Fluid, Electrolyte, and Acid-Base Balance 2

Question 1

pH -

Answer 1

7.35 - 7.45; negative logarithm of the free H+ concentration, a mesure of how much acid or alkaline the blood is; below 7.35 acidic, about 7.45 alkaline

Question 2

PaCO2 -

Answer 2

35 - 45 mm Hg; partial pressure of CO2, a measure of how well the lungs are excreting CO2, produced by cells; increased PaCO2 indicates CO2 accumlation in blood caused by hypoventilation; decreased PaCO2 indicates excessive CO2 excretions through hyperventiolation

Question 3

HCO3- (bicarbonate)

Answer 3

22-26 mEq/L; concentration of teh basek, measure of how well the kidneys are excreting metabolic acids; increased levels indicates that blood has too few metabolic acids, decrease blood has too many metabolic acids

Question 4

Pa02

Answer 4

80 - 100 mm Hg; partial pressure of oxygen, measure of how well gas exchange is occurring in the alveoli of the lungs, low values indicate poor oxygenation of the blood

Question 5

SaO2

Answer 5

oxygen saturation; percentage of hemoglobin that is carrying as much oxygen as possible

Question 6

base excess

Answer 6

-2 to +2 mmol/L; observed buffering capacity minus the normal buffering capacity, a measure of how well the blood buffers are managing metabolic acid; below - 2 metabolic acids; about +2 excessive bicarb

Question 7

Respiratory acidosis lab findings

Answer 7

pH less than 7.35, PaCO2 greater than 45 mmHg, HCO3- lvel normal if uncompensated or greater than 36 mEq/L for compensated

Question 8

Respiratory acidosis signs and symptoms

Answer 8

headache, light-headedness, decreased level of consciousness (confusion, lethargy, coma), cardiac dysrhythmia, warm and flushed skin, muscular twitching

Question 9

Respiratory alkalosis lab findings

Answer 9

ph greater than 7.45; PaCO2 less than 35; HCO3- level normal if short lived or uncompensated or less than 22 mEq/L; K+ level may be decreased; ionized Ca2+ level may be decreased

Question 10

Respiratory alkalosis signs and symptoms

Answer 10

increased rate and depth of respirations (hyperventilation), light-headedness, numbness and tingling of extremities and circumoral region (paresthesia), excitement and confusion possibly followed by decreased level of consciousness, cardiac dysrhymthias

Question 11

Metabolic acidosis Metabolic acidosis lab findings

Answer 11

ph less than 7.35; PaCO2 normal if uncompensated or less than 35 compensated; HCO3- level less than 22; Anion gap normal or high depending on cause; K+ level may be elevated depending on cause

Question 12

Metabolic acidosis signs and symptoms

Answer 12

decreased level of consciousness, abdominal pain, cardiac dysrhythmias, increased rate and depth of respirations (compensatory hyperventilation

Question 13

Metabolic alkalosis lab findings

Answer 13

ph greater than 7.45; PaCO2 normal if uncompensated or greater than 45 compensated; HCO3- greater than 26; K+ often decreased; ionized Ca2+ level may be decreased

Question 14

Metabolic alkalosis signs and symptoms

Answer 14

light headedness, numbness and tingling of fingers, toes, and circumoral region (parethesis): possible excitement and confusion followed by decreased level of consciousness, cardiac dysrhythmias (may be caused by hypokalemia)

Question 15

Age - Explain how the following can affect fluid, electrolyte, and acid-base balances.

Answer 15

very young: ECV deficit, osmolality imbalances, clinical dehydration; Very Old: ECV excesss or deficit, osmolaritity imblances

Question 16

Acute Illness - Explain how the following can affect fluid, electrolyte,
and acid-base balances.

Answer 16

respiratory disease, burns, trams, GI alterations, and acute oliguric renal disease

Question 17

Recent Surgery - Explain how the following can affect fluid, electrolyte,
and acid-base balances.

Answer 17

causes a physiological stress response which increases with extensive surgery and blood loss

Question 18

Burns - Explain how the following can affect fluid, electrolyte,
and acid-base balances.

Answer 18

place pts at high risk for ECV deficit from numerous mechanisms, including plasma to interstitial fluid shift and increased evaporative and exudate output

Question 19

Cancer - Explain how the following can affect fluid, electrolyte,
and acid-base balances.

Answer 19

depends on type, progession, and treatment; also have imalances because of side effects

Question 20

Renal Disorders - Explain how the following can affect fluid, electrolyte,
and acid-base balances.

Answer 20

can lead to oliguria

Question 21

GI disturbances - Explain how the following can affect fluid, electrolyte,
and acid-base balances.

Answer 21

increase output of fluid causes stress response which increases with extensive surgery and blood loss

Question 22

Environmental Factors - Explain how the following can affect fluid, electrolyte,
and acid-base balances.

Answer 22

hot environments increase fluid output through sweating

Question 23

Diet - Explain how the following can affect fluid, electrolyte,
and acid-base balances.

Answer 23

asses intake of fluids, salts, foods high in potassium, calcium, and magnesium

Question 24

Lifestyle - Explain how the following can affect fluid, electrolyte,
and acid-base balances.

Answer 24

chronic alcohol abuse cause hypomagnesemia because it increases renal magnesium excretion

Question 25

Loss of 2.2 pounds or more in 24 hours

Answer 25

ECV deficit

Question 26

Orthostatic hypotension

Answer 26

ECV deficit

Question 27

Bounding pulse rate

Answer 27

ECV excess

Question 28

Full or distended neck veins

Answer 28

ECV excess

Question 29

Lung sounds: crackles or rhonchi

Answer 29

ECV excess

Question 30

Dark yellow urine

Answer 30

ECV deficit

Question 31

Dependent edema in ankles

Answer 31

ECV excess

Question 32

Dry mucus membranes

Answer 32

ECV deficit

Question 33

Thirst present

Answer 33

Hypernatremia, severe ECV deficit

Question 34

Restlessness and mild confusion

Answer 34

Severe ECV deficit

Question 35

Decreased level of consciousness

Answer 35

Hyponatremia, hypernatremia, hypercalcemia, acid-base imbalances

Question 36

Irregular pulse and EKG changes

Answer 36

K+, Ca 2+, Mg 2+, and/or acid base imbalances

Question 37

Increased rate and depth of respirations

Answer 37

Metabolic alkalosis; respiratory acidosis

Question 38

Muscle weakness

Answer 38

Hypokalemia, hyperkalemia

Question 39

Decreased deep tendon reflexes

Answer 39

Hypercalcemi, hypermagnesmia

Question 40

Hyperactive reflexes, muscle twitching and cramps

Answer 40

Hypooclacemia, hypomagnesemia

Question 41

Tremors

Answer 41

Hypomagnesium

Question 42

Abdominal distention

Answer 42

hypokalemia

Question 43

Decreased bowel sounds

Answer 43

Hypokalemia

Question 44

Constipation

Answer 44

Hypokalemia, hypercalcemia