Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CNSC Exam > Fluids and Electrolytes > Flashcards

Fluids and Electrolytes Flashcards

1
Q

major extracellular electrolytes

A

Sodium (142 mEq/L), Chloride (103 mEq/L), Calcium (2.4 mEq/L)
Bicarb (28 mEq/L)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

major intracellular electrolytes

A

Potassium (140mEq/L), Magnesium (58 mEq/L), Phosphate (74 mEq/L)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

% extracellular body water

A

1/3 (33%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

% intracellular body water

A

2/3 (67%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

% body water for an adult male

A

60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

% body water for an adult female

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

% body water for an elderly male

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

% body water for an elderly female

A

45%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what weight should be used to estimate total body water in obesity

A

ideal body weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

insensible water gains

A

water oxidation of metabolism (250mL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

total water gain in healthy adult

A

1.5-2.5 Liters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

sensible water gains

A

oral fluid intake (800 mL to 1.5 L) and water from solid foods (500-700mL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

total water loss in healthy adult

A

1.5-2.5 liters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

sensible water loss

A

urine output (800-1.5 L) and GI output (0-250mL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

insensible water loss

A

skin (600-900mL) and lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Where does fluid gain occur during digestion

A

saliva, food/drink, bile, pancreatic fluid, small bowel fluid, gastric fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how much water is reabsorbed total from digestion

A

6.5 Liters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how much fluid is created daily from saliva

A

1.5 Liters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how much water is gained total from digestion

A

8.5 liters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

the stomach typically produces _____ L of fluid

A

2 liters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how much fluid is reabsorbed in the colon

A

1.9 liters (out of 2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

a patient has tented/dry skin, with dry mucous membranes, has increased heart beat (tachycardia), decreased blood pressure and urinary sodium above 20 they are likely

A

dehydrated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how to calculate fluid maintenance (adults and children over 5 years old)

A

4,2,1 or 100,50,20 method

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

calculate fluid maintenance for a 60 kg male (4,2,1 method)

A

4mL x 10 kg = 40mL/hr
2mL x10 kg = 20mL/hr
1mL x 40kg = 40mL/hr
Total 100mL/hr x 24 hours = 2.4 Liters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

calculate fluid maintenance for a 60 kg male (100,50,20 method)

A

100mL x 10 kg = 1000mL
50mL x 10kg = 500 mL
20mL x 40 kg= 800 mL
Total = 2300mL/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Fever, excessive sweating , hyperventilation and hyperthyroid _____ fluid needs

A

increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

abnormal shifts of fluid from the intravascular space (blood vessels) into the interstitial fluids (the tissues)

A

Edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

common causes of edema

A

decreased cardiac output, hypotension, decreased urine output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

when you have edema, you are considered in a state of water

A

loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

conditions that can cause 3rd spacing

A

bowel obstruction, peritonitis, acute pancreatitis, ascites in liver/renal function, trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

isotonic IV fluids

A

Normal Saline with Dextrose or balanced crystalloids (LR, plasmalyte)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

should post op major abdominal surgical patients have liberal or restricted fluids in the 1st 24 hours post op

A

liberal fluids to prevent AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

water deficit calculation

A

(Current Na - Desired Na / Desired Na) x %body water x body weight (kg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Causes of primary hypervolemia

A

poor renal function leading to sodium retention and extracellular fluid expansion to preserve blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

causes of secondary hypervolemia

A

CHF, cirrhosis, excessive IV administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

symptoms of hypervolemia

A

weight gain, edema, ascites, pulmonary effusion, rales, distended jugular veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

the primary extracellular cation is

A

sodium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

the primary anion of the ECF is

A

chloride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

the primary cation of the ICF is

A

potassium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

the primary anion of the ECF is

A

phosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

non-electrolyte components of body fluids that do not dissociate in solution are

A

glucose, urea and creatinine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

when levels of cations and anions are in equal amounts is called

A

electroneutrality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

electroneutrality is maintained by

A

buffering systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

a patient that has high loses via NG suction of about 2L a day would likely benefit from the replacement of ___ to maintain homeostasis

A

chloride

45
Q

if a patient has high losses from diarrhea they would likely benefit from the replacement of ____ to maintain homeostasis

A

bicarb, alkaline solutions

46
Q

the most common cause of hypernatremia

A

inappropriate/inadequate provision of fluids

47
Q

increased blood glucose of hypertonic sodium free IV fluids can cause

A

hypertonic hyponatremia

48
Q

when glucose is high, sodium will be artificially low because

A

hyperglycemia is a hypertonic state intracellular water shifts out from inside the cell into the vascular space causing dilutional hyponatremia

49
Q

for ever 100mg/dL increase in serum glucose from normal, serum Na decreases by

A

1.6 mEq/L

50
Q

the most common cause of hyponatremia is

A

excess water provision

51
Q

sodium is largely regulated by this organ _____ and this hormone_____

A

kidney, aldosterone (vasopressin)

52
Q

aldosterone hormone causes ____ to be reabsorbed in the distal renal tubule in response to a change in sodium/volume status

A

sodium

53
Q

serum ____ is essential to assess the cause and treatment of low sodium

A

osmolality

54
Q

fatigue, weakness and muscle twitching are signs of symptomatic

A

hyponatremia

55
Q

Normal Saline (IV) provides ____ sodium per liter

A

154 mEq/L

56
Q

Hypernatremia is always associated with a __ state. Free water moves from the ICF to the ECF causing dehydration

A

hypertonic

57
Q

dry mucous membranes, hypotension, oliguria, tachycardia and decreased skin turgor are symptoms of

A

dehydration

58
Q

calculate the free water deficit of a 70 kg man with a serum sodium of 158

A

5.4 L (to 140mEq/L) 1.6 L (to 152 mEq/L)

59
Q

Phosphorous is the primary ____ anion

A

intracellular

60
Q

Phosphorous maintains the _____ cellular fluid, normal muscle/nervous function and important in metabolic pathways

A

intracellular

61
Q

nervous system dysfunction, respiratory failure, decreased levels of 2,3-diphosphoglycerate and muscle weakness can be caused by

A

hypophosphatemia

62
Q

reasons for elevated phosphorous

A

renal failure, metastatic calcification of soft tissue/blood vessels cellular destruction from trauma, cytotoxic medications, severe rhabdomyolysis

63
Q

Optimal total serum phos and calcium should be a

A

55

64
Q

the most common clinical manifestation of hyperphosphatemia is ___ caused by hypocalcemia d/t calcium phosphate precipitation

A

tetany

65
Q

a patient with hypokalemia should also be assessed for what electrolyte

A

hypomagnesemia (magnesium regulates intracellular potassium)

66
Q

when hypokalemia co-exists with hypokalemia and hypomagnesemia replete which first

A

magnesium

67
Q

the following electrolyte disturbance can cause a deficit of hydrogen ions in the ECF precipitating in alkalosis

A

hypokalemia (potassium is on the inside of the cell normally, if low, protons will pump in potassium to correct causing a deficit of hydrogen ions into the ECF)

68
Q

this electrolyte is integrating maintaining cell volume , hydrogen ion concertation, enzyme function, neuromuscular /cardiac function and cell growth

A

potassium

69
Q

clinical manifestations of hypokalemia

A

cardiac arrhythmia, muscle weakness, ileus, EKG changes and paralysis

70
Q

renal failure, rhabdomyolysis and acidosis can all cause

A

hyperkalemia

71
Q

common causes of hypomagnesemia (3)

A

inadequate GI absorption, refeeding syndrome and DKA

72
Q

DKA lowers serum hypomagnesemia because

A
  1. increased renal excretion during diuresis from high blood glucose
  2. shifting of magnesium into the cells by insulin
73
Q

when maintained slightly above normal serum concentrations, which of the following electrolytes reduces the amount of potassium required in critically ill patients

A

magnesium

74
Q

a patient getting a standard enteral feeding constantly has a magnesium level of 3.0 mEq/L. A prudent first step would to be

A

ensure that medications with supplemental magnesium have been held

75
Q

causes of hypermagnesemia

A

renal failure ,excessive use of laxatives’ as they contain large amounts of magnesium (milk of magnesia)

76
Q

low levels of serum calcium stimulates the release of this hormone which increases bone resorption, stimulates renal conservation of calcium and activates vitamin D (in turn increasing the absorption of calcium in the GIT)

A

parathyroid hormone

77
Q

in response to elevated levels of serum calcium, the ____ releases ___ hormone which inhibits bone resorption

A

thyroid, calcitonin

78
Q

Adjust the calcium for a patient with an albumin of 2.4 and calcium of 6.9

A

8.2

79
Q

in the absence of excessive exogenous provision of calcium in a patient with normal renal function, the most common cause (s) of hypercalcemia are

A

hyperparathyroidism and bone cancer

80
Q

decreased vitamin D, decreased PTH activity after thyroidectomy/parathyroidectomy, massive soft tissue damage 2/2 trauma ,infection , or multiple blood transfusions 2/2 citrate binding of this element causes _____

A

calcium, hypocalcemia

81
Q

in the setting of critical illness or injury, a patient has decreased UOP, hypotension, tachycardia, high urinary specific gravity, high osmolality, elevated Cr, poor skin turgor with minimal if any changes in body wt. The clinician should consider this change in body fluid

A

third spacing

82
Q

Third spacing and critical illness/trauma

A

traumatic injury results in redistribution of intravascular fluid into the area of injury, therefore decreasing intravascular fluid volume, Sepsis produces generalized capillary leak, causing larger molecules such as proteins to readily pass through membranes, precipitating a disruption of oncotic pressure allowing the ICF to leak out of the cells

83
Q

what are therapies used for standard care to treat third spacing

A

IV LR/normal saline, blood transfusion, correction of underlying cause

84
Q

the most appropriate enteral formula for a patient with SIADH is

A

a concentrated formula (low in water)

85
Q

the syndrome of inappropriate antidiuretics hormone (SIADH) is likely to present as

A

hyponatremia

86
Q

hallmark signs of SIADH

A

low sodium, increased urine sodium and increased osmolarity

87
Q

Euvolemic body with total body water overload d/t inappropriate concentration of the urine

A

SIADH

88
Q

elevated serum sodium, flat neck veins, dry mucous membranes are signs of

A

dehydration

89
Q

the preferred oral rehydration solution should be/contain

A

isotonic, with sodium and glucose/carbohydrate

90
Q

oral rehydration solutions decrease _____ in short bowel syndrome

A

dehydration

91
Q

this type of fluid is readily absorbed from the jejunum

A

sodium chloride

92
Q

saline water is not absorbed well from commercially available rehydration solutions because they are hypotonic true or false

A

true

93
Q

optimal sodium level (in mmol/L) of sodium in oral rehydration solutions

A

90mmol/L

94
Q

____ in oral rehydration solutions is an important component because it promotes sodium/water absorption by acting as a transporter

A

glucose

95
Q

this disorder is represented by hypernatremia with high urine output from 4-12L /day

A

Diabetes Insipidus

96
Q

electrolyte abnormalities after feeding after starvation is called

A

refeeding syndrome

97
Q

in the early phase of refeeding syndrome excessive sodium and fluid intake causing

A

fluid overload, pulmonary edema, cardiac decompensation

98
Q

the three labs depleted in refeeding syndrome

A

hypomagnesemia, hypophosphatemia, hypokalemia

99
Q

chronic starvation/alcoholism, anorexia/malabsorption, morbid obesity with weight loss and AIDS/Cancer patients are all at risk for

A

refeeding syndrome

100
Q

A cachectic 42 year old F is re admitted 2 weeks s/p ex lap with post op SBO. She has lost an additional 8% of her body weight since her first admit to the hospital. She undergoes surgical repair of the obstruction and has a naso-enteric feeding tube placed in the OR. Upon initiation of nutrition support which of the following would be a major concern

A

refeeding syndrome

101
Q

a patient getting normal saline at 75mL/hr with 20mEq KCl/L provides how many mE1 of sodium and _ mEq potassium chloride

A

154 mEq sodium (154 x 1.8)

36 mEq potassium (20 X 1.8 )

102
Q

Lactated Ringers fluid is most similar to ____ fluid

A

jejunal fluid

103
Q

Electrolytes of the GI tract Jejunum (Na, K, Cl, Bicarb)

A

Sodium: 95-120 mEq/L
Potassium: 5-15 mEq/L
Chloride: 80-130 mEq/L
Bicarb 10-20 mEq/L

104
Q

Electrolytes of the GI tract Ileum (Na, K, Cl, Bicarb)

A

Sodium: 110-130 mEq/L
Potassium: 5-15 mEq/L
Chloride: 90-110 mEq/L
Bicarb: 20-30 mEq/L

105
Q

Electrolyte Composition of Lactated Ringers

A 
Na: 130 mEq/L
Potassium: 4 mEq/L 
Chloride: 109 mEq/L
Lactate: 28 mEq/L
Calcium 2.7-7.7 mEq/L
106
Q

1/2 Normal Saline (0.45%) provides ___ mEq of sodium and ___ mEq of chloride

A

77 mEq sodium

77 mEq chloride

107
Q

Normal Saline (0.9%) provides __ mEq/L of sodium and __ mEq/L of chloride

A

154 mEq sdoium

154 mEq chlroide

108
Q

D5W + 1/2 Normal Saline (0.45%) provides ___g/L dextrose, ___ mEq/L Sodium, and ___ mEq/L chloride

A

50 g/L dextrose
77mEq/L sodium
77mEq/L chloride

CNSC Exam (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions