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Abandoned F&E ATI Flashcards > Fluid, Electrolyte, & Acid-Base Regulation (Page 1 🥲) > Flashcards

Fluid, Electrolyte, & Acid-Base Regulation (Page 1 🥲) Flashcards

1
Q

Minerals in the body that are able to conduct electrical charges =

A

Electrolytes

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2
Q

Are electrolytes essential to sustain life?

A

Yes

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3
Q

Electrolytes are found in-

A

The blood, urine, tissues, and other body fluids

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4
Q

Common electrolytes include-

A

Potassium, Sodium, Calcium, & Magnesium

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5
Q

How can electrolyte levels be evaluated?

A

By performing metabolic panels like the BMP or CMP

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6
Q

A blood test that gives info like electrolyte + fluid balance. Also gives info about renal function + glucose levels =

A

Basic Metabolism Panel (BMP)

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7
Q

A blood test that gives info like electrolyte + fluid balance. Also gives info about the body’s metabolism + protein & liver function =

A

Complete Metabolic Panel (CMP)

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8
Q

What tests does a BMP provide?

A

Blood Urea Nitrogen (BUN), Carbon Dioxide (C02), Creatinine (CR), Glucose, Chloride (Cl- ), Potassium (K+), and Calcium (Ca+) tests

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9
Q

What tests does a CMP provide?

A

All of the tests a BMP provides, also provides Liver Enzyme , Alkaline Phosphate (ALP), Alanine Transaminase (ALT), Aspartate Aminotransferase (AST), Bilirubin (total), Protein (total), and Albumin tests

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10
Q

The indication that the Blood Urea Nitrogen test looks into is-

A

Kidney Function

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11
Q

The indication that the Carbon Dioxide (C02) test looks into is-

A

Blood Bicarbonate Level

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12
Q

The indication that the Creatinine (CR) test looks into is-

A

Kidney Function

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13
Q

The indication that the Glucose test looks into is-

A

Blood Sugar Level

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14
Q

The indication that the Chloride (Cl-) test looks into is-

A

Blood Chloride Level

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15
Q

The indication that the Potassium (K+) test looks into is-

A

Blood Potassium Level

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16
Q

The indication that the Sodium (Na+) test looks into is-

A

Blood Sodium Level

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17
Q

The indication that the Calcium (Ca+) test looks into is-

A

Liver Function

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18
Q

The indication that the Liver Enzymes test looks into is-

A

Liver Function

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19
Q

The indication that the Alkaline Phosphate (ALP) test looks into is-

A

Liver Function

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20
Q

The indication that the Alanine Transaminase (ALT) test looks into is-

A

Liver Function

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21
Q

The indication that the Aspartate Aminotransferase (AST) test looks into is-

A

Liver Function

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22
Q

The indication that the Bilirubin (total) test looks into is-

A

Liver Function

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23
Q

The indication that the Protein (total) test looks into is-

A

Total Blood Protein

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24
Q

The indication that the Albumin test looks into is-

A

Liver Function

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25
Q

Electrolytes are responsible for maintaining-

A

The balance of water in the body

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26
Q

Electrolytes are responsible for balancing-

A

The blood pH (acid-base) level

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27
Q

Electrolytes are responsible for moving nutrients-

A

Into the cells

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28
Q

Electrolytes are responsible for moving wastes-

A

Out of the cells

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29
Q

Electrolytes are responsible for maintaining proper function of the body’s-

A

Muscles, heart, nerves, and brain

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30
Q

The average person’s weight consists of how much water?

A

One-half to two-thirds water

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31
Q

For males, water makes up what percentage of weight?

A

~60% of weight

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32
Q

For females, water makes up what percentage of weight?

A

~54 %

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33
Q

For babies/ children, water makes up what percentage of weight?

A

~70 %

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34
Q

A poor balance of water can lead to-

A

Hypovolemia, Dehydration, Tachycardia, Tachypnea, Confusion, Headache, Kidney Stones, etc.

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35
Q

Heart rate above expected range =

A

Tachycardia

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36
Q

Respiratory rate above expected range =

A

Tachypnea

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37
Q

Organs that filter blood + excrete waste as urine =

A

Kidneys

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38
Q

Excess water loss without a loss of sodium =

A

Dehydration

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39
Q

Decrease in blood volume due to body fluid / blood loss =

A

Hypovolemia

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40
Q

Homeostasis =

A

Body’s natural balance

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41
Q

Measurements of the solutes within a solution =

A

Osmolality

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42
Q

How does the body work to maintain homeostasis?

A

By keeping water + electrolytes at a constant level in the blood

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43
Q

How can the level of water + electrolytes in the blood be monitored?

A

Determining the Serum Osmolality of the blood

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44
Q

The most frequently used laboratory indicator of the body’s fluid status =

A

Serum Osmolality

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45
Q

Expected range of Serum Osmolality =

A

285 - 295 m0sm / kg

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46
Q

As body water decreases, what increases?

A

The concentration of solutes

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47
Q

Whenever body water decreases and the concentration of solutes increases, this leads to an increase in-

A

Serum Osmolality and indicates decreases in hydration

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48
Q

Osmolality can’t be determined using urine.

True or false?

A

False

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49
Q

Urine can be used to measure Osmolality and what else?

A

Renal Function + Hydration Status

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50
Q

The expected range for urine Osmolality is -

A

50 - 1,200 m0sm/kg for a random specimen

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51
Q

Is the body’s water located within cells or outside cells?

A

Both

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52
Q

The body has how many main fluid compartments?

A

3

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53
Q

What’s the body’s largest fluid compartment?

A

The Intracellular Space

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54
Q

The Intracellular Space holds what percentage of the body’s water?

A

67 %

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55
Q

Aside from the Intracellular Space, there is also the other two compartments, which collectively come together to create the-

A

Extracellular Space

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56
Q

The two compartments that make up the extracellular space are called the-

A

Interstitial Space + Intravascular Space

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57
Q

The Intravascular Space holds what percentage of the body’s water?

A

8%

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58
Q

The Interstitial Space holds what percentage of the body’s water?

A

25 %

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59
Q

How does the water pass through the various fluid compartments in the body?

A

The process of Osmosis

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60
Q

The movement of water from an area of higher concentration to an area of lower concentration. An example is fluid moving into or out of a cell to maintain homeostasis =

A

Osmosis

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61
Q

What can Osmoreceptors detect?

A

Increased Osmotic Pressure

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62
Q

What can Baroreceptors (aortic arch, carotid sinus) detect?

A

Decreased Blood Pressure

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63
Q

Whenever osmoreceptors detect increased osmotic pressure or baroreceptors detect decreased BP, what happens next?

A

The Hypothalamic Neuron sends some ADH to the kidneys + blood vessels

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64
Q

Where is the hypothalamic neuron located?

A

In the Posterior Pituitary

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65
Q

What does the ADH do to the kidneys?

A

Causes an increase in the reabsorption of water

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66
Q

What does the ADH do to the blood vessels?

A

Causes Vasoconstriction

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67
Q

An increased reabsorption of water + vasoconstriction =

A

Increased Blood Volume + Increased Blood Pressure

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68
Q

The narrowing (constriction) of blood vessels by small muscles in their walls =

A

Vasoconstriction

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69
Q

The most obvious homeostatic mechanism to increase / retain water is the-

A

Thirst Response

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70
Q

How does the body monitor its own water balance?

A

The Lamina Terminalis

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71
Q

The Lamina Terminalis is located where?

A

The edge of the Hypothalamus

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72
Q

How does the lamina terminalis monitor the body’s water balance?

A

It monitors the osmolality in the ventricles of the brain

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73
Q

How much of a percentage increase in serum osmolality does it take to alert the brain’s sensors to a decrease in the body’s fluid volume?

A

A 1% increase in serum osmolality

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74
Q

Whenever the neurons of the laminate terminalis need to increase the body’s supply of water, they send out signals that signify -

A

Thirst

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75
Q

Whenever the brain senses excess body water, the thirst sensation-

A

Stops

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76
Q

As serum osmolality rises, what stimulates the posterior pituitary to release ADH?

A

The Hypothalamus

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77
Q

What does ADH stand for?

A

Antidiuretic Hormone

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78
Q

ADH can also be called-

A

Vasopressin

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79
Q

What does ADH act on?

A

The Nephrons of the Kidneys

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80
Q

The collecting ducts of nephrons respond to ADH by -

A

Increasing water absorption + decreasing urine excretion + increasing the body’s fluid volume

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81
Q

How does urination help the body retain water?

A

Urination filters the blood, which lets the blood return to circulation (the blood holds water and electrolytes so it essentially reintroduces or “recycles” water/ electrolytes)

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82
Q

Certain meds, dehydration, hypovolemia, overhydration can all lead to -

A

Fluid + Electrolyte Imbalances

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83
Q

The wrong IV fluids or feedings can lead to -

A

Fluid + Electrolyte Imbalances

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84
Q

Sweating, diarrhea, and vomiting can all lead to-

A

Fluid + Electrolyte Imbalances

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85
Q

What disorders can lead to Fluid + Electrolyte Imbalances?

A

Heart, Kidney, or Liver Disorders

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86
Q

What’s the expected electrolyte value range for Potassium (K+)?

A

3.5 to 5 mEq/L

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87
Q

What’s the expected electrolyte value range for Sodium (Na+)?

A

136 to 145 mEq/L

88
Q

What’s the expected electrolyte value range for Calcium (Ca 2+)?

A

9 to 10.5 mg/dL

89
Q

What’s the expected electrolyte value range for Magnesium (Mg 2+)?

A

1.3 to 2.1 mEq/L

90
Q

Nurses must be able to recognize abnormalities in laboratory findings, and report these findings to the-

A

Provider

91
Q

Can electrolytes and other substances that make up the solutes within a solution such as blood move across semi-permeable membranes like water can using osmosis?

A

No

92
Q

How do electrolytes and other substances that make up the solutes within a solution move across semi-permeable membranes?

A

Diffusion + Active Transport

93
Q

The movement of solutes (like electrolytes) from an area of high concentration (Like within a cell) to an area of low concentration (Like the intravascular area) =

A

Diffusion

94
Q

When does diffusion stop?

A

When the number of solutes inside and outside of a cell are equal

95
Q

A Passive Process =

A

No use of energy

96
Q

Diffusion is a -

A

Passive Process

97
Q

Does Active Transport need energy, or is it a passive process?

A

It needs energy

98
Q

Give an example of electrolyte movement via active transport =

A

The movement of sodium and potassium into / out of cells through the sodium–potassium pump

99
Q

Does Active Transportation move solutes from an area of higher concentration to one of lower concentration like diffusion does?

A

No, Active Transportation carries solutes from an area of lower concentration to one of higher concentration

100
Q

Active Transportation moves electrolytes / molecules with the use of energy in the form of-

A

Enzymes

101
Q

The body’s largest Intracellular electrolyte =

A

Potassium

102
Q

Supports the transmission of electrical impulses of the body’s nerves + muscles =

A

Potassium

103
Q

Potassium plays a major role in the conduction of -

A

Nerve cells in the heart

104
Q

Does the body maintain potassium levels in a narrow range or a wide range?

A

Narrow Range

105
Q

Potassium intake occurs through-

A

Food + Drinks + Supplements

106
Q

Electrolyte for nerve + muscle function, especially for the heart =

A

Potassium

107
Q

The recommended daily allowance (RDA) for daily intake of potassium is how many mg for adult males?

A

3,400 mg

108
Q

The recommended daily allowance (RDA) for daily intake of potassium is how many mg for adult females?

A

2,600 mg

109
Q

Responsible for the primary excretion of potassium =

A

Kidneys

110
Q

What percentage of potassium is excreted by the kidneys?

A

90%

111
Q

What percentage of potassium is excreted via sweat / the digestive tract =

A

10%

112
Q

Potassium has an expected reference range in the blood of how many mEq/L?

A

3.5 - 5 mEq/L

113
Q

Hypokalemia occurs when levels of potassium fall below -

A

3.5 mEq/L

114
Q

Critical values occur for adults at less than how much potassium?

A

3 mEq/L

115
Q

Critical values occur for newborns at less than how much potassium?

A

2.5 mEq/L

116
Q

Are PN’s allowed to view laboratory values?

A

Yes

117
Q

If the lab results are out of range, a PN must tell the-

A

RN or the Provider

118
Q

Causes of Hypokalemia?

A

Excessive sweating
Meds
Certain cardiac conditions
GI losses
Metabolic alkalosis
Decreased oral intake of potassium
Excessive alcohol use
Chronic kidney disease
Diabetic ketoacidosis
Folic acid deficiency

119
Q

If a client is exhibiting signs of hyperkalemia, hospitalization may be required to remove excess potassium from the -

A

Blood

120
Q

If an elevated potassium level is due to renal failure, what may be required?

A

Hemodialysis

121
Q

Hemodialysis =

A

Filtering waste from blood using a machine

122
Q

In terms of alternatives to hemodialysis, what are some meds that can be used to treat hyperkalemia?

A

Calcium Gluconate + Diuretics + Resin Medications

123
Q

Calcium Gluconate or Calcium Chloride can be used to-

A

Lower the effect of excess potassium levels on the heart

124
Q

Loop and thiazide diuretics cause the body to excrete excess potassium through-

A

Urination

125
Q

Sodium polystyrene sulfonate is a-

A

Resin Medication

126
Q

Resin Medications (like sodium polystyrene sulfonate) can help decrease potassium levels via-

A

Bowel Movements

127
Q

How do resin meds decrease potassium levels via bowel movements?

A

Resins bind to the potassium in the body, then are excreted via stool

128
Q

Can the administration of insulin help lower potassium levels?

A

Yes

129
Q

How does the administration of insulin help lower potassium levels?

A

Insulin causes the potassium to enter cells, thus lowering the serum potassium level

130
Q

Clients receiving insulin to treat hyperkalemia should have what kind of monitoring?

A

Blood Glucose Monitoring

131
Q

Why should clients receiving insulin to treat hyperkalemia have their blood glucose monitored?

A

Because of increased risk of hypoglycemia

132
Q

Blood glucose level expected range =

A

74 - 106 mg/dL

133
Q

A blood glucose level lower than the expected range (74 - 106 mg/dL)

A

Hypoglycemia

134
Q

The provider may instruct the client with hyperkalemia to lower potassium levels by decreasing -

A

Dietary Consumption

135
Q

Some salt substitutes can contain-

A

Potassium

136
Q

Salt substitutes are commonly used by clients who have to limit their-

A

Sodium Intake

137
Q

Does potassium chloride (contained in certain salt substitutes) raise potassium levels?

A

Yes

138
Q

The body’s most common extracellular electrolyte =

A

Sodium

139
Q

Supports functioning of muscles + nerves, maintaining a normal BP, regulates fluid balance in the body =

A

Sodium

140
Q

Sodium is ingested into the body through-

A

Food + drink

141
Q

Sodium is excreted primarily through -

A

Urine + Sweat

142
Q

The RDA for sodium is less than how many mg per day?

A

Less than 2,300 mg (~1 Teaspoon)

143
Q

Do most Americans get more sodium than they actually need?

A

Yeah

144
Q

The expected reference range of sodium is -

A

136 - 145 mEq/L

145
Q

Sodium level below expected reference range (136 - 145 mEq/L) =

A

Hyponatremia

146
Q

The most common cause of hypokalemia is loss of potassium from the -

A

Kidneys or GI Tract

147
Q

A category of medications that cause increased urination =

A

Diuretics

148
Q

Name off 3 potassium-wasting diuretics =

A

Loop Diuretics, Osmotic Diuretics, Thiazide Diuretics

149
Q

Meds that most commonly result in hypokalemia through urinary loss =

A

Diuretics

150
Q

Amphotericin B, high doses of penicillin, and theophylline all can lead to-

A

Hypokalemia

151
Q

Decreased potassium from GI losses may result from -

A

Diarrhea or vomiting, Chronic laxative use, bowel diversion, or gastric suctioning

152
Q

A potassium level of 3 to 3.5 mEq/L is classified as-

A

Mild Hypokalemia

153
Q

Common manifestations that can be seen with hypokalemia of less than 3 mEq/L include -

A

Muscle Weakness, Cardiac Arrhythmias, Constipation, Fatigue

154
Q

Defined as a potassium level less than 2.5 mEq/L =

A

Life-threatening Hypokalemia

155
Q

What can cause respiratory paralysis and failure to occur?

A

Severe life-threatening hypokalemia

156
Q

Paralytic Ileus, Hypotension, Tetany, Rhabdomyolysis, and Life-Threatening Cardiac Arrhythmias can all be caused by-

A

Severe Life-Threatening Hypokalemia

157
Q

Repeated episodes of hypokalemia can affect -

A

Renal Function

158
Q

The provider may order an electrocardiogram (ECG) to determine -

A

If the level of potassium is affecting the rhythm of the heart

159
Q

Arrhythmias =

A

Abnormal Heart Rhythm

160
Q

Paralysis =

A

Loss of muscle functioning

161
Q

Cessation of intestinal motility =

A

Paralytic Ileus

162
Q

Hypotension =

A

BP below expected range

163
Q

Rhabdomyolysis =

A

Muscle Breakdown

164
Q

What does muscle breakdown result in?

A

The release of the protein myoglobin into the bloodstream

165
Q

Whenever muscle breakdown causes the release of myoglobin into the bloodstream, what does this cause damage to?

A

The Kidneys

166
Q

Rhabdomyolysis is characterized by-

A

Red-colored urine, low urine output, weakness, and muscle pain

167
Q

A test to check heart activity including heart rate and rhythm =

A

Electrocardiogram (ECG)

168
Q

Treatment of hypokalemia starts with

A

Identifying the underlying cause

169
Q

The provider may prescribe what to restore potassium levels to the expected reference range?

A

Potassium Supplementation

170
Q

Potassium supplements can be in the form of-

A

PO Meds or IV Infusion

171
Q

Why should PO supplements be administered with or following a meal?

A

They can cause GI distress

172
Q

Potassium is considered to be a high-alert medication whenever given by-

A

IV

173
Q

If something is a high-alert medicine, then that means that-

A

If given incorrectly, the client can suffer great harm

174
Q

When potassium is administered via IV, how many mL of a compatible solution must it be diluted?

A

Potassium should be diluted in 100 to 1,000 mL of a compatible solution

175
Q

When administering potassium via IV, should Potassium ever be administered directly from the vial?

A

No

176
Q

The dose of potassium (given via IV) shouldn’t go over-

A

40 mEq/L

177
Q

When is the only time that a dose of potassium (given via IV) can go over 40 mEq/L?

A

Whenever severe hypokalemia is being treated

178
Q

The rate of potassium administration is commonly set to how many mEq/hour to prevent adverse outcomes?

A

10 - 20 mEq/L

179
Q

When receiving IV potassium, the client should be on continuous-

A

ECG Monitoring

180
Q

When administering Potassium intravenously, the client’s potassium level should be checked periodically to ensure that they -

A

Don’t receive too much potassium

181
Q

If hypokalemia is the result of diuretic use, the provider may prescribe -

A

Routine PO potassium supplements as an adjunct treatment

182
Q

If hypokalemia is the result of diuretic use, the provider may prescribe routine oral potassium supplements as an adjunct treatment or -

A

Switch the PT to a Potassium-Sparing Diuretic

183
Q

If hypokalemia is the result of diuretic use, the provider may instruct the client to raise the potassium level by -

A

Increasing Dietary Consumption of Potassium

184
Q

Are nurses allowed to instruct clients in increasing potassium intake by teaching about foods that have a high potassium content?

A

Yes

185
Q

Most potassium-rich vegetable?

A

Baked Potato

186
Q

Most potassium-rich fruit juice?

A

Prune Juice

187
Q

Most potassium-rich dairy product?

A

Plain, Non-Fat Yogurt

188
Q

Most potassium-rich fish?

A

Salmon

189
Q

Most potassium-rich fruit?

A

Bananas

190
Q

Amount of potassium per serving of baked potato =

A
191
Q

Amount of potassium per serving of prune juice =

A
192
Q

Amount of potassium per serving of carrot juice =

A
193
Q

Amount of potassium per serving of white beans =

A
194
Q

Amount of potassium per serving of plain, nonfat yogurt?

A
195
Q

Amount of potassium per serving of sweet potato?

A
196
Q

Amount of potassium per serving of salmon?

A
197
Q

Amount of potassium per serving of banana?

A
198
Q

Amount of potassium per serving of spinach?

A
199
Q

Amount of potassium per serving of avocado?

A
200
Q

Following intervention, a repeat BMP or CMP should be evaluated to determine if the client’s potassium levels are -

A

Within the expected reference range

201
Q

When a PT experiences potassium levels above the expected reference range =

A

Hyperkalemia

202
Q

Hyperkalemia is defined as a potassium value greater than-

A

5 mEq/L

203
Q

Critical values of hyperkalemia occur at levels greater than -

A

6.1 mEq/L

204
Q

The body maintains the potassium level within a narrow range, and deviations can lead to significant -

A

Neurologic, Respiratory, or Cardiac Consequences

205
Q

Causes of Hyperkalemia include =

A

Renal Failure + Dehydration + Diabetes Mellitus + Meds + Trauma + Excess Potassium Intake + Burns + Transfusions of Packed Red Blood Cells + Acidosis + Sepsis

206
Q

The most common cause of hyperkalemia is-

A

Renal Failure

207
Q

The meds that most commonly result in hyperkalemia are-

A

Potassium-Sparing Diuretics + Non-Steroidal Anti-Inflammatory Meds (NSAIDs) + Angiotensin-Converting Enzyme (ACE) Inhibitors

208
Q

Does mild hyperkalemia present any manifestations?

A

It may or may not

209
Q

Common manifestations that can be seen with hyperkalemia greater than 5 mEq/L include -

A

Nausea, vomiting, muscle aches + weakness, decreased deep tendon reflexes, paralysis, dysrhythmias or palpitations

210
Q

Severe life-threatening hyperkalemia is defined as a potassium level greater than-

A

7 mEq/L

211
Q

Severe hyperkalemia can cause -

A

Paralysis + Heart Failure

212
Q

Routine blood tests such as the BMP or CMP are used to measure -

A

Potassium Levels

213
Q

What may a provider prescribe to determine if the level of potassium is affecting the rhythm of the heart?

A

An ECG

214
Q

As with hypokalemia, treatment of hyperkalemia begins with -

A

Identifying and treating the cause

215
Q

What is your goal whenever treating hyperkalemia?

A

Removing excess potassium and stabilizing the heart

216
Q

Factors that can place a client at risk for developing hyponatremia =

A

Meds + Chronic / Severe Vomiting or Diarrhea + Drinking Excess Amounts of Water + Excess Alcohol Intake + Heart, Kidney, Liver Problems, Severe Burns

Abandoned F&E ATI Flashcards (1 decks)

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