FLUIDS, ELECTROLYTES, ACID/ BASE BALANCE

Question 1

SERUM NORMAL RANGES…

a. sodium
b. potassium
c. magnesium

Answer 1

a. 135-145 mEq/L
b. 3.5-5.0 mmol/L
c. 0.70-0.95 mmol/L

Question 2

SERUM NORMAL RANGES…

a. calcium
b. phosphate
c. chloride
d. bicarbonate

Answer 2

a. 2.20-2.55 mmol/L
b. 0.83-1.3 mmol/L
c. 98-107 mEq/L
d. 22-26mEq/L

Question 3

what is hypovolaemia? causes?

Answer 3

it is FLUID LOSS.

CAUSES: trauma, dehydration, diarrhoea, vomiting, sweating, haemorrhage, diuretics, excessive urination

Question 4

what is hypervolaemia? causes?

Answer 4

it is FLUID OVERLOAD.

CAUSES: excess fluid intake, over infusion of IV fluids, renal failure, congestive heart failure, high sodium intake

Question 5

factors that increase the risk of a fluid or electrolyte imbalance?

Answer 5

diabetes
hypertension
elderly population 
infants 
significant burns
significant trauma (broken bones) 
heart failure
alcohol abuse 
heat exhaustion 
eating disorders

Question 6

normal pH range?

Answer 6

7.35-7.45

Question 7

how do we identify acid-base status?

Answer 7

1. ASSESS pH: if low= acid, if high= alkalosis
2. ASSESS C02: if C02 outside normal range + going opposite direction to pH= RESPIRATORY cause
   if C02 normal or outside going the SAME way to pH= METABOLIC issue
3. ASSESS HC03: if ok= not metabolic problem, if high it is a metabolic problem

REMEMBER ROME: RESPIRATORY OPPOSITE, METABOLIC EQUAL

Question 8

What can be the cause of respiratory acidosis?

Answer 8

inadequate function of the lungs which causes arteriole CO2 to accumulate

Question 9

what can be the cause of metabolic acidosis?

Answer 9

excessive production of metabolic acid
ingestion of acid
decreased ability of the kidneys to excrete acids

Question 10

what can be the cause of metabolic acidosis?

Answer 10

excessive production of metabolic acid
ingestion of acid
decreased ability of the kidneys to excrete acids
lactic acidosis

Question 11

what causes respiratory alkalosis?

Answer 11

anxiety
hyperventilation
hysteria
sepsis

Question 12

what causes metabolic alkalosis?

Answer 12

vomiting
diuretics
excessive use of antacids

Question 13

how does the body correct metabolic acidosis?

Answer 13

CHEMICAL: acid combines w/ bicarbonate to neutralise the acid (CREATES CARBONIC ACID)
RESPIRATORY: carbonic acid gets broken down into CO2 AND H2O, the lungs can then excrete the CO2 through HYPERVENTILATION (therefore reducing the acidity of the body)

Question 14

acid + bicarbonate =

Answer 14

carbonic acid.

which can be broken down into C02 AND H2O

Question 15

how does the respiratory system help regulate blood pH?

Answer 15

by blowing off CO2

Question 16

what are the stages of hypovolaemic shock?

Answer 16

1. compensated shock- low blood flow detected- HR increases, blood vessels constrict, kidneys retain fluid
2. progressive/ uncompensated shock- compensation begins to fail, pts syx reflect this- O2 deprivation, sats drop, pt confused and disorientated
3. irreversible shock- long time of poor perfusion- begins to take a permanent toll on pts organs and tissues

Question 17

hyponatraemia vs hypernatraemia? s+s?

Answer 17

hypo: low levels of sodium (defect in na or water excess)
s+s= pale skin, dry mucous membranes, tachycardia, hypotension, muscle weakness, N+V, confusion

hyper: high sodium/low water
s+s= flushed dry skin, tachycardia, increased muscle tone, polyuria,

Question 18

hypokalaemia vs hyperkalaemia? s+s?

Answer 18

hypo: low levels of potassium
causes: crash diets, gi fluid loss,
s+s= constipation, lethargy, muscle weakness, cardiac arrest

hyper: