Fluid/ Electrolytes Flashcards
signs hypernatremia
disorientation
signs hyperkalemia
U-waves on ECG, n/v, heart palpitations, abdominal pain, musc weakness or numbness
signs hypocalcemia
Tetany (intermittent musc. spasms)
signs hypermagnesemia
depressed deep tendon reflex
sign fluid overload
weight gain, hypertension, edema, jugular vein distension, crackles lungs,
signs fluid deficit
thirst, inelastic skin turgor, hypotension, oliguria
water v adipose tissue ratio
mre fat= less water
ecf
v intracellular
separated by cell membrane
extracellular cf- outside cells (intravasc- arteries, veins and cap/ plasma) (interstitial- area around cells incl NaCl and H2))
intracellular- within cells 2/3 body water
capillary mem
sep extracellular intravascular space and intersitial space
semiperm mem
passive transport incl
osmosis diffusion filtration
osmosis
mvmnt fluid across semiperm mem
low solute to high solute conc
diffusion
mvmnt ions/ mol across semiperm mem
filtration
water and solutes mve to area lower hydrostatic pressure
osmolality
measure # particles diss in a solution
norm 275-295
effects tonicity (whether water move or stay)
hyperosmolality
> 295
hypo-osmolality
<275
osmotic p
p needed prevent osmosis through mem
btw solution and solvent
ex. isotonic
hypotonic sol
lwr osmotic p than blood
shift fluid into cells
hypertonic sol
higher osmotic p than blood
shift fluid out of cells
RAAS
blood vol dec=dec renal perfusion
syn renin
renin combines w/ angiotensinogen to for ag1
converted to ag2
stim adrenal cortex release aldosterone
inc kidney reabsorb Na
water flows back to ECF (water follows salt)
ADH
secreted by posterior pit. gland
in response to inc osmolality
sensed in hypothal by osmo recep
inc water reabsorb
atrial natriuretic peptide
released when heart atriums stretched= hypertension
dec fluid retention via blocking secretion of aldosterone and inhib renin
hypovolemia and causes
diminished blood vol
fluid loss, vomiting, diarrh, fever, lack fluid intake, burns, pancreatitis
hypovolemia symptoms
hypotension, tachycardia, thirst, poor skin turgor, dry muc mem dec urine output, shock
hypovolemia treat
isotonic sol
antidiarr/antiemetic
hypervolemia and causes
fluid excess in intravasc space
inc na and water retention
fluid shift from intracellular to extracellular
heart/ renal failure
edema
fluid excess in interstitial space
signs hypervolemia
edema, dyspnea, crackles, tachypnea, hypertension, dis neck veins, edema, ventricular gallop
hypervolemia treatment
restrict na/fluid intake
diuretics, mech ventilation, dialysis
sodium ecf
water distribution
nerve/musc fiber transmission
sodium regulation
dietary intake
excretion via kidneys
hormonal- aldosterone (Na reabsorb)
ADH- water reabsorb
hyponatremia
<135
water into cells
hypernatremia
> 145
water out of cells
hyponatremia causes
Na loss
Gi, diuretics, sweating, excess water intake
causes hypernatremia
rapid infusion hypertonic saline
loss water- diarrh, diab inspipidus, impaired thirst center
manifestations hyponatremia
headache, weakness, edema, n/v, disorientation, agitation, seizures, anorexia
manifestations hypernatremia
thirst, dec skin turgor, weak/rapid pulse, oliguria, irritability, dec reflexes, hallucination
hypernatremia treatment
hypotonic sol
potassium icf
3.5-5
est normal resting mem potential
changes glucose to glycogen and aa to protein
K+ regulation
filtered through glomerulus
reabsorb prox tubules
excreted distal convoluted tubules
excretion via kidneys
hormonal reg via aldosterone
hypokalemia
<3.5
Hyperkalemia
> 3.5
hypokalemia causes
alkalosis
alcoholism
diuretics
anorexia
causes hyperkalemia
intake supp Ca
acidosis
burns
renal failure
manifestations hypokalemia
muscle fatigue apnea flat T wave large U wave prolonged Pr interval
manifestations hyperkalemia
abdomial pain tingling fingers tall t wave wide qrs ventricular fibrillation cardiac arrest
treatment hyperkalemia
reduce K+ rich foods
50% glucose iv insulin
give kayexalate
treatment hypokalemia
diet change
iv potassium
chloride lvl
95-105
maintains acid/b bal, osmotic p and acidity of gastric secretions ie HCL
chloride reg
dietary intake
excretion via kid
reabsorb w/ Na
if acidic= Cl excreted
Hypochloremia causes
<95
loss acid
vomiting
Hyperchloremia causes
> 105
excessive intake, dec excretion
hypochloremia manifestations
meta alkalosis
hypertonicity muscles
depressed respir
tetany
hyperchloremia manifestations
metabolic acidosis
rapid respir
weakness
coma
Calcium
8.5-10.5 found bones, teeth, blood muscles neuromusc fun, trans nerve impulses contraction muscles,, blood clotting, maint cell mem perm formation bones
Ca reg
dietary intake vitamin D PTH reg absorp and excretion- release Ca into blood Calcitonin- dec bone reabsorb inverse relationship w/ Phosphate!!
hypocalcemia causes
hyperphosphatemia
vitamin d deficiency
hypoalbuminemia
causes hypercalcemia
hypophosphatemia
renal failure
cancer
thyroid disorder
hypocalcemia manif
pins/needles musc cramping numbess hypotension seizures poor clotting dec myocardial contractility chvostek sign
hypercalcemia manif
anorexia, constipation, hypertonicity, dec heart rate, confusion
Mg
1.5 to 2.5 stored soft tissue/bone enzyme act carb/protein metab synprotein/ dna electrical act heart, musc, nerves
regulation Mg
dietary intake
pth
Ca inc = less Mg
excreted kid
hypomagnesemia
<1.5
Hypermagnesemia
> 2.5
causes hypomagnesia
malnutrition prolonged NPO SIDAH hypercalcemia diuretics
causes hypermagnesemia
dec renal excretion
inc intake (antacids)
soft tissue injury
manif hypomagnesia
anorexia, n/v, weakness, tetany
manif hypermagnesemia
musc flaccid, dec breathing rate, hypotension, bradycardia, atrioventricular block
