fluid, electrolyte and acid- base homeostasis Pt.2 chapter 6 Flashcards
1
Q
cations
A
positively charged electrolytes
2
Q
anions
A
negatively charged electrolytes
3
Q
electrolytes balance plays a role in
A
- muscle and neural activity
- acid-base and fluid balance
4
Q
sodium normal range
A
135- 145 mEq/l
5
Q
sodium role and function
A
- controls serum osmolarity and water balance
- facilitates muscles and nerve impulses
- regular fluid balance
6
Q
sodium intake and output
A
- main sources is deitary
- processed/packaged foods
- salt/ seasonings
7
Q
sodium output
A
- excreted through the kidneys and gastrointestinal tract
- perspiration
8
Q
hypernatremia
A
sodium > 145 mEq/l
- sodium osmolarity increases, resulting in fluid shifts
9
Q
hypernatremia causes
A
- excessive intake: dietary na, hypertonic iv solutions, cushings syndrome, corticosteroids use
- deficient water: insufficient intake, third spacing, excessive output
10
Q
hypernatremia clinical manifestations
A
- thirst
- irritability
- weakness
- headache
- edema
- decreased urine output
- seizures
11
Q
hypernatremia diagnosis
A
- serium NA level
- urinalysis
12
Q
hypernatremia treatment
A
- NA restriction
- fluid replacement: oral and hypotonic solutions
- diuretcs
13
Q
hyponatremia
A
sodium < 135 mEq/l
- serium osmolarity decreases
14
Q
hyponatremia causes
A
deficient sodium
- too much: diuretics, Gi loss (V/d), diaphoresis
- not enough in: Na restricting
excessive water
- too much in: hypotonic solutions, oral hydration
- not enough out: renal failure, heart failure, SIADH
15
Q
hyponatremia clinical maifestations
A
- GI upset
- lethargy
- confusion
- decrease deep tendon reflexes
- muscle weakness
- seizures
- coma
16
Q
hyponatremia diagnosis
A
- serum Na level
- urinalysis
17
Q
hyponatremia treatment
A
- fluid restriction
- increase dietary Na
18
Q
potassium
A
normal range 3.5- 5.0 mEq/l
19
Q
potassium role/function
A
- nerve and muscle impulses assisting with skeletal contraction
- cardiac muscle contraction and electrical conductivity
20
Q
potassium intake/output
A
intake:
- main source is dietary: meats, fruits, veggies, beans
output:
- excreted through the kidneys and gastrointestinal tract
21
Q
hyperkalemia
A
potassium > 5 mEq/l
22
Q
hyperkalemia causes
A
- deficient excretion: renal/ liver failure, medications
- excessive intake: oral K supplements, rapid IV administration
- lot of older adults defficent
- check inf they are on a diuretic
23
Q
hyperkalemia clinical manifestations
A
- paraesthesia
- muscle weakness
- respiratory depression
- EKG CHANGES ( dysrthmias) need to shock them
- cardiac arrest
- abdominal cramping
24
Q
hyperkalemia diagnosis
A
- serum k levels
- EKG
25
hyperkalemia treatment
- decrease intake
- hold supplements
- medications: diruects, kayexalate, insulin
- telemetry monitoring (continuous way to monitor EKG)
26
hypokalemia
potasium < 3.5 mEq/l
27
hypokalemia causes
excessive loss
- vomiting, diarrhea, nasogastric suctioning, laxatives, potassium- losing diuretics
deficient intake
- malnutrition, extreme dieting, and alcoholism
increased shift into the cell
- insulin excess: too much K+ into the blood and out of cell
28
hypokalemia clinical manifestations
- muscle weakness
- decrease bowel sounds
- illeus
- dysrhythmias
- EKG changes
- cardiac arrest
29
hypokalemia diagnosis
serum K
30
hypokalemia treatment
- replacement: oral, intravenous
31
Calcium
4-5 mEQL
32
calcium role function
- formation/structur bone and teeth
- blood clotting
- nerve transmission and muscle contraction
33
calcium intake and output
intake:
- main source is dietary intake (vitamin D aids absorption) absorbed through the gastrointestinal tract (small intestine)
output
- excreted in urine and stool
34
hypercalcemia
> 5 mEq/l
35
hypercalcemia causes:
increased intake or release
- calcium antacids and supplements, cancer, immobilization, corticosteroids, vitamin D deficiency
deficit excretion
- renal failure, thiazide diuretics, and hyperparathyroidism
36
hypercalcemia clinical manifestations
- confusion
- muscle weakness
- decreased deep tendon reflexes
- lethargy
- increased HR & BP
- decreased Gi motility
37
hypercalcemia diagnosis
serum calcium
38
hypercalcemia treatment
identify and manage underlying caused
- increase mobility: strength bone
- calcitonin: meds that helps pull calcium out of blood
- intravenous fluids: diluate
- diuretics: pulls Na and K+ good not really CA
39
hypocalcemia
calcium < 4 mEq/l
40
hypocalcemia causes
- excessive losses: hypoparathyroidism, renal failure, laxatives, diarrhea, and other medications
- deficient intake: decreased dietary intake, alcoholism, and absorption disorders
41
hypocalcemia clinical manifestations
- confusion
- irritability
- paresthesia
- increased deep tendon reflexes
- increased GI motility
- trousseau's sign (hand drop-down)
- chvostek's sign (face twitch)
42
hypocalcemia diagnosis
serum calcium
43
hypocalcemia treatment
- calcium replacement
| - vitamin D
44
magnesium
normal range: 1.8-2.5 mEq/l
45
magnesium role/function
- muscle and nerve function
- cardiac rhythm
- immune function
46
magnesium intake/output
intake: main source is deitary intake
output: excreted through the kidneys and gastrointestinal system
47
hypermagnesemia
magnesium > 2.5 mEq/l
48
hypermagnesemia causes
to little out
- renal failure
too much in
- excessive laxative and antacid use
49
hypermagnesemia clinical manifestations
- similar to hypercalacemia
50
hypermagnesemia diagnosis
serum magnesium
51
hypermagnesemia treatment
- diuretics, dialysis, and intravenous calcium
52
hypomagnesemia
magnesium < 1.8 mEq/l
53
hypomagnesemia causes
too little in
- inadequate intake
- alcoholism
- malnutrition
too much out
- diarrhea
- diuretics
54
hypomagnesemia clinical manifestations
- similar to hypocalcemia
55
hypomagnesemia diagnosis and treament
diagnosis: serum mag
treatment
- magnesium replacement: oral of IV
56
acid-base balance
- measured by PH: normal serum- 7.35-.7.45
- body fluids, kidneys, and lungs help maintain balance
- subtle changes can cause serious effects
57
acid-base balance
- cellular buffers- 1st line: acts as a sponge to soak up extra hydron ions if there are too many (acidic) or release hydrogen ions if not enough (alkaline)
- lungs- 2nd
- acidic- lungs blow off additional CO2, rapid breaths
- alkaline conserve CO2 via shallow breaths
- kidneys- slow response
- regular of bicarbonate
