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NURS312 Patho > fluid/electrolytes > Flashcards

fluid/electrolytes Flashcards

1
Q

normal range sodium

A

135-145; maintains h2o balance

impulse transmission, muscle contraction, fluid and electrolyte balance

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2
Q

normal range potassium

A

3.5-5; transmission of nerve and muscle impulses

resting membrane potential, action potentials of nerves and muscles, maintain intracellular volume

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3
Q

normal range chloride

A

104-106; buffer and regulates acid-base
regulating osmotic pressure, forming HCl in gastric acid. controlled indirectly by ADH and processes that affect renal reabsorption of sodium

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4
Q

normal range calcium

A

9-11; nerve impulse transmission; heart contractions

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5
Q

normal range BUN

A

10-20; urea is by product of metabolism

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6
Q

Normal range creatinine

A

0.7-1.2; produced by your muscle metabolism

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7
Q

normal range co2

A

22-26 buffer

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8
Q

normal range magnesium

A

1.5-2.5 nerve conduction and muscle tissue function

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9
Q

sum of cations in body=sum of anions in body

A

both 153

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10
Q

phosphates

A

regulate pH, controlled by aldosterone and renal system

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11
Q

excess Sodium

A 
hypernatremia
thirst
CNS deterioration
Increased interstitial fluid
cellular dehydration
net loss of water or sodium gain
dehydration
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12
Q

Sodium deficit

A 
Hyponatremia
CNS deterioration
often age related etiology due to decreased renal function
fingerprint edema
muscle cramps, weakness, fatigue
nausea, vomiting, cramps, diarrhea
apathy, lethargy, headache
depression of deep tendon reflexes
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13
Q

excess potassium

A 
hyperkalemia (decreased renal elimination, excessively rapid administration, mvmt of K+ from ICF to ECF)
ventricular fibrillation
ECG changes 
CNS changes
Weakness
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14
Q

Potassium deficit

A 
Hypokalemia (inadequate intake, excessive GI, skin, renal losses-diuretic therapy, or redistribution to ECF from ICF)
bradycardia
ECG changes
CNS changes
Fatigue
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15
Q

excess calcium

A

hypercalcemia
thirst
CNS deterioration
Increased interstitial fluid

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16
Q

calcium defict

A 
hypocalcemia
tetany
Chvostek's, Trousseau's signs
Muscle twitching
CNS changes
ECG changes
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17
Q

Excess Magnesium

A

hypermagnesemia
Loss of deep tendon reflexes (DTR’s)
Depression of CNS
Depression of neuromuscular function

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18
Q

Magnesium deficit

A

hypomagnesemia
hyperactive DTR’s
CNS changes

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19
Q

nonelectrolytes

A

urea
glucose
creatinine
bilirubin

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20
Q

isotonic fluid

A

280-300 mOsm/kg

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21
Q

Hypotonic fluid

A

less than 280 mOms/kg
used to hydrate the cells
cells draw in water and swell

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22
Q

Hypertonic fluid

A

greater than 300 mOsm/kg

draws fluid from the cells

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23
Q

increase ECF osmolality

A

cells shrink

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24
Q

decrease ECF osmolality

A

cells swell

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25
Q

The rules of fluid replacement

A 
replace blood with blood
plasma with colloid
resuscitate with colloid
ecf depletion with saline
rehydrate with dextrose
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26
Q

how does the body regulate our fluid volume?

A 
Thirst
ADH
RAAS
SNS
ANP
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27
Q

adh

A

increases water reabsorption
increases urine concentration
decreases serum concentration

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28
Q

disorders of ADH

A

SIADH

Diabetes Insipidis

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29
Q

SIADH

A

overproduction of ADH
fluid retention, edema
low sodium triggers increased ADH
HYPONATREMIA

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30
Q

diabetes insipidus

A

lack of ADH

damage to hypothalamus or pituitary gland

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31
Q

nephrogenic diabetes insipidus

A

failure of kidneys to respond to ADH and vasopressin

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32
Q

Renin

A

enzyme produced and released by kidney in response to decreased renal perfusion secondary to decreased circulating volume or increased SNS stimulation

Renin interacts with angiotensinogen to produce angiotensin 1

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33
Q

angiotensin 1

A

converted to angiotensin 2 in lungs by converting enzyme ACE

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34
Q

angiotensin 2

A

stimulates secretion of aldosterone

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35
Q

aldosterone

A

mineralocorticoid hormone released by the adrenal cortex which acts upon the distal portion of the renal tubule

  • slowly boosts water reabsorption by the kidneys by increasing the reabsorption of NaCl
  • acts as a volume regulator bc sodium retention leads to water retention
36
Q

ANP

A

atrial natriuretic peptide
hormone released by the cardiac atria in response to increased atrial pressure
released in resonse to any condition that causes elevated cardiac filling pressures
effect of angiotensin 2

37
Q

First spacing

A

normal distribution of fluid in ICF and ECF (the vascular space)

38
Q

second spacing

A

abnormal accumulation of interstitial fluid (edema)

39
Q

Third Spacing

A

Fluid accumulation in part of body where it is not easily exchanged with ECF (ascites)

40
Q

hematocrit

A

%RBC in whole blood
increases with dehydration (hemoconcentration)
decreases with overhydration (hemodilution)
normal male 40-54%
normal female 37-47%

41
Q

BMP

A

BUN blood urea is a byproduct of metabolism and is primarily excreted by the kidneys in urine
normal 7-20 mg/dL

42
Q

urine osmolality

A

measures solute concentration of urine
24 hour specimen 300-900 mOsm/kg
urea, creatinine, and uric acid are the primary determinants of urine osmolality

43
Q

urine specific gravity

A

elevates the kidney’s ability to conserve or excrete urine

normal 1.010-1.020

44
Q

Fluid Volume Excess

A 
neck vein distension
pulmonary edema
weight gain
peripheral edema
full, bounding pulses, elevated BP
congestive heart failure
45
Q

fluid volume deficit

A 
sunken eyeballs
dry mucus membranes
weight loss
increased respiratory rate
decreased skin turgor
flattened neck veins
increased heart rate
decreased BP
46
Q

acidosis

A

an abnormal process which would lower arterial pH if there were no secondary changes in response to the primary etiological factor
too many circulating H+

47
Q

Alkalosis

A

an abnormal procss which would raise arterial pH if there were no secondary changes in response to the primary etiological factor
not enough H+ in ECF

48
Q

acidemia

A

arterial pH less than 7.35

49
Q

alkalemia

A

arterial pH greater than 7.45

50
Q

normal pH ACID BASE BALANCE

A

7.35-7.45

51
Q

normal PaCO2 RESP

A

35-45 mm Hg

52
Q

normal HCO3- KIDNEY

A

22-26 mEq/L

53
Q

pulmonary embolism

A

respiratory alkalosis

54
Q

hypotension

A

metabolic acidosis

55
Q

vomiting

A

metabolic alkalosis

56
Q

severe diarrhea

A

metabolic alkalosis

57
Q

cirrhosis

A

resp alkalosis

58
Q

renal failure

A

metabolic acidosis

59
Q

sepsis

A

respiratory alkalosis, metabolic acidosis

60
Q

pregnancy

A

resp alkalosis

61
Q

diuretic use

A

metabolic alkalosis

62
Q

COPD

A

resp acidosis

63
Q

respiratory acidosis

A

carbonic acid excess caused by blood levels of CO2 above 45 mmHG
hypercapnia-high levels of CO2 in blood
breathing too slow
depression of respiratory center in brain -drugs, head trauma
paralysis of respiratory or chest muscles
emphysema

64
Q

adult respiratory distress syndrome

A

acute respiratory acidosis

65
Q

pulmonary edema

A

acute respiratory acidosis

66
Q

pneumothorax

A

acute respiratory acidosis

67
Q

treatment of respiratory acidosis

A

restore venitlation
IV lactate solution
treat underlying dysfunction or disease

68
Q

Respiratory Alkalosis

A

carbonic acid defict
pCO2 less than 35 mm HG (hypocapnea)
most common acid-base imbalance
breathing is too fast

69
Q

causes of respiratory alkalosis

A 
high altitudes
pulmonary disease and congestive heart failure caused by hypoxia
acute anxiety
fever, anemia
cirrhosis
gram - sepsis
70
Q

treatment of respiratory alkalosis

A

treat underlying cause
breathe into a paper bag
IV Choloride containing colution Cl- replace lost HCO3-

71
Q

metabolic acidosis

A

HCO3- deficit (less than 22 mEq/L)

72
Q

Causes to metabolic acidosis

A

diarrhea or renal dysfunction (loss of HCO3-)
accumulation of acids (lactic acid or ketones)
Failur of kidneys to excrete H+

73
Q

Symptoms of metabolic acidosis

A

headache, lethargy
nausea, vomiting, diarrhea
coma
death

74
Q

treatment of metabolic acidosis

A

IV lactate solution

75
Q

metabolic alkalosis

A

HCO3= excess (greater than 26 mEq/L)

76
Q

causes of metabolic alkalosis

A 
excess vomiting and diarrhea=loss of stomach acid
excessive use of alkaline drugs
certain diuretics
endocrine disorders
heavy ingestion of antacids
severe dehydration
77
Q

symptoms of metabolic alkalosis

A 
respiration is slow and shallow
hyperactive reflexes (tetany)
often related to depletion of electrolytes
atrial tachycardia
dysrhythmias
78
Q

treatment of metabolic alkalosis

A

electrolytes to replace those lost
IV Chloride containing solution
treat underlying disorder

79
Q

interpreting the ABG

A

note whether the pH is low (acidosis) or high (alkalosis)

decide which value (pCO2=resp or HCO3- =metabolic) is outside normal range

80
Q

Compensation?

A

look at the value that doesnt correspond to the observed pH change. If it is within normal range, then there is NO COMPENSATION occurring. If it is outside the normal range, the body is partially compensating for the problem.

81
Q

hypertonic hyponatremia

A

osmotic shift of water from the ICF to the ECF compartment (hyperglycemia)

82
Q

hypotonic hyponatremia

A

most common

caused by water retention

83
Q

hypovolemic hyponatremia

A 
water is lost along with sodium
excessive sweating due to heat
heavy exercise
vomiting and diarrhea
a lack of aldosterone increases renal losses of sodium and cortisol deficiency leads to increased release of ADH with water retention.
84
Q

Euvolemic or Normovolemic hypotonic hyponatremia

A

retention of water with dilution of sodium while maintaining the ECF volume within normal range.
Result of SIADH
risk increases post op
high ADH levels increase water reabsorption by kidney

85
Q

hypervolemic hypotonic hyponatremia

A 
hyponatremia+edema associated disorders
decompensated heart failure
advanced liver disease
renal disease
effective circulating volume is often sensed as inadequate by baroreceptors resulting in increased ADH levels
abuse of MDMA (ecstasy)

NURS312 Patho (5 decks)

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