Lecture Exam # 3: Electrolytes

Question 1

Identify the electrolyte most influential in determining circulating blood volume and the hormone which control its concentration in the body.

Answer 1

1) Sodium 2) Aldosterone

Question 2

RAAS

Answer 2

1) Activated by decreasing blood volume/ decreasing hydrostatic pressure 2) Decreasing BV causes arteries to constrict, stimulating the release of aldosterone 3) Aldosterone causes Na+ retention and water volume retention

Question 3

Normal Serum Na

Answer 3

135-145 mEq/L

Question 4

What is sodiums role in thirst?

Answer 4

When Sodium Levels increase, thirst receptors in the hypothalamus stimulate thirst sensations

Question 5

What do sodium levels tell you/not tell you?

Answer 5

They tell you the level of hydration in the body, however they do not tell you about the possibility of over consumption of sodium

Question 6

Hypernatremia (levels and hydration analysis)

Answer 6

high levels of sodium in the serum/blood; mimics dehydration, because during dehydration levels of sodium are high.

Question 7

What level of sodium is indicative of hypernatremia?

Answer 7

levels greater than 145 mEq/L

Question 8

Symptoms of hypernatremia

Answer 8

Excessive Thirst, Altered mental status, and lethargy/seizures/coma

Question 9

What are some possible causes of hypernatremia?

Answer 9

Overall loss of water resulting in excess of serum sodium ( water intake, profuse sweating, Diarrhea/vomiting, and high fever)

Question 10

Treatment of hypernatremia

Answer 10

Adequate fluid intake

Question 11

Hyponatremia

Answer 11

Excessive loss of sodium

Question 12

What sodium levels are indicative of hyponatremia?

Answer 12

Serum sodium less than 135 mEq/L

Question 13

What are symptoms of hyponatremia?

Answer 13

Rapid weight loss, abdominal cramps, and convulsions

Question 14

What are some causes of hyponatremia?

Answer 14

usage of diuretics; Excessive loss of gastrointestinal fluids from vomiting, diarrhea or fistula drainage; renal disease with sodium wasting states

Question 15

Treatment of hyponatremia

Answer 15

Administer normal or hypertonic saline

Question 16

Pseudohyponatremia

Answer 16

Blood contains excess water relative to salt; caused by fluid overload

Question 17

Sodium levels associated with pseudohyponatremia

Answer 17

Serum sodium levels below 135 mEq/L

Question 18

Symptoms of pseudohyponatremia

Answer 18

Rapid weight gain, signs of over-hydration; Levels below 130 mEq/L: Nausea/headache, Confusion/agitation, seizures/coma/death

Question 19

Causes of pseudohyponatremia

Answer 19

Edematous states; Ascites w/cirrhosis of the liver; congestive heart failure

Question 20

What group of individuals are the most at risk for developing hyponatremia?

Answer 20

The elderly

Question 21

Treatment of hyponatremia

Answer 21

may require fluid and or sodium restriction

Question 22

What is the major intracellular electrolyte?

Answer 22

Potassium

Question 23

Normal Serum Potassium Levels

Answer 23

3.5 - 5.0 mEq/L

Question 24

What organ is responsible for potassium balance?

Answer 24

The Kidneys

Question 25

What serum potassium level is associated with hyperkalemia?

Answer 25

serum potassium levels greater than 5.0 mEq/L

Question 26

Major symptom of hyperkalemia

Answer 26

Cardiac arrhythmias

Question 27

Causes of hyperkalemia

Answer 27

1) inability to excrete K+ (renal failure) 2) Excessive potassium intake w/renal disease 3) Release of intracellular potassium into the blood stream as a result of tissue injury, malnutrition, or stress

Question 28

Treatment of hyperkalemia

Answer 28

1) Medication/treatment to enhance cellular uptake of potassium 2) Medications to enhance loss of potassium in the feces or the urine

Question 29

What Potassium level is associated with hypokalemia?

Answer 29

Serum potassium less than 3.5 mEq/L

Question 30

Major symptom of hypokalemia?

Answer 30

Cardiac arrhythmias

Question 31

Factor contributing to hypokalemia

Answer 31

1) Metabolic alkaosis 2) Renal tubular dysfunction 3) Unusual potassium losses due to diuretics, gastric suctioning, or diarrhea

Question 32

Treatment of hypokalemia

Answer 32

High potassium foods, and K+ Supplements

Question 33

What foods are high in potassium?

Answer 33

Potatoes, bananas, oranges

Question 34

Normal pH

Answer 34

7.35 to 7.45

Question 35

Carbonic Acid, Bicarbonate, and CO2/H2O equation

Answer 35

CO2 + H2O gt H2CO32 gt H+ + HCO3-

Question 36

Lungs role in Acid/Base balance

Answer 36

Major organ for acid base balance. Converts CO2 and H2O to carbonic acid and vice versa. Regulate acid-base by expelling or retaining CO2

Question 37

How do the kidneys adjust pH balance

Answer 37

excretion of of H+ through urine and absorption of H+ in the glomerulus

Question 38

Normal pH of urine

Answer 38

6.0

Question 39

Serum K and Acid-Base Balance

Answer 39

1) If serum H+ high, H+ uptaken by cells traded with K+ causes hyperkalemia 2) H+ low in serum, H+ leaves the cell and K+ uptaken in the cells leads to hypokalemia

Question 40

Respiratory Acidosis

Answer 40

Conditions which diminish the lungs ability to exhale carbon dioxide (emphysema, asthma, bronchitis, CHF)

Question 41

Respiratory Alkalosis

Answer 41

Condition which cause the lungs to exhale larger quantities of carbon dioxide than normal (Hysteria, high altitudes, heart failure w/SOB)

Question 42

Metabolic acidosis

Answer 42

acid gain - diabetic ketoacidosis

Question 43

Metabolic alkalosis

Answer 43

loss of acid- Loss of gastric juice/vomiting or diarrhea

Question 44

Lab values decreased w/hydration status

Answer 44

Over-hydration: decreases serum sodium, osmolality, abumin, BUN, hematocrit/hemoglobin, USP, UO

Question 45

Lab values increased w/hydration status

Answer 45

Under-hydration: increases serum sodium, osmolality, abumin, BUN, hematocrit/hemoglobin, USP, UO