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Nursing 135 > Fluid Lytes Part 2 > Flashcards

Fluid Lytes Part 2 Flashcards

1
Q

How much Hydrogen ion does the body produce in a day?

A

50-100 mEq

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2
Q

True or False: Does Cellular Metabolism produce Oxygen?

A

False Cellular Metabolism produce CO2

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3
Q

True or False: Does the body produce more acid than Base?

A

True

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4
Q

When does Acid-Base balance exist?

A

When the Net rate at which the body produces acids or bases equals the rate which acids or bases produces.

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5
Q

What is normal levels for ECF?

A

7.4

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6
Q

Blood pH level range?

A

7.35-7.45

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7
Q

What numbers are classified as Acidosis (academia)?

A

7.35

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8
Q

What levels are considered to be Alkalosis (Alkalemia)?

A

7.45

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9
Q

Acid is what?

A

Contains H+ ion that can be released in solution

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10
Q

What is considered a strong acid in the body?

A

Hydrochloric Acid releases all H+

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11
Q

What is considered a weak acid in the body?

A

Carbonic acid releases some H+

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12
Q

How is bicarbonate created?

A

H2CO3 releases H+ to form HCO3

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13
Q

What is a Chemical Buffer?

A

Combine with acid or bases to control pH

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14
Q

True or False: Does a Buffer system take up H+ or release H+ as conditions change?

A

True

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15
Q

What is the ratio of Bicarbonate to Carbonic acid?

A

20:1

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16
Q

How can the body pH be changed via respiration?

A

Changing rate and depth of breathing

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17
Q

How can the body retain carbonic acid?

A

By blowing off CO2

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18
Q

PaCo2 normal levels?

A

35-45 mmHg

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19
Q

What are the function for kidneys related to acid-base within the body?

A

Eliminate large amount of acid
excrete base
conserve and produce bicarb ions
Most effective regulator of pH

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20
Q

What would happen if the the pH of ECF decreases?

A

kidneys will eliminate more acid and retain or produce more bicarbonate.

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21
Q

Why happens if the pH increases in blood?

A

kidneys retain H+ and excrete HCO3

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22
Q

What are the normal levels of Bicarbonate?

A

22-26 mEq/L

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23
Q

How long does it take for buffers to take affect within the body?

A

Buffers functions almost instantaneously

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24
Q

How long does it take for respiratory buffers to take affect?

A

Minutes to hours

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25
Q

What is metabolic alkalosis?

A

Loss of H+, Na, K and CL

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26
Q

What is metabolic acidosis?

A

Loss of intestinal bicarbonate, Na, Cl, K

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27
Q

How is thirst generated?

A

increase in plasma osmolarity or decrease in blood volume regulates fluid intake also xerostomia

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28
Q

What are some psychological factors for fluid intake?

A

Depression, confusion

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29
Q

Diaphoresis

A

Fever, excessive exercise

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30
Q

Diuretics

A

Prescribed to excrete excess water and Na but -K andMg loss occurs

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31
Q

What factors could affect F&E?

A

Cardiac Failure, Liver Failure, Respiratory Failure

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32
Q

How does Cardiac Failure affect F&E?

A

decreased b/p, aldosterone and ADH stimulated equals water retention

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33
Q

How does Liver Failure affect F&E?

A

Decreased production of albumin

Decreased Colloid Osmotic Pressure

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34
Q

How does Respiratory Failure affect F&E?

A

Loss of compensatory mechanism to decrease H+ equals CO2 retained equals respiratory acidosis

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35
Q

Surgery affects F&E how ?

A

NPO status, increased insensible loss, Hyperkalemia from cellular destruction, hypokalemia as urine excretion

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36
Q

Water and electrolytes loss or gained in proportion

A

Isotonic

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37
Q

Loss or gain of water only

A

Osmolar

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38
Q

Severity of Dehydration is measured based by weight loss. What are the percentage of weight that must be lost?

A

5% mild
10% severe
15% life threatening

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39
Q

What is Third Spacing

A

Fluid leaves vascular area and remains in interstitial fluids and transcellular compartments

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40
Q

What is the Etiology of Thirs Space fluid shift?

A

Increased fluid volume
increased capillary hydrostatic pressure
hyponatremia
increased tissue permeability

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41
Q

What are some intervention for F&E?

A 
Assess for clinical signs for FVD
Monitor weight
VS 
I&O
Specific gravity > 1.025
lab finding 
measures for skin breakdown
42
Q

Hypervolemia

A

Increase in interstitial or vascular volume

43
Q

True or False: Does the body retain both water and Na in same proportions?

44
Q

Having Increased fluid volume also increases what?

A

Increased hydrostatic pressure

45
Q

If your body has fluid volume excess. How would your pulse respond respond?

A

Pulse would be bounding and Tachy

46
Q

What are some Symptoms of excess fluid volume?

A

Bounding pulse, Increased B/P, pitting edema: Feet, ankles lower legs, distended neck veins
Polyuria, possible decreased urine output, pulmonary edema, Respiratory patterns changed

47
Q

What would a treatment be for a person with Fluid Volume Excess?

A

Fluid and Na restrictions

48
Q

What places on the body would be apparent with a person with FVE?

A

around the eyes and dependent tissues where hydrostatic pressure is high

49
Q

What interventions would you as a nurse perform for a person with FVE?

A

monitor weight daily and VS, assess for edema
Assess breath sounds, I&O (intake greater than output)
place in Fowler position, Restrict fluid (IF ORDERED)
Restrict dietary Na (IF ORDERED), prevent skin breakdown

50
Q

When does water or osmolarity imbalance occur?

A

When water intake or decrease is excessive

51
Q

How would you be able to determine if a patient has water imbalance?

A

Check or estimate serum osmolarity

52
Q

If Na and electrolytes are left behind and only water is lost, what increases?

A

Osmolarity

53
Q

If water is drawn from ICF, where does it go and what occurs?

A

goest to ECF space and Cells shrink

54
Q

An increase in water loss without Na loss if referred to as?

A

Hyperventilation

55
Q

What are normal serum osmolarity

A

> 300 Mosm/L

56
Q

as cells shrinks in the brain what begins to occurs?

A

Confusion, agitation, convulsions coma and possibly death

57
Q

normal Serum Na levels?

A

> 145 mEq/L

58
Q

An increase in water intake in excess of electrolytes results in what?

A

Low Na, Low Osmolarity

59
Q

What are some symptoms of excess water?

A

Lethargy, irritability, confusion, personality changes, seizures, death, anorexia, nausea, vomiting, muscle weakness and cramping.

60
Q

What would a treatment be for water excess?

A

ECF volume replacement of Na to decrease neurological changes

61
Q

If you want to analyze blood gas what would you look at first?

62
Q

Respiratory acidosis

A

Primary excess of carbonic acid in ECF

63
Q

Respiratory alkalosis

A

Primary deficit of carbonic acid in ECF

64
Q

Metabolic acidosis

A

Proportionate deficit of bicarbonate in ECF

65
Q

Metabolic alkalosis

A

Primary excess of bicarbonate in ECF

66
Q

When does Acid-Base imbalances occur?

A

When carbonic acid or bicarbonate levels become disproportionate

67
Q

What is levels are considered to respiratory acidosis?

A

low pH 45 mmHg

68
Q

As the pH drops below normal ranges during Respiratory Acidosis. What are the kidneys doing?

A

Compensating by retaining more HCO3 in an attempt to raise the pH.

69
Q

If the kidneys begins to excrete H+ during Respiratory acidosis. Is the urine Acidic or Alkaline?

A

Acidic. H+ is acidic

70
Q

How would a person who is suffering form respiratory acidosis be able to promote the release of CO2?

A

breathe deeply, Turn, CDB, Semi-Fowlers postion

71
Q

Carbonic acid excess

A

Increased blood levels of CO2 above 45mmHg (Hypercarbia)

72
Q

What is a chronic condition for respiratory acidosis?

A

Depression of respiratory center in brain that controls breathing rate
Paralysis of respiratory or chest muscles
emphysema - COPD

73
Q

What would be acute conditions of Respiratory acidosis?

A

Adult respiratory distress syndrome

pulmonary edema, pneumothorax, pneumonia, narcotic overdose, asthma mechanical ventilation.

74
Q

Respiratory Alkalosis levels?

A

elevated pH>7.45 or higher. PaCO2

75
Q

When does respiratory alkalosis occurs?

A

Increased rate or depth of ventilation. due to pain and anxiety, pulmonary disease, ventilator settings too high or too fast, hypoxia: fever encephalitis, high altitudes, salicylate poisoning (aspirin poisoning)

76
Q

What is the primary cause of respiratory alkalosis?

A

Hyperventialtion

77
Q

How does the kidneys compensate for Respiratory alkalosis?

A

Excreting HCO3 and retaining H+
Urine becomes more alkaline
Treatment is aimed at eliminating cause

78
Q

What is the goal for respiratory alkalosis?

A

To increase CO2 in body, slow breathing

79
Q

What would a treatment be for Respiratory alkalosis?

A

Treat underlying cause, Breathe into a paper bag

80
Q

Levels for Metabolic acidosis?

81
Q

During metabolic acidosis the body rapidly excrete what?

A

bicarbonate or the inability to retain it

82
Q

During metabolic acidosis what system compensate?

A

Respiratory system

83
Q

What is the cause of metabolic acidosis?

A

Loss of HCO3 from diarrhea, Lack of exertion of H= ions: renal failure
Overproduction of hydrogen ions: diabetic ketoacidosis, starvation, fever

84
Q

During metabolic acidosis. What are the lungs attempting to do and Why?

A

Blow off CO2 deep and rapidly to lower CO2 in the body

85
Q

When kussmaul respiration be used?

86
Q

What are the kidneys during metabolic acidosis?

A

Excrete H+ and urine becomes more acidic. May take days or weeks.

87
Q

True or False: If a pt has renal damage during metabolic acidosis. Will the patient be able to excrete H+.

88
Q

pH levels for Metabolic alkalosis?

A

pH >7.45 PaCO2 normal or increased HCO3 increased

89
Q

What is a cause of Metabolic alkalosis?

A

Ingestion of large amounts of HCO3 or loss of acid by prolonged vomiting, NG functioning, some diuretics, antacids.

90
Q

True or False: Breathing occurs rapidly and deep to retain CO2?

A

False: Breathing becomes slow and shallow to retain CO2

91
Q

What are the kidneys during when metabolic alkalosis occur?

A

retain H+ or excrete HCO3 so urine becomes more alkaline

92
Q

What are risk factors for imbalances?

A

Pathophysiology underlying acute and chronic illnesses, abnormal losses of body fluids, burns, trauma, surgery, therapies that disrupt fluid and electorate balance.

93
Q

If a pt losses 1Kg of body weight how much water can we assume that was lost of a pt had water retention?

A

1L of fluid

94
Q

What objective Data would you assess for patients for fluids and electrolytes?

A

Plasma Electrolytes, BUN and creatinine, CBC - Hematocrit, Plasma Osmolarity, ABG, Urine Osmolarity, Urine specific gravity, Urine pH

95
Q

What would be some Nursing diagnosis for for Fluid Volume?

A

Deficient Fluid Volume, Risk for Deficient fluid volume, Excess Fluid Volume, Risk for imbalanced fluid volume

96
Q

What would some expected outcomes be for a pt who is recovering from fluid imbalance?

A

maintain fluid I&O balance 2500 ml over 3 days. Maintain urine specific gravity WNL 1.010 - 1.025. Practice self care behavior

97
Q

IF pH and PaCO2 move in opposite direction what is this. Respiratory or metabolic?

A

Respiratory problem

98
Q

If pH and HCO3 go down but PaCO2 remains steady what problem is this?

A

Metabolic acidosis

99
Q

If pH goes up and PaCO2 goes down but HCO3 remains steady. What problem is this?

A

Respiratory Alkalosis

100
Q

If both pH and HCO3 go up and PaCO2 remains steady. What problem is this?

A

Metabolic Alkalosis

101
Q

If Pogoes down and PaCO2 goes up but HCO3 remains steady> What problem si this

A

Respiratory acidosis

102
Q

Normal levels of HCO3?

A

22-26mEq/L

Nursing 135 (8 decks)

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