on cardiac
Cardiac monitoring
Labs: CMP

Bold is what might be on a case-study like question (my suspcions alone)

39
Q

What is the range for hypokalemia?

A

Less than(<) 3.6

Range for potassium is 3.6-5.0

40
Q

What are causes for hypokalemia?

There are three

A

Potassium loss (GI, Renal, low Magnesium)
Decreased intake
Shift from ECF to ICF

41
Q

What are clinical manifestations for hypokalemia?

There are five

A

Impaired muscle contractions
Electrocardiac changes
Dysrhythmias
Weakness
Parethesias (numbness/tingling)

42
Q

What are managements for hypokalemia?

There are four

A

PO/IV potassium chloride (KC1)
Potassium rich foods
Cardiac monitoring
Monitor labs (CMP)

Safety: Never crush or give KCL pills and IV push respectively. If given IV, slow push with monitoring

43
Q

What does diuretics do to sodium and water?

A

Reduces sodium and water reabsorption; water and sodium loss.

44
Q

What is the normal range for calcium?

A

9.0-10.5 mg/dL

45
Q

What does calcium contribute to?

A

BONES, muscle contraction (including the heart)

46
Q

What controls calcium regulation?

There are two

A

The parathyroid horomone (PTH) and Calcitonin

So if you lose your thyroid your calcium can go out of wack.

47
Q

(T/F) The Thyroid gland will relase calcintonin to cause a fall in blood calcium levels

A

True

48
Q

(T/F) The thyroid will relase the parathyroid hormone (PTH) to cause a rise in blood calcium levels

A

True

49
Q

What are the causes for calcium imbalances?

There are four

A

Hyperparathyroidism
Cancer
Tumors
Bone breakdown

Remember, PTH causes a rise in calcium, so if you’re getting an excess of the hormone your calcium will rise

50
Q

What is the range for hypercalcemia?

A

More than (>) 10.5

Range is 9.0-10.5

51
Q

What are clincial manifestations for hypercalcemia?

There are two important ones, two kinda important ones

A

Sedative symptoms
Fatigue, weakness, confusion, seizures, coma
Bone pain
Dysrhythmias
Kidney stones
Nausea, vomiting, anorexia
Increased BP

Bold is what I think can turn up, italics are possibiltiies (50/50)

52
Q

What are the symptoms of hypercalcemia based on rhyme “bones, stones, groans, and psychiatric overtones”

A

Bones–abnormal bone remodeling and fracture risk
Stones–kidney stones!
Groans–abdominal cramping, nausea, ileus, constipation
Psychiatric overtones–Lethargy, depressed mood, psychosis, cognitive dsyfunction

53
Q

What are managements for hypercalcemia?

There are five, one important

A

Weight-bearing activity
Hydration (3-4L)
Biphosphonates
Calcitonin (injection)
Dialysis

Hydration to dilute water. Calcitonin brings your calcium levels down.

54
Q

What is the range for hypocalcemia?

A

Less than (<) 9.0

Range is 9.0-10.5

55
Q

What are the causes for hypocalcemia?

There are three

A

Low PTH (Parathyroid removal, radiation)
Chronic alcohol use
Diarrhea

56
Q

What are clinial manifestations for hypocalcemia?

There are six, three important

A

Nerve excitability
Tetany
Chvostek sign
Trousseau sign
Numbness/tingling (extremities and circumoral)
Cardiac changes

57
Q

What is the difference between tetany and Trousseau sign?

A

Tetany is muscle contractions, Trousseau sign is a carpopedal spasm that can be a sign of latent tetany

58
Q

What is management for hypocalcemia?

There are five, two important

A

Diet (Vitamin D)
Supplements
Calcium Gluconate (IV)
Post-surgical management
Monitor labs (CMP)

Vitamin D helps with absorption of calcium

59
Q

What is the normal range for phosphorous?

A

3.0-4.5

60
Q

(T/F) Phosphorous has a inverse relationship with calcium

A

True

Balanced with PTH and kidneys

61
Q

What is the range for hyperphosphatemia?

A

Greater than (>) 4.5

62
Q

What are causes for hyperphosphatemia?

There are four

A

Kidney injury/disease
Laxatives/enemas
Shift from ICF to ECF
Hypoparathyroidism

Inverse relationship with calcium, if the PCT is down then phosphorus goes up.

63
Q

What are clinical manifestations of hyperphosphatemia?

There are four

A

Same as symptoms of hypocalcemia (nerve excitability, tetany, paresthesias)
Soft tissue calcium deposits

64
Q

What are the managements for hyperphosphatemia?

One important one, four total

A

Treat underlying cause
Dietary restrictions
Calcium carbonate (Tums)
Hemodialysis

65
Q

What is the range for hypophosphatemia?

A

Less than (<) 3.0

Range is 3.0-4.6

66
Q

What are the causes for hypophosphatemia?

There are three, eight advanced

A

Decreased absorption (malnourishment, high use of certain antacids, diarrhea, chronic alcohol use
Increased excretion (diarrhea)
ECF to ICF shift (respiratory alkalosis)

67
Q

What are the clinical manifestations of hypophosphatemia?

A

Central Nervous System (CNS) depression
Weakness
Pain
Respiratory or heart failure
Rickets/osteomalacia

68
Q

What is the management for hypophosphatemia?

A

Diet or supplements
IV phosphate
Monitor labs (CMP)

69
Q

What is the normal range for magnesium imbalance?

A

1.3-2.1 mEq/L

70
Q

What does magnesium contribute to?

A

Muscle contractions/relaxations
Neuro function

71
Q

(T/F) Magnesium has a close parallel relationship with calcium

A

True, when calcium rises so does magnesium and vice versa

72
Q

What is magnesium regulated by?

There are two

A

GI and Kidneys

73
Q

What is the range for hypermagnesium?

A

Greater than (>) 2.1

74
Q

What are the causes of hypermagnesium?

There are three

A

Increased intake
Renal problems
Magnesium-containing medications

75
Q

What are the clincial manifestations of hypermagnesium?

There are ten

A

Decreased BP and HR
Facial flushing
Nausea/vomiting
Lethargy
Muscle paralysis, weakness, decreased deep tendon reflexes (DTR)
Coma
Cardiac or respiratory arrest

76
Q

What are the managements for hypermagensium?

There are five

A

Dietary limitations
Increase fluids
Diuretics
Dialysis
Calcium Gluconate (for cardiac muscle)

77
Q

What are the range for hypomagnesium?

A

Less than (<) 1.3

78
Q

What are the causes for hypomagnesium?

There’s five

A

Diet
GI or renal loss
Chronic alcohol use
Meds: diuretics, proton pump inhibitors (PPIs), some antibiotics
Pancreatitis

79
Q

What are the clinial manifestations for hypomagnesium?

There are 10

A

Same as hypocalcemia
Cramps, tremors, tetany, increased DTR
Chvostek, Trousseau
Confusion, vertigo, seizures
Dsyrhytmias

80
Q

What are the managements for hypomagnesium?

A

Treat cause
Diet/supplements
IV magnesium

81
Q

What are the two fluid imbalances that have symptoms of tetany, Chovestsk, and Trosseau?

A

Hypocalcemia
Hypomagnesium