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CNUR 203 > Intro - Full > Flashcards

Intro - Full Flashcards

1
Q

What makes 42% of our total body weight?

A

Intracellular

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2
Q

What makes 17% of our body weight?

A

Extra cellular fluid?

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3
Q

What provides the cells with nutrients?

A

Intracellular

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4
Q

What transports chemicals across the cell membrane?

A

Intracellular

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5
Q

What includes interstitial fluid?

A

Extra cellular

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6
Q

Included intracellular vascular fluid?

A

Extra cellular

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7
Q

How much fluid is in the human body?

A

60% 4L of fluid

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8
Q

What is the interstitial space?

A

Space bw cells

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9
Q

What is intravascular space?

A

Space between bw blood vessels

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10
Q

What is trans cellular fluid?

A

All other fluid in the body

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11
Q

What does 1st, 2nd and 3rd spacing mean?

A

1st: Normal fluid
2nd: too much fluid in Interstitial space (edema usually)
3rd: fluid residing in abdominal space that can’t be used in the body

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12
Q

What is the best way to measure a change in a persons fluid status?

A

Weighing them. 1L = 1kg of weight

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13
Q

What is diffusion? What kind of a process is it?

A

Moving molecules from areas of high to low concentration. It’s a passive process, meaning it requires no energy

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14
Q

What is osmosis? What kind of a profess is it?

A

Movement of water across a cell from a low concentration to a high concentration of solutes across a semi permeable membrane. It is a passive process.

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15
Q

What are sterling forces?

A

Forces that control movement of fluids between compartments and help keep fluids where they belong.

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16
Q

What types of pressure is exerted inside capillaries?

A
  • capillary hydrostatic pressure: blood pressure

- capillary oncotic pressure (pressure exerted by solute concentrations in fluid)

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17
Q

What types of pressure are exerted outside the capillaries ?

A

Interstitial hydrostatic pressure: pressure from fluid itself
Interstitial oncotic pressure

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18
Q

What are the two main types of IV fluids?

A

Crystalloids and colloids

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19
Q

What kind of molecules are in crystaloids?

A

Small that are easily dissolved in a solution

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20
Q

How do crystalloids vary in solutes?

A

They can be electrolytes (sodium) or non electrolytes (dextrose)

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21
Q

What are crystalloids relationship with semi permeable membrane?

A

Move easily across it

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22
Q

What’s an example of a crystalloid?

A

NS, RL

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23
Q

What kind of molecules do colloids have and what is their rs with semi permeable membrame?

A

Large molecules that can’t pass thru semi permeable membranes

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24
Q

Where do colloids reside?

A

In intravascular space

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25
Q

Example of colloid

A

Albumin and fresh frozen plasma

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26
Q

How do isotonic solutions affect the cell?

A

Osmotic pressure inside and outside the cell remains constant so size of cell is not affected

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27
Q

Where do isotonic solutions reside and how are they distributed?

A

In extracellular space and is distributed bw intravascular and interstitial compartments

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28
Q

How do isotonic solutions affect the intravascular blood volume?

A

Increases it

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29
Q

What are example of isotonic solutions?

A

0.9 NaCl
RL
D5W

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30
Q

When should isotonic solutions be used?

A 
Hemorrhage
GI losses
Shock 
Burns 
Trauma 
Any fluid resuscitation 
Fluid volume deficit
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31
Q

What is a hypotonic solution

A

Caused fluid to shift out of vascular space and into the interstitial and intracellular spaces.

Hydrates cells

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32
Q

What are examples of hypotonic solutions?

A
  1. 45% sodium chloride
  2. 5 dextrose in water
  3. 33% sodium chloride
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33
Q

When should hypotonic solutions be used?

A

Intracellular dehydration
Diabetic ketoacidosis
Promote renal excretion when there is excess water and electrolytes

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34
Q

What is a hypertonic solution?

A

Pulls fluid out of the cells

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35
Q

How does a hypertonic solution affect intravascular space?

A

Expands it, volume expander

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36
Q

What are examples of hypertonic solutions?

A

5% dextrose in 0.45% NaCl and 0.9% NaCl
25% albumin
3% NaCl
10% dextrose

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37
Q

When should hypertonic solutions be used?

A

Cerebral edema, severe hyponatremia

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38
Q

What is hypovolemia?

A

Low circulating blood volume in intravascular and interstitial spaces from loss of sodium or fluid

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39
Q

How do pt lose fluid?

A

GI: diarrhea, vomiting, NG suction, bleeding p
Urinary: drug therapy, hyperglycaemia, diabetes
Integumentary: burns, diaphoresis, increased capillary permeability
Other: hemorrhage, wound drainage

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40
Q

What is fluid volume deficit (fvd)

A

Volume within the vessels is low

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41
Q

What happens to cells during a state of hypovolemia

A

Intracellular dehydration bc fluid shifts out of the cells to increase intravascular volume

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42
Q

What is fluid volume excess?

A

Hypervolemia or fluid overload. It is over hydration of the intravascular compartment.

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43
Q

What happens to fluid as a result of fluid volume excess?

A

Fluid is pushed out from vascular space and into interstitial spaces

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44
Q

How do we know FVE has resolved?

A 
Stable CV with low BP
Dieresis 
Balanced intake and output, weight loss 
Decreased edema
Improving lung sounds 
Improved mental status 
Stabilizing blood work
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45
Q

What is included in a CBC?

A 
RBC count 
Hemoglobin 
Hematocrit 
WBC 
Platelet count
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46
Q

What is RBC primary function?

A

Carry o2 in the bloodstream

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47
Q

How does a hemorrhage relate to RBC count?

A

Low RBC value

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48
Q

How does hemolysis relate to RBC value? And what is it

A

Hemolysis: rupturing of RBC

Low RBC value

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49
Q

How does bone marrow failure relate to RBC value?

A

Low RBC value

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50
Q

How does hemoconcentration relate to RBC value?

A

High RBC value

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51
Q

How does hypoxia relate to RBC value and why?

A

High blood count bc hypoxia increases of EPO levels which stimulate the production of mature RBC from the bone marrow

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52
Q

How do ingestion of drugs affect RBC count?

A

Low RBC value

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53
Q

How do dietary deficiencies relate to RBC value?

A

Low RBC Value

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54
Q

How does hemodilution relate to RBC value? Why

A

Low RBC value. Hemodilution means to remove RBC.

55
Q

What is hemoglobin?

A

The protein in RBC that carries O2 around the body and it carries iron.

56
Q

What happens when hemoglobin is too low?

A

CV system is strained leading to risk of angina, MI, HF and stroke

57
Q

What happens when hemoglobin is too high?

A

Risk of stroke and organ infarction

58
Q

What is hematocrit?

A

Total volume percentage of RBC in blood

59
Q

What are the five types of WBC?

A 
Lymphocytes 
Neutrophils
Monocytes 
Eosinophils 
Basophils
60
Q

What do neutrophils relate to?

A

Bacterial infections

61
Q

What d lymphocytes relate to?

A

Chronic infections and viral infections

62
Q

What do monocytes relate to?

A

Acute infections and chronic inflammatory conditions

63
Q

What do eosinophils relate to?

A

Allergic reactions

64
Q

What do basophils relate to?

A

Thyroid disorders

65
Q

Why would WBC levels be low?

A 
Drug toxicity 
Overwhelming infections 
Dietary deficiency 
Autoimmune disease 
Stress
66
Q

What are platelets ? What are they also called?

A

Thrombocytes. They circulate in the blood and bind together to form a clot over the damaged blood vessel.

67
Q

What is it called when there are low levels of platelets?

A

Thrombocytopenia

68
Q

Where is thrombocytopenia found in?

A

Hemorrhage, leukemias, lupus, pernicious, hypersplenism, cancer chemotherapy

69
Q

What is it called when platelet levels are too high?

A

Thrombocytosis?

70
Q

What are electrolytes?

A

Positive and negative electrically charged ions/salts dissolved in bodily fluids and dispersed throughout the body into all compartments

71
Q

What do electrolytes do?

A

Produce energy
Help with electrical conduction
Help your nerves and muscles to function
Regulate acid base balance
Help to regulate the extracellular and intracellular fluid balance

72
Q

What happens when there is an electrolyte imbalance?

A

Negative effects on all body systems

Our cells won’t function without them

73
Q

What are the main extracellular electrolytes?

A

Sodium
Chloride
Calcium

74
Q

What are the main intracellular electrolytes?

A

Potassium
Magnesium
Phosphorus

75
Q

What is the most abundant cation in extracellular fluid?

A

Sodium

76
Q

What is sodium’s relationship with volume and how does it affect ECF volume?

A

Attracts water

77
Q

Sodium imabalances mean

A

Fluid imbalance

78
Q

Where is sodium absorbed? Excreted?

A

Intestines

Kidneys

79
Q

What does sodium work with? And what do they do?

A

Works with potassium to maintain electrolyte balance between inside and outside of cells (sodium potassium pump)

80
Q

What is the most common electrolyte disorder in hospitalized pts and post ops?

A

Hyponatremia

81
Q

What is hyponatremia?

A

Pt has too much fluid in the vessels and thus sodium is over diluted and low. Now there’s a higher concentration of sodium in the cells and water will flow where salt is causing edema.

82
Q

What is the goal for treating hyponatremia?

A

Replace and normalize serum sodium.

83
Q

How is mild hyponatremia treated?

A

Dietary sources

84
Q

What kind of fluid is given to hyponatremia pts? Why

A

Isotonic bc it encourages salt to enter the vessel.

85
Q

How is a pt with severe hyponatremia treated?what are they at risk for?

A

Given hypertonic saline that is used for limited time with extreme caution. Risk for osmotic demyelination syndrome.

86
Q

What do you closely monitor in hyponatremia pts?

A

I and Os
Neuralgic status
Bloodwork

87
Q

What is hypernatremia?

A

Fluid volume in the vessels in low (dehydration). Therefore sodium is over concentrated. Water shifts from intracellular to extracellular space and cells shrink.

88
Q

What are the clinical manifestations of hypernatremia?

A

Neurological, thirst, dry mucous membranes

89
Q

In treatment, what is the goal for hypernatremia?

A

To replace water and normalize serum sodium

90
Q

What type of fluids are given hypernatremia pts?

A

Hypotonic

91
Q

What kind of pills can be given to hypernatremia pts?

A

Diuretics: pills that help excrete water and sodium as urine

92
Q

Where is calcium mostly stored?

A

Bones

93
Q

What are the primary functions of calcium?

A

Regulation of muscle
Nerve impulse transmission
Component in final coagulation pathway

94
Q

What is hypocalcemia?

A

Low levels of calcium in the liquid of blood.

95
Q

What are primary clinical manifestations of hypocalcemia?

A

Irritability, parasthesia (pricking sensations in hands), tetany (involuntary muscle contraction), ECG changes, dysrhymias, hypotension

96
Q

What’s chvosteks sign?what does it indicate?

A

Twitching of the facial muscles in respond to tapping over the area of the facial nerve.
Indicates hypocalcemia

97
Q

What is trousseus sign? What does it indicate?

A

The hand twitches toward the elbow when BP cuff is on. Indicates hypocalcemia.

98
Q

What do you treat hypocalcemia with?

A

IV calcium gluconate, IV calcium chloride

99
Q

What is hypercalcemia?

A

Calcium in blood is above normal

100
Q

In hypercalcemia, what conditions cause calcium to enter the ECF faster than the kidneys can excrete?

A

Hyperparathyroidism

Many malignancies

101
Q

What are the primary clinical manifestations of hypercalcemia?

A

Low neuromuscular action
Low gastric motility
Low HR

102
Q

List three ways to treat hypercalcemia

A

Isotonic IV (NS) to dilute calcium concentration and promote renal excretion
Diuretics
Use of bio phosphates

103
Q

What is the most abundant cation in intracellular fluid?

A

Potassium

104
Q

What is hypokalemia?

A

Low K+ levels

105
Q

Common causes of hypokalemia?

A

GI loss
Dieuretics
Insulin

106
Q

What number is considered hypokalemic?

A

Less than 3.5 mmol/L

107
Q

What bodily changes are expected at less than 2.5 mmol/ Lof potassium?

A

ECG changes
New irregular HR
Cardiac arrest

108
Q

What bodily changes are expected at 2.5 to 3.5 mmol/L of potassium?

A

Muscle weakness and cramps

109
Q

What bodily changes are expected at 3.0 to 3.5 mmol/ Lof potassium?

A

Asymptomatic

110
Q

What is the goal with treatment for hypokalemia?

A

Restore serum potassium level and rule out emergencies like cardiac dysthymias

111
Q

What are ways to orally treat hypokalemia?

A

Dilute liquid form in water or juice
Give pills with food
Potassium rich foods

112
Q

What are ways to treat hypokalemia with IV?

A

K+ by infusion pump

Monster iv site as it’s very irritating to veins

113
Q

What is hyperkalemia? And what it’s minimum value?

A

Higher than normal levels of potassium in the blood, greater than 5.3 mmol/L

114
Q

What medications cause hyperkalemia?

A

Beta adrenergic blockers
NSAIDS
Ace Inhibitors

115
Q

At what level of potassium for hyperkalemia do clinical manifestations show?

A

Greater than 6 mmol/L

116
Q

How is mild hyperkalemia treated?

A

Removal of K with furosemide. Medication that expels K in urine

117
Q

How do we treat moderate hyperkalemia?

A

Removal with cation exchange resins like kayaexelate to promote GI excretion

118
Q

How to treat severe hyperkalemia?

A

Stabilize cardiac tissue then try to move K back into cells and promote renal excretion

119
Q

What are normal levels of magnesium?

A

Small amount is found in vascular space so normal serum magnesium level is low

120
Q

What role does magnesium play in the body?

A

Neuromuscular and cardiovascular activities

Enzymatic and metabolic functions

121
Q

Where is magnesium absorbed and excreted?

A

Intestines

Kidneys

122
Q

What is hypomagnesemia?

A

Low magnesium levels in the blood

123
Q

Hypomagnesemia is seen often in patients with…

A

GI loss
Malabsorption
Alcoholism

124
Q

What are primary clinical manifestations of hypomagnesemia?

A 
Tremors 
Tetany (involuntary contraction of muscles) 
Positive chvosteks and troussues sign 
ECG changes 
Primarily neuromuscular and cardiac
125
Q

How to treat asymptomatic pt with hypomagnesemia?

A

Oral Mg supplements

126
Q

How to treat pt with hypomagnesemia with cardiac or neurological symptoms?

A

IV mg sultans administered slowly

127
Q

When administering meds for pts with cardiac or neurological symptoms, what should you monitor?

A

BP, heart rhythm, ECG changes, other electrolytes (low K is normal alongside low Mg)

128
Q

What is hypermagnesemia

A

Too much magnesium in the blood

129
Q

In what kind of pts is hypermagnesemia seen?

A

Pts with renal insufficiency/failure or with excess Mg intake

130
Q

What are the primary clinical manifestations of hyoermagnesemia?

A 
Think understimulation of heart and neurological system 
Low DTR  
Lethargy 
Weakness 
Maybe resp depression 
ECG chnages 
Bradycardia 
Cardiac arrest 
HTN with n & v
131
Q

How is mild hypermagnesemia treated?

A

Not treated unless underlying renal disease

132
Q

How is sever hypermagnesemia treated?

A 
Continuing cardiac monitoring 
IV calcium gluconate 
Monitor for resp depression 
Assess neurological function frequently 
May require dialysis
133
Q

Where is urea and creatinine excreted by?

A

Kidneys

134
Q

What do urea and creatinine levels determine? High creatinine means?

A

Determine renal function

If increased, reduced renal function

CNUR 203 (5 decks)

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