Fluid, Electrolyte, and Acid-Base Balance 2 Flashcards
pH -
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
PaCO2 -
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
HCO3- (bicarbonate)
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
Pa02
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
SaO2
oxygen saturation; percentage of hemoglobin that is carrying as much oxygen as possible
base excess
-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
Respiratory acidosis lab findings
pH less than 7.35, PaCO2 greater than 45 mmHg, HCO3- lvel normal if uncompensated or greater than 36 mEq/L for compensated
Respiratory acidosis signs and symptoms
headache, light-headedness, decreased level of consciousness (confusion, lethargy, coma), cardiac dysrhythmia, warm and flushed skin, muscular twitching
Respiratory alkalosis lab findings
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
Respiratory alkalosis signs and symptoms
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
Metabolic acidosis Metabolic acidosis lab findings
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
Metabolic acidosis signs and symptoms
decreased level of consciousness, abdominal pain, cardiac dysrhythmias, increased rate and depth of respirations (compensatory hyperventilation
Metabolic alkalosis lab findings
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
Metabolic alkalosis signs and symptoms
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)
Age - Explain how the following can affect fluid, electrolyte, and acid-base balances.
very young: ECV deficit, osmolality imbalances, clinical dehydration; Very Old: ECV excesss or deficit, osmolaritity imblances
Acute Illness - Explain how the following can affect fluid, electrolyte,
and acid-base balances.
respiratory disease, burns, trams, GI alterations, and acute oliguric renal disease
Recent Surgery - Explain how the following can affect fluid, electrolyte,
and acid-base balances.
causes a physiological stress response which increases with extensive surgery and blood loss
Burns - Explain how the following can affect fluid, electrolyte,
and acid-base balances.
place pts at high risk for ECV deficit from numerous mechanisms, including plasma to interstitial fluid shift and increased evaporative and exudate output
Cancer - Explain how the following can affect fluid, electrolyte,
and acid-base balances.
depends on type, progession, and treatment; also have imalances because of side effects
Renal Disorders - Explain how the following can affect fluid, electrolyte,
and acid-base balances.
can lead to oliguria
GI disturbances - Explain how the following can affect fluid, electrolyte,
and acid-base balances.
increase output of fluid causes stress response which increases with extensive surgery and blood loss
Environmental Factors - Explain how the following can affect fluid, electrolyte,
and acid-base balances.
hot environments increase fluid output through sweating
Diet - Explain how the following can affect fluid, electrolyte,
and acid-base balances.
asses intake of fluids, salts, foods high in potassium, calcium, and magnesium
Lifestyle - Explain how the following can affect fluid, electrolyte,
and acid-base balances.
chronic alcohol abuse cause hypomagnesemia because it increases renal magnesium excretion
Loss of 2.2 pounds or more in 24 hours
ECV deficit
Orthostatic hypotension
ECV deficit
Bounding pulse rate
ECV excess
Full or distended neck veins
ECV excess
Lung sounds: crackles or rhonchi
ECV excess
Dark yellow urine
ECV deficit
Dependent edema in ankles
ECV excess
Dry mucus membranes
ECV deficit
Thirst present
Hypernatremia, severe ECV deficit
Restlessness and mild confusion
Severe ECV deficit
Decreased level of consciousness
Hyponatremia, hypernatremia, hypercalcemia, acid-base imbalances
Irregular pulse and EKG changes
K+, Ca 2+, Mg 2+, and/or acid base imbalances
Increased rate and depth of respirations
Metabolic alkalosis; respiratory acidosis
Muscle weakness
Hypokalemia, hyperkalemia
Decreased deep tendon reflexes
Hypercalcemi, hypermagnesmia
Hyperactive reflexes, muscle twitching and cramps
Hypooclacemia, hypomagnesemia
Tremors
Hypomagnesium
Abdominal distention
hypokalemia
Decreased bowel sounds
Hypokalemia
Constipation
Hypokalemia, hypercalcemia
