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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
Q

what are causes of ECF volume deficit (5)

A
  • insensible water loss (fever, stroke)
  • hemorrhage
  • GI losses (V/D, gastric suctioning)
  • burns
  • overuse of diuretics
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26
Q

what are causes of ECF volume excess (5)

A
  • heart failure
  • renal failure
  • cushing syndrome
  • long use of corticosteroids
  • excess isotonic or hypotonic IV fluids
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27
Q

what are some manifestations of ECF volume deficit (5)

A
  • thirst
  • cold clammy skin
  • decreased skin turgor and cap refill
  • decreased urine output
  • increased respiratory rate
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28
Q

what are some manifestations of ECF volume excess (7)

A
  • peripheral edema
  • JVD
  • S3 heart sound
  • increased bp
  • polyuria
  • dyspnea, crackles
  • muscle spasms
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29
Q

what is ECF volume deficit called

A

hypovolemia

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30
Q

what is ECF volume excess called

A

hypervolemia

31
Q

how to correct hypovolemia

A

isotonic solutions (0.9% NS or LR)

32
Q

how to correct hypervolemia (3)

A
  • diuretics
  • fluid restriction
  • restriction of sodium intake
33
Q

Elevated serum sodium occurring with
inadequate water intake, excess water loss or
sodium gain
-causes cellular dehydration

A

hypernatremia

34
Q

manifestations of hypernatremia (4)

A
  • thirst
  • alterations in LOC
  • weakness
  • muscle cramps
35
Q

Results from loss of sodium-containing fluids
and/or from water excess (cellular edema- Na
shifts in the cell)

A

hyponatremia

36
Q

manifestations of hyponatremia (4)

A
  • difficulty concentrating, irritability
  • increased bp
  • N/V/D
  • seizures
37
Q

what are some causes of hyponatremia (5)

A
  • vomiting/diarrhea
  • GI suctioning
  • inadequate salt intake
  • diuretics
  • hypertonic solutions (fluid shift from ICF to ECF)
38
Q

how to treat hyponatremia (3)

A

fluid restriction
loop diuretic
hypertonic IV solution: 3% NaCl

39
Q

how to treat hypernatremia (4)

A
  • fluid replacement with sodium
  • withhold diuretics
  • give drugs that block ADH
  • increase oral intake
40
Q

food sources of potassium

A

fruits (apricot, avocado, banana, grapefruit, orange)
vegetables (beans, greens, potatoes)
other (pb, granola, milk)

41
Q

high serum potassium

A

hyperkalemia

42
Q

what can cause hyperkalemia (4)

A
  • impaired renal excretion
  • shift from ICF to ECF (acidosis, massive cell destruction)
  • massive intake
  • medications (digoxin, heparin, ACE inhibitors)
43
Q

manifestations of hyperkalemia (4)

A
  • cardiac dysrhythmias (peaked T waves, prolonged PR)
  • cramping leg pain
  • weak or paralyzed skeletal muscles
  • abdominal cramping or diarrhea
44
Q

how to treat hyperkalemia (3)

A

eliminate potassium intake
increase elimination potassium (diuretic, kayexelate)
administer calcium gluconate

45
Q

med used to treat hyperkalemia

A

sodium polystyrene sulfate (kayexelate)

46
Q

how does calcium gluconate help treat hyperkalemia

A

prevent cardiac dysrhythmias

47
Q

low serum potassium

A

hypokalemia

48
Q

causes of hypokalemia (5)

A
  • respiratory alkalosis via hyperventilation
  • metabolic alkalosis via diuretic use
  • NG suctioning
  • severe vomiting and diarrhea
  • insulin therapy
49
Q

manifestations of hypokalemia (5)

A
  • cardiac: flattened T wave, prolonged QT, U wave
  • skeletal muscle weakness
  • decreased respirations
  • anorexia and decreased GI motility
  • hyperglycemia
50
Q

low potassium can cause toxicity of what med

A

digoxin

51
Q

how to treat hypokalemia

A

-potassium chloride supplements

52
Q

calcium needs what vitamin in order to be absorbed

A

vitamin D

53
Q

what two things balance calcium levels

A

parathyroid hormone

calcitonin

54
Q

2 causes of hypercalcemia

A
  • hyperparathyroidism

- malignancy

55
Q

manifestations of hypercalcemia (5)

A
  • fatigue
  • hallucinations
  • cardiac dysrhythmias
  • bone pain and fractures
  • polyuria, dehydration
56
Q

how to treat hypercalcemia (3)

A
  • increase hydration to 3,000-4,000 mL/day (can give isotonic saline IV)
  • loop diuretics
  • synthetic calcitonin
57
Q

3 causes of hypocalcemia

A
  • decreased production of parathyroid hormone
  • multiple blood transfusions
  • alkalosis
58
Q

manifestations of hypocalcemia (5)

A
  • positive trousseau’s or chvostek’s sign
  • laryngeal stridor
  • dysphagia
  • tingling around mouth
  • cardiac dysrhythmias (prolonged QT)
59
Q

what is a positive trousseau’s sign

A

spasm of hand and wrist with blood pressure cuff

60
Q

what is a positive chvostek’s sign

A

twitching of face when touching by ear

61
Q

how to treat hypocalcemia (2)

A
  • rebreathe into paper bag

- give calcium supplements

62
Q

what electrolyte does calcium have a reciprocal relationship (see-saw) with

A

phosphate

63
Q

4 causes of hyperphosphatemia

A
  • acute kidney injury or chronic kidney disease
  • chemotherapy
  • excessive intake of phosphate or vitamin D
  • hypoparathyroidism
64
Q

manifestations of hyperphosphatemia (2)

A
  • neuromuscular irritability and tetany

- calcified depositions in soft tissue

65
Q

how to manage hyperphosphatemia (3)

A
  • restrict dairy products
  • loop diuretic
  • hemodialysis
66
Q

4 causes of hypophosphatemia

A
  • malnourishment/malabsorption
  • diarrhea
  • use of antacids
  • inadequate replacement during parental nutrition
67
Q

4 manifestations of hypophosphatemia

A
  • CNS depression
  • rickets and osteomalacia
  • respiratory and heart failure
  • muscle weakness and pain
68
Q

how to manage hypophosphatemia (3)

A
  • oral supplements
  • increased intake of dairy products
  • IV administration of sodium or potassium phosphate
69
Q

2 causes of hypermagnesemia

A
  • increased magnesium intake when renal failure is present

- excessive IV magnesium admin

70
Q

6 manifestations of hypermagnesemia

A
  • lethargy
  • urinary retention
  • nausea and vomiting
  • impaired reflexes
  • muscle paralysis
  • respiratory and cardiac arrest
71
Q

how to manage hypermagnesemia (2)

A
  • IV CaCl or calcium gluconate

- fluids and IV furosemide

72
Q

5 causes of hypomagnesemia

A
  • prolonged fasting/starvation
  • diuretics
  • prolonged parenteral nutrition without supplement
  • fluid loss from GI tract
  • chronic alcoholism
73
Q

6 manifestations of hypomagnesemia

A
  • hyperactive reflexes
  • muscle cramps
  • tremors
  • seizures
  • cardiac dysrhythmias
  • hypocalcemia and hypokalemia
74
Q

how to treat hypomagnesemia

A
  • oral supplements

- increase dietary intake (nuts)

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