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test 2 > fluids and electrolytes > Flashcards

fluids and electrolytes Flashcards

1
Q

what is the path of extracellular volume regulation

A 
BARORECEPTORS
• SYMPATHETIC NERVOUS SYSTEM
• RENIN ANGIOTENSIN SYSTEM
• VASOCONSTRICTION AND RELEASE OF ALDOSTERONE
• ALDOSTERONE (CONSERVES NA++ AND WATER)
• ANTIDIURETIC HORMONE
• ATRIAL NATRIURETIC PEPTIDE (ANP)
• THIRST- WATER LOSS >2%
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2
Q

Thirts mechanism kicks in at what point

A

water loss great than 2%

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3
Q

hypovolemia know diffrence in subjective and objective finding

A

Ojective

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4
Q

vomting and diuretics can lead to meabolic shift

A

Alkalosis

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5
Q

diarrhea, DKA, shock can lead to what type of metabolic shift

A

acidosis

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6
Q

Patient with WEIGHT GAIN
• INCREASED BP
• EDEMA
• ASCITES
• DECREASED HG, HCT, RBC
• RESPIRATORY ALKALOSIS (PH >7.45, PACO2 < 35)
• CHEST X-RAY-PULMONARY CONGESTION you suspect what type of fluid volume and treat with

A 
hypervolemia
FLUID AND NA RESTRICTION
• DIURETICS
• DIALYSIS
• OXYGEN VIA NASAL CANNULA
• FOLLOWING SUCCESSFUL TREATMENT
• CLEAR LUNGS
• NO S3 OR S4
• NORMAL URINARY OUTPUT
• NORMAL URINE SPECIFIC GRAVITY
• NO EDEMA, NORMAL BP, HR, CVP, AND PCWP
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7
Q

FIRST STEP IN MANAGEMENT hyponatremia

A 
URINE SODIUM (NORMAL 10-20 MEQ/L)
• SERUM OSMOLALITY (USUALLY 2X NA = 280)
• CLINICAL STATUS
• MEASURING URINE SODIUM HELPS TO DETERMINE RENAL FROM NONRENAL
CAUSES
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8
Q

Monitor serum Na how often in symptomatic patients needing sodium correction

A

every 2-4 hours

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9
Q

normals for urine osmolality

A 
URINE SODIUM (NORMAL 10-20 MEQ/L)
•
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10
Q

Normals for serum osmolality

A

SERUM OSMOLALITY (USUALLY 2X NA = 280)

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11
Q

Management of Hypernatremia SEVERE HYPERNATREMIc HYPOVOLEMIa

A

NS iv

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12
Q

1/2 ns and or D5W will allow for what

A

fluid into cells

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13
Q

treatment for hypervolemic hypernatriemia

A

TREAT WITH D5W AND LOOP DIURETICS

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14
Q 
which has the highest potassium; 
Seaweed
avocado
bananas
tomatoes 
lamb
A

seaweed

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15
Q

normal calcim

A

8.5 to 10.5mg/dL

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16
Q

normal ionized Ca

A

4.5 to 5.5mg/dL

17
Q

elderly person comes in with low albumin what else would you expect ot be low and what the best way to check this level

A

Ca will be low so need to check ionized ca

18
Q

Acidemia increase or decrease ionized calcium

A

increases ionized calcium

19
Q

patient getting multiple blood transfusions you expect ca to go

A

low

20
Q

Over use of thiazide diuretics affect ca in what way

A

hypercalcemia

21
Q

ca greater than 12mg?dl

A

IF >12 MG/DL –NS INFUSION WITH LOOP DIURETICS
• TEACHING ABOUT DIET, FLUID INTAKE, SIGNS AND SYMPTOMS, PAIN
CONTROL

22
Q

Hypercalcemia management medication for impaired renal or cardiovascular problem

A

calcitonin

23
Q

Hypercalcemia can be managed with Dialysis true or False

A

True

24
Q

chronic alcoholic suspect impaired intestinal absorbtion leading to low VitD and lead you to suspect low

A

phosphorus, Hypophosphatemia

25
Q

Causes of hypophosphatemia

A

phosphorus <2.8mg/dL
refeeding syndrome (
insulin spike
hungrey bone syndrome

Increased renal secreation with high PTH
osmotic diuretic
rickets
renal proximal tubular disorder
Fanconi syndrome
inpaired intestinal absorption
vit D deficiency
chronic alcoholism
26
Q

Phosphorus level <1mg/dL cause end organ effects due to lack of

A

adenosin triphosphate; effects all muscles

27
Q

urine phosphorus excretion of >100mg in 24 hours mean

A

high loss of phosphorus hypophosphatemia

28
Q

what is molarity

A

moles per liter of solution

29
Q

what is molality

A

moles per liter of solvent

30
Q

what is diffusion

A

movement of particles or molecules from an area of high concentration to an area of low concentration

31
Q

Membrane that allows certan materials to pass throughbut not other

A

selective permeable membrane

32
Q

A dexcription of the relative solute concentration in a soultion as compred to another solution

A

tonicity

33
Q

solution with higher concentratoin than other

A

hypertonic

34
Q

solution with lower concentration than other

A

hypotonic

35
Q

diffusion regulated by protein channels in the membran and requires no energy input from cell

A

facilitate diffusion

36
Q

movement of molecules or ion into or out of cells against it concentration gradietn from low to high and requires an input of enrey

A

active transport

test 2 (13 decks)

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