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Pathophysiology/Pharmacology Across the Lifespan I (NURS-351) > Fluids and Electrolytes > Flashcards

Fluids and Electrolytes Flashcards

1
Q

Acidosis

A

An acid–base imbalance characterized by an increase in H+ concentration

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2
Q

Ascites

A

A type of edema in which fluid accumulates in the peritoneal cavity

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3
Q

Active transport

A

Physiologic pump that moves fluid from an area of lower concentration to one of higher concentration; active transport requires ATP for energy

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4
Q

Alkalosis

A

An acid–base imbalance characterized by a reduction in H+ concentration

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5
Q

Diffusion

A

The process by which solutes move from an area of higher concentration to one of lower concentration; does not require energy

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6
Q

Homeostasis

A

Maintenance of a constant internal equilibrium in a biologic system that involves positive and negative feedback mechanisms

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7
Q

Hydrostatic Pressure

A

The pressure created by the weight of fluid against the wall that contains it.

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8
Q

Hypertonic Solution

A

A solution with an osmolality higher than that of serum. Moves fluid out of cells into the vasculature.

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9
Q

Hypotonic Solution

A

A solution with an osmolality lower than that of serum. Causes fluids to move from interstital spaces into cells. More water, less electrolytes.

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10
Q

Isotonic Solution

A

A solution with the same osmolality as serum and other body fluids. Expands ECF volume.

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11
Q

Osmolality

A

The number of milliosmoles (the standard unit of osmotic pressure) per kilogram of solvent; expressed as milliosmoles per kilogram (mOsm/kg)

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12
Q

Osmolarity

A

The number of milliosmoles (the standard unit of osmotic pressure) per liter of solution; expressed as milliosmoles per liter (mOsm/L); describes the concentration of solutes or dissolved particles

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13
Q

Osmosis

A

The process by which fluid moves across a semipermeable membrane from an area of low solute concentration to an area of high solute concentration; the process continues until the solute concentrations are equal on both sides of the membrane

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14
Q

Tonicity

A

Fluid tension or the effect that osmotic pressure of a solution with impermeable solutes exerts on cell size because of water movement across the cell membrane (hypotonic, hypertonic, isotonic)

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15
Q

Third spacing

A

When fluid moves out of either the intracellular and extracellular spaces and into areas that don’t maintain homeostasis (Ex. edema)

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16
Q

How many compartments do extracellular fluid have? What are they?

A
  1. Intravascular
  2. Interstitial: surrounds the cells
  3. Transcellular: various, often smaller spaces
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17
Q

Sodium Concentration Range

A

135-145 mEq/L

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18
Q

Potassium Concentration Range

A

3.5-5.0 mEq/L

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19
Q

Chloride Concentration Range

A

98-106 mEq/L

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20
Q

Bicarbonate Concentration Range

A

24-31 mEq/L

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21
Q

Calcium Concentration Range

A

8.5-10.5 mg/dL

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22
Q

Phosphorus Concentration Range

A

2.5-4.5 mg/dL

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23
Q

Magnesium Concentration Range

A

1.8-3.0 mg/dL

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24
Q

Osmostic Pressure

A

Amount of pressure needed to stop the flow of water, determined by the concentration of solutes.

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25
Q

Oncotic Pressure

A

Pressure extended by proteins.

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26
Q

Osmotic Diuresis

A

Increase in the urine output caused by the excretion of substances.

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27
Q

Osmoles

A

Particles in our bodies that affect the movement of water

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28
Q

Hyponatremia

A

Serum sodium less than 135 mEq/L

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29
Q

Causes of Hypoatremia

A

Imbalance of water, losses by vomiting, diarrhea, sweating, diuretics, adrenal insufficiency, certain medications, SIADH

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30
Q

Hypernatremia

A

Serum sodium greater than 145 mEq/L. Occurs when there is a gain in sodium or an excessive loss of water.

31
Q

Hypokalemia

A

Potassium serum levels less than 3.5 mEq/L

32
Q

Causes of hypokalemia

A

GI lossses, medications, alterations of acid-base balance, etc

33
Q

Manifestations of hypokalemia

A

ECG changes, dysrhythmias, dilute urine, thirst, muscle weakness etc.

34
Q

Hyperkalemia

A

Serum potassium greater than 5.0 mEq/L

35
Q

Causes of hyperkalemia

A

Impaired renal function, rapid administration of potassium, hypoaldosteronism, medications, tissue trauma, acidosis

36
Q

Manifestations of hyperkalemia

A

Cardiac changes and dysrhythmias, muscle weakness, paresthesias, anxiety, GI manifestations

37
Q

Hypocalcemia

A

Serum level less than 8.5 mg/dL

38
Q

Cause of hypocalcemia

A

Hypoparathyroidism, malabsorption, osteoporosis,
pancreatitis, alkalosis, transfusion of citrated blood, kidney
injury, medication

39
Q

Hypercalcemia

A

Serum level greater than 10.5 mg/dL

40
Q

Causes of hypercalcemia

A

Malignancy and hyperparathyroidism, bone loss related to
immobility, diuretics

41
Q

Clinical manifestations of hypercalcemia

A

Polyuria, thirst, muscle weakness, intractable nausea, abdominal cramps, severe constipation, diarrhea, peptic ulcer, bone pain, ECG changes, dysrhythmias

42
Q

Hypomagnesemia

A

Serum level less than 1.8 mg/dL

43
Q

Manifesations of Hypomagnesmia

A

Apathy, depressed mood, psychosis, neuromuscular irritability, muscle weakness, tremors, ECG changes and dysrhythmias

44
Q

Hypermagnesemia

A

Serum level greater than 3.0 mg/dL

45
Q

Causes of hypermagnesemia

A

Kidney injury, diabetic ketoacidosis, excessive administration of magnesium, extensive soft tissue injury

46
Q

Manifestations of hypermagnesemia

A

Hypoactive reflexes, drowsiness, muscle weakness,
depressed respirations, ECG changes, dysrhythmias, and cardiac arrest

47
Q

Hypophosphatemia

A

Phosphorus Serum level below 2.5 mg/dL

48
Q

Causes of Hypophosphatemia

A

Alcoholism, refeeding of patients after starvation, pain, heat stroke, respiratory alkalosis, hyperventilation, diabetic ketoacidosis, hepatic encephalopathy, major burns, hyperparathyroidism, low magnesium, low potassium, diarrhea, vitamin D deficiency, use of diuretic and antacids

49
Q

Manifestations of Hypophosphatemia

A

Neurologic symptoms, confusion, muscle weakness, tissue hypoxia, muscle and bonevpain, increased susceptibility to infection

50
Q

Hyperphosphatemia

A

Phosphorus Serum level above 4.5 mg/d

51
Q

Causes of Hyperphosphatemia

A

Excess phosphorus, excess vitamin D, acidosis, hypoparathyroidism, chemotherapy

52
Q

Manifestations of Hyperphosphatemia

A

Soft-tissue calcifications, symptoms occur due to associated hypocalcemia

53
Q

Hypochloremia

A

Chlorine Serum level less than 98 mEq/L

54
Q

Causes of Hypochloremia

A

Addison disease, reduced chloride intake, GI loss, diabetic ketoacidosis, excessive sweating, fever, burns, medications, metabolic alkalosis

55
Q

Manifestations of Hypochloremia

A

Agitation, irritability, weakness, hyperexcitability of muscles, dysrhythmias, seizures, coma

56
Q

Hyperchloremia

A

Chlorine Serum level more than 106 mEq/L

57
Q

Causes of Hyperchloremia

A

Excess sodium chloride infusions with water loss, head injury, hypernatremia, dehydration, severe diarrhea, respiratory alkalosis, metabolic acidosis, hyperparathyroidism, medications

58
Q
A
59
Q

Hypovolemia

A

Dehydration or fluid volume deficit

60
Q

Fluid volume deficit

A

Loss of ECF including both serum electrolytes and water are lost in same proportion.

61
Q

Dehydration

A

Dehydration is the rapid loss of body
weight due to the loss of water.

62
Q

Risk Factors for Dehydration

A

Abnormal renal losses
Altered intake
Hyperventilation
Diabetic ketoacidosis

63
Q

Clinical Causes for Fluid Volume Deficit

A

Abnormal GI loss: vomiting, nasogastric suctioning, diarrhea
▪ Abnormal skin loss: diaphoresis
▪ Abnormal renal losses: diuretic therapy, diabetes insipidus renal disease, adrenal insufficiency osmotic diuresis
▪ Third spacing: peritonitis, intestinal obstruction, ascites, burns
▪ Hemorrhage

64
Q

Typical Vital Signs for FVD

A

Hyperthermia, tachycardia, weak pulses, hypotension, tachypnea

65
Q

Fluid Volume Excess

A

Edema
o JVD (distended neck veins)
o Crackles on lung auscultation
o Productive cough
o Weight gain
o Lethargy
o CNS disturbances/changes

66
Q

Colloids

A

Increase vascular space without excess fluid.
* Example: someone who has third spacing meaning more fluid in the interstitial space than intravascular space. Providing
this fluid will draw that fluid back into the vasculature.

67
Q

Types of colloids

A

Albumin, blood, plasma, Dextran 40

68
Q

When to give colloids

A
  1. To increase osmostic gradient
  2. Increase intravacular volume without giving an excessive amount of volume to patient
  3. Hemorrhage
  4. When regulatory organs are compromised
69
Q

Crystalloids types

A

Isotonic, hypotonic, hypertonic

70
Q

When will a isotonic solution be used?

A

In hypovolemic states, shock, mild Na deficit, resuscitative efforts, and hypercalcemia etc

0.9% NaCl is considered normal saline.

71
Q

When are hypotonic solutions used?

A

To treat hyperotnic dehydration, Na+ and Cl- depletion, and gastric fluid loss

0.45% NaCl

72
Q

When are hypertonic solutions used?

A

Used to decrease cellular swelling.

3% and 5% NaCl

73
Q

When to give crystalloids?

A

Patients requring fluid resuscitation and other situations depending on the tonicity of the patient.

74
Q

When to be cautious with fluid resucitation?

A

Organ dysfunction lifke kidney failure, heart failure, pulmonary edema, head trauma, children, and the elderly.

Pathophysiology/Pharmacology Across the Lifespan I (NURS-351) (13 decks)

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