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PathoPharm > lewis ch 16 (fluids and electrolytes) > Flashcards

lewis ch 16 (fluids and electrolytes) Flashcards

1
Q

2/3 of body’s water is in the ____________ fluid

A

intracellular fluid

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2
Q

what is the best indicator of gain/loss of fluids

A

daily weights

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3
Q

what are the two prevalent electrolytes in the intracellular fluid

A

potassium

phosphate

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4
Q

what are the two prevalent electrolytes in the extracellular fluid

A

sodium

chloride

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5
Q

normal sodium range

A

135-145

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6
Q

normal potassium range

A

3.5-5

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7
Q

normal calcium range

A

9-10.5

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8
Q

normal phosphate range

A

3-4.5

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9
Q

normal magnesium rnage

A

1.3-2.1

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10
Q

normal bicarbonate range

A

22-26

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11
Q

normal chloride range

A

98-106

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12
Q

Movement of molecules across a
permeable membrane from high to
low concentration

A

diffusion

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13
Q

Uses carrier to move molecules

A

facilitated diffusion

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14
Q

• Process in which molecules move
against concentration gradient
• External energy (ATP) is required
for this process

A

active transport (ex: sodium potassium pump)

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15
Q 
• Movement of water “down”  
concentration gradient
• From a region of low solute 
concentration to one of high solute 
concentration
• Across a semipermeable membrane
A

osmosis

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16
Q

fluids with the same osmolality as the

surrounding cells

A

isotonic

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17
Q 
solutions that are less concentrated than in 
the cells (moves into cell, swells and possibly bursts)
A

hypotonic

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18
Q 
fluids that are more concentrated than in 
the cells (moves out of cell, shrinks and possibly dies)
A

hypertonic

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19
Q

fluid in the interstitial space (second spacing)

A

edema

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20
Q

Primary organs for regulating fluid and electrolyte

balance

A

kidneys

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21
Q

normal urine output / hr

A

30 mL/hr

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22
Q

(from adrenal glands) glucocorticoid that has anti-inflammatory affects and increases blood glucose

A

cortisol

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23
Q

(from adrenal glands) mineralcorticoid that causes sodium and water retention

A

aldosterone

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24
Q

what does the heart release to decrease blood volume and pressure

A

natriuretic pepties (ANP and BNP)

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25
what are causes of ECF volume deficit (5)
- insensible water loss (fever, stroke) - hemorrhage - GI losses (V/D, gastric suctioning) - burns - overuse of diuretics
26
what are causes of ECF volume excess (5)
- heart failure - renal failure - cushing syndrome - long use of corticosteroids - excess isotonic or hypotonic IV fluids
27
what are some manifestations of ECF volume deficit (5)
- thirst - cold clammy skin - decreased skin turgor and cap refill - decreased urine output - increased respiratory rate
28
what are some manifestations of ECF volume excess (7)
- peripheral edema - JVD - S3 heart sound - increased bp - polyuria - dyspnea, crackles - muscle spasms
29
what is ECF volume deficit called
hypovolemia
30
what is ECF volume excess called
hypervolemia
31
how to correct hypovolemia
isotonic solutions (0.9% NS or LR)
32
how to correct hypervolemia (3)
- diuretics - fluid restriction - restriction of sodium intake
33
Elevated serum sodium occurring with inadequate water intake, excess water loss or sodium gain -causes cellular dehydration
hypernatremia
34
manifestations of hypernatremia (4)
- thirst - alterations in LOC - weakness - muscle cramps
35
Results from loss of sodium-containing fluids and/or from water excess (cellular edema- Na shifts in the cell)
hyponatremia
36
manifestations of hyponatremia (4)
- difficulty concentrating, irritability - increased bp - N/V/D - seizures
37
what are some causes of hyponatremia (5)
- vomiting/diarrhea - GI suctioning - inadequate salt intake - diuretics - hypertonic solutions (fluid shift from ICF to ECF)
38
how to treat hyponatremia (3)
fluid restriction loop diuretic hypertonic IV solution: 3% NaCl
39
how to treat hypernatremia (4)
- fluid replacement with sodium - withhold diuretics - give drugs that block ADH - increase oral intake
40
food sources of potassium
fruits (apricot, avocado, banana, grapefruit, orange) vegetables (beans, greens, potatoes) other (pb, granola, milk)
41
high serum potassium
hyperkalemia
42
what can cause hyperkalemia (4)
- impaired renal excretion - shift from ICF to ECF (acidosis, massive cell destruction) - massive intake - medications (digoxin, heparin, ACE inhibitors)
43
manifestations of hyperkalemia (4)
- cardiac dysrhythmias (peaked T waves, prolonged PR) - cramping leg pain - weak or paralyzed skeletal muscles - abdominal cramping or diarrhea
44
how to treat hyperkalemia (3)
eliminate potassium intake increase elimination potassium (diuretic, kayexelate) administer calcium gluconate
45
med used to treat hyperkalemia
sodium polystyrene sulfate (kayexelate)
46
how does calcium gluconate help treat hyperkalemia
prevent cardiac dysrhythmias
47
low serum potassium
hypokalemia
48
causes of hypokalemia (5)
- respiratory alkalosis via hyperventilation - metabolic alkalosis via diuretic use - NG suctioning - severe vomiting and diarrhea - insulin therapy
49
manifestations of hypokalemia (5)
- cardiac: flattened T wave, prolonged QT, U wave - skeletal muscle weakness - decreased respirations - anorexia and decreased GI motility - hyperglycemia
50
low potassium can cause toxicity of what med
digoxin
51
how to treat hypokalemia
-potassium chloride supplements
52
calcium needs what vitamin in order to be absorbed
vitamin D
53
what two things balance calcium levels
parathyroid hormone | calcitonin
54
2 causes of hypercalcemia
- hyperparathyroidism | - malignancy
55
manifestations of hypercalcemia (5)
- fatigue - hallucinations - cardiac dysrhythmias - bone pain and fractures - polyuria, dehydration
56
how to treat hypercalcemia (3)
- increase hydration to 3,000-4,000 mL/day (can give isotonic saline IV) - loop diuretics - synthetic calcitonin
57
3 causes of hypocalcemia
- decreased production of parathyroid hormone - multiple blood transfusions - alkalosis
58
manifestations of hypocalcemia (5)
- positive trousseau's or chvostek's sign - laryngeal stridor - dysphagia - tingling around mouth - cardiac dysrhythmias (prolonged QT)
59
what is a positive trousseau's sign
spasm of hand and wrist with blood pressure cuff
60
what is a positive chvostek's sign
twitching of face when touching by ear
61
how to treat hypocalcemia (2)
- rebreathe into paper bag | - give calcium supplements
62
what electrolyte does calcium have a reciprocal relationship (see-saw) with
phosphate
63
4 causes of hyperphosphatemia
- acute kidney injury or chronic kidney disease - chemotherapy - excessive intake of phosphate or vitamin D - hypoparathyroidism
64
manifestations of hyperphosphatemia (2)
- neuromuscular irritability and tetany | - calcified depositions in soft tissue
65
how to manage hyperphosphatemia (3)
- restrict dairy products - loop diuretic - hemodialysis
66
4 causes of hypophosphatemia
- malnourishment/malabsorption - diarrhea - use of antacids - inadequate replacement during parental nutrition
67
4 manifestations of hypophosphatemia
- CNS depression - rickets and osteomalacia - respiratory and heart failure - muscle weakness and pain
68
how to manage hypophosphatemia (3)
- oral supplements - increased intake of dairy products - IV administration of sodium or potassium phosphate
69
2 causes of hypermagnesemia
- increased magnesium intake when renal failure is present | - excessive IV magnesium admin
70
6 manifestations of hypermagnesemia
- lethargy - urinary retention - nausea and vomiting - impaired reflexes - muscle paralysis - respiratory and cardiac arrest
71
how to manage hypermagnesemia (2)
- IV CaCl or calcium gluconate | - fluids and IV furosemide
72
5 causes of hypomagnesemia
- prolonged fasting/starvation - diuretics - prolonged parenteral nutrition without supplement - fluid loss from GI tract - chronic alcoholism
73
6 manifestations of hypomagnesemia
- hyperactive reflexes - muscle cramps - tremors - seizures - cardiac dysrhythmias - hypocalcemia and hypokalemia
74
how to treat hypomagnesemia
- oral supplements | - increase dietary intake (nuts)

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