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Pathophysiology NP > Fluids & Electrolytes, Acids & Bases > Flashcards

Fluids & Electrolytes, Acids & Bases Flashcards

1
Q

Net Filtration

A

Forces favoring filtration - forces opposing filtration

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2
Q

Capillary hydrostatic pressure

A

blood pressure

-facilitates the outward movement of water from the capillary to the interstitial space

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3
Q

Capillary oncotic pressure

A

osmotically attracts water from the interstitial space back into the capillary.

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4
Q

Interstitial hydrostatic pressure

A

facilitates the inward movement of water from the interstitial space in to the capillary

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5
Q

Interstitial oncotic pressure

A

osmotically attracts water from the capillary into the interstitial space

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6
Q

Forces that favor filtration

A

-capillary hydrostatic pressure
-interstitial oncotic pressure

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7
Q

Forces that oppose filtration

A

-capillary oncotic pressure
-interstitial hydrostatic pressure

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8
Q

Causes of Edema

A
  1. venous or lymphatic obstruction
  2. increased vascular volume (increased hydrostatic pressure)
  3. plasma protein loss
  4. increased capillary membrane permeability (decreased plasma oncotic pressure)
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9
Q

Effusion

A

Fluid accumulation in a body cavity or space (aka third space)

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10
Q

Difference between interstitial fluid, extra cellular fluid and transcellular fluid

A

Interstitial fluid: fluid surrounding the cells and found in the spaces between cells but not within blood vessels

Extracellular fluid: fluid outside the cells including interstitial, intravascular and transcellular fluids.

Transcellular: fluids contained in epithelial-lined cavities (pleural, synovial, peritoneal, pericardial, intraocular, gastric juice, saliva, bile, pancreatic juice, ileal fluid, cecal fluid, CSF and sweat)

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11
Q

What is the difference between a volatile and non volatile acid

A

Volatile: can be eliminated as CO2 gas

Nonvolatile: can only be eliminated by the kidney

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12
Q

Difference between acidemia and acidosis

A

Acidemia: state in which the pH of arterial blood is less than 7.35

Acidosis: systemic increase in H+ concentration or a loss of base

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13
Q

What regulates sodium?

A

Aldosterone which is controlled by
renin and angiotensin enzymes

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14
Q

Osmolarity vs Osmolality

A

Osmolarity: number of osmoles of solute per L of solution

Osmolality: number of osmoles of solute per KG of solution

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15
Q

Causes of hyperchloremia

A

Hypernatremia & elevated bicarbonate concentrations

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16
Q

What is the predominant EXTRA cellular fluid electrolyte

A

Sodium

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17
Q

What is the predominant INTRA cellular fluid electrolyte

A

Potassium

18
Q

What are the 5 essential functions of calcium

A
  1. bone structure
  2. blood clotting
  3. hormone secretion
  4. function of cell receptors
  5. membrane stability
19
Q

Phosphate

A

-buffer in acid-base balance
-energy for muscle contraction

20
Q

HYPOcalcemia
Value & causes

A

<9.0mg/dL

Causes:
1. inadequate absorption
2. deposition into bone or soft tissue
3. blood administration
4. decreased PTH and Vit D

21
Q

HYPERcalcemia
Value & causes

A

> 10.5mg/dL

causes:
1. hyperparathyroidism
2. bone metastases
3. sarcoidosis
4. excess vit D

22
Q

HYPOphosphatemia
Value & Causes

A

<2.0mg/dL

causes:
1. intestinal malabsorption
2. increased renal excretion

23
Q

HYPERrphosphatemia
Value & Causes

A

> 4.7mg/dL

Causes:
acute or chronic renal failure with loss of GF

24
Q

HYPOmagnesmia
Value & Causes

A

<1.5mEq/L

Causes: malabsorption

24
Q

HYPERmagnesmia

A

> 3.0 mEq/L

causes: renal failure (still rare)

25
Q

What are the primary plasma pH buffers

A
  1. bicarbonate
  2. phosphate
  3. protein (Hb)
26
Q

What is the sole volatile acid

A

carbonic acid

27
Q

What are the nonvolatile acids (5)

A
  1. Lactic acid
  2. phosphoric acid
  3. sulfuric acid
  4. acetoacetic acid
  5. beta-hydroxybutyric acid
28
Q

Aquaporins

A

Family of water channel proteins that provide water permeability

29
Q

Hypovolemic HYPERnatremia
What it is and causes

A

It is: loss of Na is accompanied by a relatively greater loss of body water.

Causes: look diuretics, diuretic stages or renal disease, osmotic diuresis from DM hyperglycemia or mannitol.

30
Q

Isovolemic HYPERnatremia

A

Loss of electrolyte free water with a near normal sodium concentration.

causes: inadequate H2O intake, excessive sweating, fever with hyperventilation, increased water loss from lungs, burns, vomiting, diarrhea and DI (central or nephrogenic)

31
Q

HYPERvolemic HYPERnatremia

A

increase in TBW with a greater increase in total body Na –> hypervolemia with high Na.

causes: hypertonic saline, over secretion of ACTH or aldosterone, or deliberate over consumption (salt water or soy sauce)

32
Q

HYPERnatremia
Clinical symptoms, evaluation and treatment

A

Sx: Weakness, lethargy, hyperreflexia, muscle twitching, confusion, coma and seizures

Eval: lab tests, H&P. serum Na >145 & urine specific gravity > 1.030, Hct & plasma protein will be elevated if water loss

Treatment: isovolemic and hypovolemic hypernatremia is H2O PO or D5 SLOW!

Hypervolemic hypernatremia is loop diuretics. (frequent Na checks)

33
Q

Isovolemic HYPOnatremia

A

loss of Na without significant loss of water

Causes: water retention SAIDH, hypothyroidism, PNA, glucocorticoid deficiency.

34
Q

Dilutional hypotonic hyponatremia (water intoxication)
Causes

A

intake of large amounts of electrolyte free water or replacement of fluid loss with D5, tap water enemas, aspiration of fresh water in nonfatal drowning, SSRIs and SAIDH.

35
Q

HYPERvolemic HYPOnatremia
Definition and causes

A

total body Na is increased AND there is excess water –> increase in ECF decreasing serum Na.

causes: heart failure, cirrhosis, nephrotic syndrome.

36
Q

HYPERtonic HYPOnatremia
Definition and causes

A

Shift of water from the ICF to the ECF. Osmotic fluid shift to the ECF dilutes the concentration of Na and other electrolytes

Causes: hyperglycemia, hyperlipidemia, and hyperproteinemia.

37
Q

Hyperchloremia
Value and causes

A

<97mEq/L

causes: with hyponatremia, elevated bicarbonate, metabolic alkalosis, restricted NaCl intake, diuretics, vomiting, Cystic fibrosis.

38
Q

Potassium adaptation

A

ability of the body to adapt to increased levels of K+, sudden increases can be fatal but slow intake

39
Q

Familial hypokalemic periodic paralysis

A

Rare genetically transmitted disease that causes potassium to shift into the intracellular space with episodes of extreme muscle weakness.

40
Q
A

Pathophysiology NP (3 decks)

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