Fluid & Electrolytes

Question 1

Where is water movement mediated

Answer 1

Hypothalamus

Question 2

Hypothalamus controls what hormones?

Answer 2

Antidiuretic (ADH) -kidneys water balance
Aldosterone (ALD) - adrenal glands and BP
Renin - controls aldosterone levels

Question 3

Capillaries capabilities

Answer 3

Freely permeable to water, not to proteins. Water moves from areas of higher concentration to lower concentration

Question 4

Effects on capillaries

Answer 4

Hydrostatic, osmotic/oncotic, capillary wall integrity, lymph integrity

Question 5

What is edema?

Answer 5

Excess fluid in interstitial spaces

Question 6

What is systemic edema

Answer 6

Bilateral (arms or legs) presentation, indicative of heart failure

Question 7

What is local edema

Answer 7

Unilateral presentation (stroke) or indicative of a DVT

Question 8

Edema Categories

Answer 8

Increased hydrostatic pressure, hypoeteinemia, lump obstruction, sodium retention, inflammation

Question 9

Clinical manifestations of Edema

Answer 9

Edema, effusion, ascites, anasarca

Question 10

Effects of Edema

Answer 10

Increase in body weight, function impairment, pain, impaired circulation

Question 11

Where are the largest fluid compartments in the body?

Answer 11

Extra cellular -> plasma and interstitial
Intracellular

Question 12

Pitting Edema

Answer 12

Depression in the skin stays after finger has been lifted

Question 13

Patient presents with swelling in both legs. What type of edema does this indicate?

Answer 13

Systemic edema

Question 14

Patient presents with a stroke. What type of edema may we see?

Answer 14

Local edema, unilateral

Question 15

What is dehydration?

Answer 15

Insufficient body fluid due to inadequate intake or excessive loss

Question 16

Who should we monitor for dehydration?

Answer 16

Infants and geriatric populations

Question 17

What is 3rd spacing?

Answer 17

Simultaneous fluid deficit and fluid excess

Question 18

Where does 3rd spacing occur

Answer 18

Fluid shift from blood to interstitial space and stays there

Question 19

When does 3rd spacing commonly occur?

Answer 19

Most common in liver disease (low protein level) and burns (increased capillary permeability)

Question 20

Most prevalent electrolytes in the body

Answer 20

Sodium, potassium, calcium, magnesium, chloride, phosphate

Question 21

Role of sodium in the body

Answer 21

Maintains extracellular volume, nerve conduction, muscle contraction

Question 22

Role of calcium in the body

Answer 22

Bone formation

Question 23

Role of magnesium in the body

Answer 23

Enzyme reaction, protein, dna synthesis

Question 24

Role of potassium in the body

Answer 24

Nerve conduction, muscle contraction

Question 25

Result of a sodium imbalance

Answer 25

Impaired nerve function, decreased blood volume/pressure, increased swelling

Question 26

Sodium imbalance PT actions

Answer 26

Monitor vitals, assess cardiac rhythm, assess cognitive and neurological changes, assess for fall risk, consider seizure protocol

Question 27

Normal Electrolyte level for calcium

Answer 27

9-10.5 mg/dL

Question 28

Normal magnesium levels

Answer 28

1.3-2.1 mEq/L

Question 29

Normal potassium levels

Answer 29

3.5-5.0 mEq/L

Question 30

Normal sodium levels

Answer 30

136-145 mEq/L

Question 31

Potassium imbalance signs

Answer 31

Muscle weakness, paresthesia, dysrhythmia, hypotension, bradycardia

Question 32

PT actions with potassium imbalance

Answer 32

Monitor vital signs, assess cardiac rhythm, assess acute decline in muscle strength, decrease physical activity due to cardiac events

Question 33

Calcium imbalance signs

Answer 33

Reflexia, dysrhythmia, lethargy, confusion, nausea, agitation, seizure,

Question 34

PT actions for Calcium imbalance

Answer 34

Monitor vital signs, assess cardiac rhythm, assess for decline in muscle strength, seizure precautions.

Question 35

What population commonly has calcium imbalances

Answer 35

Patients undergoing cancer treatments

Question 36

Magnesium imbalance signs

Answer 36

Tonia, reflexia, dysrhythmia, nystagmus, tremors, hypotension, seizures

Question 37

PT actions with magnesium imbalance

Answer 37

Monitor vitals, assess cardiac rhythm, decrease physical activity, assess for decline in muscle strength, consider seizure protocol

Question 38

Body normal pH

Answer 38

7.34-7.45

Question 39

Homeostasis

Answer 39

Body’s way to maintain its normal environment

Question 40

Lungs role in pH

Answer 40

Make quick changes (breathing) by modifying Co2 levels

Question 41

Co2 is a ?

Answer 41

Acid

Question 42

HCO3 is a ?

Answer 42

Base

Question 43

Respiratory Acidosis and is caused by what?

Answer 43

Is a increase in CO2 (more acidic) COPD, pneumonia, airway obstruction, chest injury, depressed respiratory

Question 44

What is the visible effect of respiratory acidosis?

Answer 44

Deep rapid breathing

Question 45

Metabolic Acidosis and what is it caused by?

Answer 45

Decrease HCO3 (more acidic) caused by diarrhea, renal failure,

Question 46

Metabolic acidosis will cause

Answer 46

Secretion of urine with a low pH

Question 47

Kidneys role in pH

Answer 47

Slow response (hours to days) to reabsorb HCO3 and excrete H+

Question 48

Respiratory Alkalosis and is caused by?

Answer 48

Decrease in CO2 (more basic) caused by hyperventilation

Question 49

Metabolic Alkalosis and is caused by?

Answer 49

Loss of H+ ions through kidneys or GI, caused by an increase in HCO3 (more basic), loss of hydrochloric acid, hypokalemia, and excessive anti acids

Question 50

A patient is hyperventilating. How will this change the pH?

Answer 50

Decrease in CO2 will cause a more basic pH

Question 51

Patient has reported COPD. How does their breathing present in the clinic?

Answer 51

Deep rapid breathing, need to assume an increase in CO2 which will become more acidic