Fluids and Electrolytes Flashcards

1
Q

What percentage of body weight is fluid in the adult?

A

60%

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2
Q

What percentage of body weight is fluid in the child?

A

75%

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3
Q

Body Fluid is water with

A

chemical compounds (electrolytes), & Blood cells

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4
Q

Body regulates 2 things to achieve balance:

A
  1. The volume of fluid in extracellular space

2. The water concentration of solutes (osmolarity) of all body fluids

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5
Q

Fluid Compartment within the cell

A

Intracellular

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6
Q

Fluid Compartment within the GI tract and eye

A

Transcellular

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7
Q

The fluid in here is water

A

Intracellular

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8
Q

All the fluid found outside of the cell

A

Extracellular

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9
Q

ECF broken into 2 spaces

A

Intravascular

Interstitial

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10
Q

To maintain balance of ECF btwn vascular & interstitial spaces depends on 3 things

A

Protein content of the blood

Integrity of the vascular endothelium

Hydrostatic pressure

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11
Q

Most important & regulated aspect of fluid balance

A

Vascular volume

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12
Q

Prolonged periods of low BP is called

A

Shock

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13
Q

Normal Body functioning depends upon

A

fluid & electrolyte balance

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14
Q

Most important aspect of body fluid is

A

volume

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15
Q

Fluid compartment with minimal amount of fluid

A

Transcellular

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16
Q

Fluid compartment that accounts for 2/3 of body

A

intracellular

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17
Q

Fluid compartment that accounts for 1/3 of body

A

Extracellular

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18
Q

ECF Space in vessels

A

intravascular

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19
Q

ECF Space between cells

A

interstitial

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20
Q

fluid compartment that resembles plasma

A

interstitial

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21
Q

ECF space that contains sodium, chloride, and bicarbonate

A

interstitial

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22
Q

Without fluid volume there is no…

A

Blood Pressure

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23
Q

ADH

A

Antidiuretic hormone

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24
Q

In a child, one large stool can

A

cause fluid imbalance

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25
Q

Fluid and electrolyte balance must be maintained for

A

survival

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26
Q

Water maintains…

A

blood volume, body temp, and elimination

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27
Q

liquid portion of blood

A

plasma

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28
Q

fluid compartment that has plasma

A

intravascular

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29
Q

hypovolemia

A

fluid volume deficit

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30
Q

Plasma is 0.9% or

A

normal saline and electrolytes

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31
Q

To maintain balance of ECF between vascular & interstitial spaces depends on 3 things

A

Protein content of the blood

Integrity of the vascular endothelium

Hydrostatic pressure

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32
Q

Protein in blood is needed for

A

balance

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33
Q

ECF keeps fluid in

A

vessels

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34
Q

Protein content of blood

A

albumin and globulin

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35
Q

Pressure within the vessels that tries to push fluids out

A

hydrostatic pressure

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36
Q

the minimum pressure which needs to be applied to a solution to prevent the inward flow of its pure solvent across a semipermeable membrane

A

osmostic pressure

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37
Q

If a person is in shock there is no

A

perfusion

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38
Q

most important & regulated aspect of fluid balance

A

Vascular volume

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39
Q

when there is not adequate volume, blood pressure will

A

Drop

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40
Q

What 3 things Regulate and control Volume?

A

Baroreceptors or stretch receptors in the vasculature

The renin – Angiotensin –Aldosterone System
Kidney’s, Lungs, & Adrenal glands

Natriuretic Peptide Hormone System (ANP)

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41
Q

ANP is released to help reduce volume by….

A

increasing sodium

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42
Q

Amino Acids are produced by

A

the cardiac atrium

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43
Q

an increase in volume triggers

A

ANP

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44
Q

The cardiac hormone whose main function is to lower blood pressure and to control electrolyte homeostasis .

A

atrial natriuretic hormone (ANP)

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45
Q

ANP

A

Natriuretic Peptide Hormone System

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46
Q

Shock is characterized by

A

Weak, thready tachycardia

pale, clammy skin

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47
Q

Decreased volume causes Renin from kidneys

A

to split angiotensinogen (produced by the liver)

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48
Q

angiotensinogen is produced by

A

the liver

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49
Q

Located in the major arteries and responds to stretching of arteries and monitors vascular volume

A

Baroreceptors

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50
Q

Decreased volume causes:

Angiotensin I is further converted by the lungs to II which causes

A

vasoconstriction

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51
Q

Decreased volume causes:

Angiotensin II stimulates secretion of Aldosterone which causes

A

sodium & H2O reabsorption by the kidneys.

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52
Q

Aldosterone is secreted by the.

A

adrenal glands

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53
Q

ICF Volume:

Water moves freely across the cell membrane &

A

Electrolytes move with active transport

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54
Q

Cells with too Much water

A

swell and burst

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55
Q

Cell with too Little water

A

shrivel and die

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56
Q

Fluids and the balance of electrolytes takes place in a ________ environment

A

ALKALINE

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57
Q

The PH range is

A

7.37-7.43

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58
Q

this is necessary for cellular metabolism

A

Normal ph range 7.37-7.43

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59
Q

PH is determined by

A

H+ ions

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60
Q

Acid, donates H+ ions to a solution while a Base is

A

a substance which decreases H+ ions in a solution.

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61
Q

Refers to the concentration of dissolved particles in a given weight of fluid (kilogram)

A

Osmolality

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62
Q

Concentration of dissolved substances in volume of fluid

A

Osmolarity

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63
Q

Cells in the brain monitor changes in

A

Body fluid osmolality

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64
Q

Cells respond by varying the secretion of

A

ADH

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65
Q

ADH Keeps water

A

Balanced

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66
Q

All body fluids contain

A

ELECTROLYTES

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67
Q

Compounds that in solution can conduct an electric charge

A

Electrolytes

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68
Q

In a solution, electrolytes break into charged particles called

A

Ions

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69
Q

Types of ions

A

+ & - ions

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70
Q

Electrolytes are measured in

A

mEq/liter

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71
Q

ADH is secreted when needed by the

A

hypothalamus

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72
Q

Occurs when the concentration of sodium in your blood is abnormally low .

A

Hyponatremia

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73
Q

A high concentration of sodium in the blood.

A

Hypernatremia

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74
Q

Positively charged ions are

A

Cations

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75
Q

Negatively charged ions are

A

Anions

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76
Q

What does maintaining electrolyte balance mean??

A

If one electrolyte moves out of a cell, another must take it’s place

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77
Q

All electrolytes have these general functions:

A

Promote neuromuscular irritability

Maintain body fluid volume & osmolality

Distribute water between compartments

Regulate acid-base balance

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78
Q

Controls/regulates volume of body fluids

A

Na+ (sodium)

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79
Q

Regulator of enzymes & H2O content

A

K+ (potassium)

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80
Q

Controls nerve impulse, blood clotting, muscle contraction, B12 absorption

A

Ca2+ (calcium ion)

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81
Q

Controls metabolism of carbohydrates & proteins, vital actions involving enzymes

A

Mg2+ (Magnesium ion)

82
Q

Maintains osmotic pressure in blood, produces hydrochloric acid

A

Cl- (chloride ion)

83
Q

Body’s primary buffer system

A

HCO3- (bicarbonate ion)

84
Q

chemical involving cell division, energy metabolism, and hereditary traits

A

Phosphorus

85
Q

Normal sodium level is

A

135 to 145 mEq/L

86
Q

Na+

A

Sodium

87
Q

Normal potassium level is

A

3.5 to 5.0 mEq/L

88
Q

K+

A

Potassium

89
Q

Normal calcium level is

A

8.9 to 10.1 mEq/L

90
Q

Ca2+

A

Calcium

91
Q

Normal magnesium level is

A

1.4 to 1.75 mEq/L

92
Q

Mg2+

A

Magnesium

93
Q

Normal Chloride level is

A

96 to 106 mEq/L

94
Q

Cl-

A

Chloride

95
Q

Normal Bicarbonate level is

A

22 to 26 mEq/L

96
Q

HCO3-

A

Bicarbonate

97
Q

Normal Phosphate level is

A

2.5 to 4.5 mEq/L

98
Q

Insulin transports

A

potassium

99
Q

Diabetics may have too much

A

potassium

100
Q

Fluid movement occurs primarily by

A

Osmosis & Filtration

101
Q

Osmosis & Filtration goes from

A

lower to higher

102
Q

Electrolytes move via

A

diffusion, filtration & active transport

103
Q

diffusion, filtration & active transport goes from

A

higher to lower

104
Q

Types of passive transport

A

diffusion, filtration, and osmosis

105
Q

Movement of solvent or solutes (molecule) move from an area of higher concentration to lesser concentration

A

Diffusion

106
Q

Movement of fluid through a semi permeable membrane

A

Osmosis

107
Q

A condition in which the blood has a high concentration of salt (sodium), glucose, and other substances.

A

Hyperosmolar

108
Q

An abnormal decrease in the osmolarity of the body fluids.

A

Hypoosmolar

109
Q

Transfer of water and dissolved substances through a permeable membrane

A

Filtration

110
Q

Occurs within the kidney’s glomerular capillaries

A

Filtration

111
Q

This is the energy required to move substances through the membrane(lesser to greater concentration- the Na K in the cell( sodium –potassium pump)

A

Active Transport

112
Q

Prevents too much sodium in the cell so the cell won’t burst

A

Active transport

113
Q

Force of attraction for water by undissolved particles helps keep fluid within blood vessels

A

Osmotic Pressure

114
Q

Plasma proteins help osmotic pressure

A

– they attract water

115
Q

_____, ______, and ______are major Extracellular substances that help move water between ECF and Cell

A

Sodium, chloride, & Glucose

116
Q

Fluids affect on cell wall

A

Tonicity

117
Q

_______ ________ enters- there is no movement of water across membranes …so cells maintain their normal size

A

Isotonic Solution

118
Q

NORMAL SALINE IS

A

ISOTONIC (0.9% NaCl)

119
Q

NORMAL SALINE causes

A

Vascular expansion, electrolyte replacement

120
Q

concentration is less than blood plasma

A

HYPOTONIC SOLUTION

121
Q

Moves fluid into cells & interstitial space

Cellular dehydration

A

Hypotonic solution

122
Q

Isotonic, Hypotonic, & Hypertonic are

A

Crystalloid Solutions

123
Q

Increase intravascular osmotic pressure (pressure of plasma proteins) within the intravascular space

A

Colloid Solutions

124
Q

Restores serum protein

A

Colloid solutions

125
Q

The pressure gradient pulls fluids into the vascular space.

A

Colloid solutions

126
Q

Normal saline is a

A

Volume expander

127
Q

Saline and electrolyte IV

A

Lactated Ringer

128
Q

IV solution ordered when you lose extracellular volume

A

Lactated ringer

129
Q

Isotonic solution but sugar metabolizes making it a hypotonic solution

A

D5 Water

130
Q

TPN

A

Total Parenteral Nutrition

131
Q

Solution given to alcoholics and anorexics

A

TPN

132
Q

PPN

A

Peripheral Parenteral Nutrition

133
Q

Has 20% to 50% dextrose and a lot of calories

A

TPN

134
Q

Solution that is caustic and thick and given through a central line

A

TPN

135
Q

Solution that is given for cerebral edema

A

Hypertonic

136
Q

Causes filtration from an area of higher pressure to an area of lower pressure

A

Hydrostatic Pressure

137
Q

Is created by the weight or force of a solution e.g.. The pressure caused by BP against the walls of vessels causes fluid to move out depending on the BP

A

Hydrostatic Pressure

138
Q

Hydrostatic pressure minus osmotic pressure and tries to push fluids into tissue spaces

A

Filtration Pressure

139
Q

Adults & Older Adults have decrease ______ in the Kidney

A

Nephrons

140
Q

1 Liter of blood loss need how much solution?

A

3 to 4 bags of solution

141
Q

Normally Fluid & Electrolyte lost are replaced by

A

adequate fluid intake

142
Q

Fluid loss through Respiratory, stool & sweat is called

A

Insensible Loss

143
Q

Average fluid loss through bowel movement

A

200 mL per day

144
Q

Average fluid loss through sweat is

A

100 mL per day

145
Q

ECF volume excess or deficit

A

Fluid imbalance

146
Q

ECF volume influence only the

A

vascular and interstitial compartments

147
Q

No change in _______ with ECF volume imbalances

A

cell volume

148
Q

ECF is a ____% solution

A

0.9%

149
Q

Most critical ECF volume imbalance –

A

ECF deficit

150
Q

Refers to loss of water along with the salt that is normally in the water

A

Isotonic dehydration

151
Q

Saline Deficit

A

Hyponatremia

152
Q

Loss of fluid into a space it doesn’t belong. Has nowhere to go

A

third spacing

153
Q

First sign of third spacing

A

Decreased urine output

154
Q

Signs and symptoms of ECF Volume Deficit

A

Orthostatic/postural changes in Pulse &BP.

Decreased Urine Output

155
Q

Signs and symptoms of decreased interstitial volume

A

Dry mucous membranes & poor skin turgor

Thirst

156
Q

Treatment for ECF Volume Deficit

A

Oral Replacement
IV replacement
Safety

157
Q

Extracellular fluid Volume Excess

A

Cannot be eliminated – causing Edema

158
Q

Signs and Symptoms of Fluid volume excess

A
Rapid weight gain
Increase BP 
Bounding Pulse 
Pulmonary Edema
Neck Vein Distention
Na levels WNL
159
Q

Treatment of of Fluid volume excess

A

Restrict NA & saline & diuretics, find cause

160
Q

Happens when water intake is increased or decreased

Or when water is retained or excreted excessively

A

Water or Osmolality Imbalance

161
Q

Occurs when decrease in H2o intake, an increase in water loss, or excess intake of solute

Serum Na greater than 145 mEq/L

A

Water deficit (ICF Deficit) or Hyperosmolaltiy or Hypernatremia

162
Q

Signs and Symptoms of Hyperosmolality or Hypernatremia

A

Confusion, agitation Seizures, coma maybe death,

163
Q

SIADH

A

Syndrome of inappropriate ADH

164
Q

Treatment for Hyperosmolality or Hypernatremia

A

Replace orally or IV D5W

165
Q

Happens when there is an increase in water intake, abnormal secretion of ADH, or decreased urinary output of water

Serum Na of less than 135 mEq/L

A

Water Excess or Hypoosmolality or Hypnotremia

166
Q

Signs and symptoms of Water Excess or Hypoosmolality or Hypnotremia

A

Lethargy, irritability, confusion personality changes, seizures, coma death

167
Q

Treatment of Water Excess or Hypoosmolality or Hypnotremia

A

water restriction

168
Q

Potassium is maintained by

A

sodium-potassium pump in the cells

169
Q

K+ changes lead to

A

altered excitability of muscles, cardiac cells and neuro

170
Q

Potassium is eliminated by

A

The kidneys

171
Q

______ causes K+ to move out of ECF & into cells esp. skeletal muscle & liver cells!!!

A

Insulin

172
Q

Potassium higher than 5 mEq/L is called

A

Hyperkalemia

173
Q

Hyperkalemia is caused by:

A

renal failure, acidosis, massive tissue injury e.g. burns, self med errors, rapid IV infusion

174
Q

Hyperkalemia signs and symptoms

A

muscle irritability, EKG changes

175
Q

Treatment for Hyperkalemia

A

low Na+ diet, Kayexalate enemas or by po. IV Calcium Gluconate, IV Insulin. Can give diuretics if moderately elevated

176
Q

Hypokalemia is

A

Potassium below 3.5 mEq/L

177
Q

Hypokalemia can be caused by

A

vomiting, diarrhea, diuretics, aldostreone, alkalosis

178
Q

Signs and symptoms of Hypokalemia

A

Impaired neuromuscular transmission which leads to decrease in reflexes, muscle weakness which can lead to muscle paralysis, anorexia, N/V, EKG changed, greater risk of digoxin toxicity

179
Q

Treatment of Hypokalemia

A

Orally with Foods 2000-5500mg daily
Po supplements
IV

180
Q

Phosphorus level below 2.5 is called

A

Hypophosphatemia

181
Q

Hypophosphatemia is caused by

A

Alcoholism, Renal wasting, Uncontrolled diabetes Mellitus

182
Q

Hypophosphatemia signs and symptoms

A

Neuromuscular dysfunction, weakness (especially respiratory muscles), Fatigue, Ventricle dysrhythmias, confusion

183
Q

Hypophosphatemia treatment

A

Treat underlying cause, foods high in phosphorous, oral phosphorous replacement

184
Q

Major functions of Calcium

A

Transmission of nerve impulses, cardiac contractions, blood clotting, formation of teeth & bone, and muscle contraction

185
Q

Calcium is controlled by

A

Vit D, parathyroid hormone, and Calcitonin

186
Q

Patients who’ve had thyroidectomy have problems

A

with calcium

187
Q

Improper absorption from the GI tract, decreased fat soluble vitamins. Pancreatitis no parathyroids renal disease, & massive transfusions

A

Hypocalcemia

188
Q

cells increased excitability- which leads to muscle twitching , tingling & parasthesias of face fingers & toes increased reflexes, chvostek’s sign & tetany

A

Signs and symptoms of hypocalcemia

189
Q

Bone cancer, immobility, excessive antacid use hyperparathyroidism, and increase in Vit D

A

Causes of hypercalcemia

190
Q

impaired nerve and muscle conduction, decreased tone, bone pain, kidney stones(calculi), confusion, memory impairment & lethargy

A

Signs and symptoms of hypercalcemia

191
Q

Causes: prolonged malnutrition, surgery, alcohol abuse

A

hypomagnesium

192
Q

tremors, cramps, increased BP, tachycardia, confusion & convulsions

A

Signs and symptoms of hypomagnesium

193
Q

60% of this goes to the bones and the rest in tissues

A

Magnesium

194
Q

Causes: kidney failure, excess ingestion of laxatives/ antacids

A

Hypermagnesium

195
Q

lethargy, coma when > 2.5, weak, paralysis, decreased reflexes, bradycardia

A

Signs and symptoms

196
Q

Ice cream is considered

A

A liquid

197
Q

Document an excess amount of

A

sweat

198
Q

Plasma osmolality norm

A

280-300 osmos per kg

199
Q

Urine osmolality

A

50 -1200 osmos per kg (the higher, the more dehydrated)

200
Q

Urine specific gravity norm

A

1.010 to 1.020

201
Q

tube feeding is a common cause of

A

dehydration