Med Surg Flashcards
____ is the movement of water that goes from a dilute to concentrated
Osmosis
_____ _____ is the process by which dissolved substances move from an area of high concentration to an area of lower concentration through a semipermeable membrane.
Passive diffusion.
_____ ____ process of a carrier in which certain dissolved substances require the assistance of a carrier molecule to pass from one side of a cellular membrane to the other.
Facilitated diffusion
____ spacing is the normal distribution of body fluids
1st spacing
___ spacing is dependent edema
2nd spacing
___ spacing is fluid is in a space where it does you no good
Ex is asites
Third spacing
What’s the normal value for Na
135-145 mEq
What’s the normal value mg
1.3-2.1mEq/dl
What’s the normal range for K
3.5-5.0 mEq
What’s the normal range for Ca
9-11 mg/dl
______ (fluid volume deficit) refers to a low volume of extracellular fluid.
Hypovolemia
Lethargic, depressed, difficulty swallowing, or diarrhea is signs, eats food poorly, require assistance to drink Bc of weakness, paralysis, or limited range of motion and symptoms of
Hypovolemia
_____ results when the volume of body fluid is significantly reduced in both extracellular and intracellular compartments
Dehydration
What’s the most common fluid imbalance in older adults
Dehydration
Use of diuretics, laxatives, or enemas may also deplete fluid volume in older adults. Chronic fluid volume deficit can lead to other problems such as electrolyte imbalances.
Know
____ (fluid volume excess) means there is a high volume of water in the intravascular fluid compartment
Hypervolemia
Hypervolemia can result to circulatory overload. A fluid volume that exceeds what is normal for the intravascular space and can potentially compromise cardiopulmonary function
Know
Signs of ____ is weight gain, elevated BP, increased breathing effort.
Hypervolemia
_____ edema, intentions in the skin after compression
Pitting
__ edema is edema in body areas most affected by gravity such as the feet, ankles, sacrum, or buttocks
Dependent
In _____ the blood cell count and hematocrit level are low as a result of hemodilution. The urine specific gravity is also low reflecting the larger proportion of water
Hypervolemia
____ is a reduced ratio of blood components to watery plasma
Hemodilution
What’s the main cause of metabolic acidosis
Diabetic ketoacidosis
Causes of ______ ______ is rapid decrease in extracellular volume, loss of hydrogen, and chloride ions.
Metabolic alkalosis
Cause of ___ ___ is from a carbonic acid deficit when rapid breathing releases more CO2 with expired air
Respiratory alkalosis
Causes of _____ _____ is excess carbonic acid. Causes blood pH to drop below 7.34
Respiratory acidosis
When you have a high K what will stand out on the ECG
Tall tented T wave
Normally there will be no U wave in ECG. Unless with low K
Know
A high CO2= a low level of consciousness
A high CO2= a low O2
Know
___ is fluid equal with cell
Isotonic
_____ is solute concentration increased outside of the cell
Hypertonic
___ are large sized substances that can attract water
Colloids
Most common type of shock
Hypovolemic
Signs and symptoms of shock
Increased RR & tachycardia Low BP Anxious Pallor Oliguria Clammy Pulse is fast and thready
What position should you put someone in for low BP
Trendelenburg
Sodium level is totally dependent on fluid in body
Know
___ is the most abundant extracellular fluid
Sodium
___ is the most abundant intracellular
K
___ is substances that release Hydrogen into fluid
Acid
____ is a liquid in which substances are dissolved
Solvent
Water
- Universal solvent
- Transport median
- Assists in metabolic reactions
Know
_____ ____ is fluid between cells outside of blood vessels
Interstitial fluid
Water within cells
Intracellular fluid
Water outside cells
Extracellular fluid
___ ____ is energy source requires ATP to drive from a low to high concentration
Active transport
____ is fluid dissolved in substances removed from a higher to lower concentration
Filtration
Third spacing is associated with loss of colloids, may accompany hypoalbuminemia or burns or severe allergic reactions.
Know
What element is chief cation
Sodium
___ is a positively charged electrolyte in extracellular fluid and is essential for maintaining Normal nerve and muscle activity
Cation
What’s the drugs given for shock?
2 IV large bore 18-20g
Oxygen and blood
What do osmoreceptors do
Trigger thirst receptors
Second spacing examples
Pedal edema
_______-_____ _____ ____ is a series of chemicals released to increase both BP and blood volume
Renin-angiotensin-aldosterone system
Angiotensin raises BP
Know
___ ___ is hormone like substances that act in opposite to the renin angiotensin aldosterone system.
Natriuretic peptides
_____ ____ is a general term describing any of several conditions in which the body’s water is not in the proper volume or location
Fluid imbalance
What lab determines the severity of CHF less than 100
BMP
Fluid volume is regulated primarily by the excretion of water in the form of urine and the promotion of thirst. This is regulated by the HYPOTHALAMUS
Know
____ ____ or concentration of substances in blood.
Serum osmolality
_____ are stretch receptors in the aortic arch and carotid sinus that sjgnal the brain to release ADH when blood volume decreased by 10%
Baroreceptors
______ is dilution- to much H2O not enough Na
Hyponatremia
Causes of ____ is diaphoresis, excessive ingestion of plain water or admin of nonelectrolyte fluids. Profuse dieuresis, loss of GI secretions, prolonged vomiting, GI suctioning and Addison’s disease
Hyponatremia
_____ -dehydration. Excess sodium in blood
Hypernatremia
Causes of ____ is profuse watery diarrhea, excessive salt intake without sufficient water intake, high fever, deceased water intake
Hypernatremia
____ results in thirst, dry sticky membranes, decreased urine output, lethargy can progress to coma
Treatment is oral admin of water or IV hypotonic solution
Hypernatremia
If sodium is high potassium is low
Know
Cardiac arrhythmia can happen if on digitalis
Know
causes ____ lasix, edecrin, hydrochlorothiazide contribute. Loss of fluid from GI, Vomiting diarrhea, draining intestinal fistula, large dose of steroids, IV of insulin
Hypokalemia
____ causes fatigue? Weakness, anorexia, nausea, vomiting cardiac arrhythmias
Hypokalemia
Good sources of potassium?
Bananas and cantaloupe
____ can occur with severe renal failure. Symptoms are diarrhea, nausea, muscle weakness, paresthesisas, and cardiac arrhythmia… causes unique ECG waves
Hyperkalemia
Potassium is excreted by the
Kidneys
If IV potassium is ordered it must be diluted with an IV solution and administered at a rate below 10meq/hr
Know
Causes of _____ is vitamin d deficiency, hyperparathyroidism, severe burns, acute pancreatitis, certain drugs like steroids, rapid admin of blood, intestinal malabsorption disorders, accidentally removal of parathyroid
Hypocalcemia
____ is evidenced by tingling of extremities and around mouth, muscle and abdominal cramps, positive chvosteks sign, tetany (muscle twitching)
Hypocalcemia
What is tetany
Muscle twitching
Trousseau sign is carpoedal spasms
Know
___ is caused from a pathological fracture. Causes deep bone pain, constipation, polyuria, promotes formation of kidney stones
Hypercalcemia
___ is found in bone cells and specialized cells of heart, liver, and skeletal muscles. Involved in transmission of nerve impulses and muscle excitability and activated several enzyme systems
Magnesium
Conditions that can cause __ is chronic alcoholism, diabetic ketoacidosis, severe burns, severe renal disease,
Hypomagnesemia
Magnesium rich foods
Green leafy veggies and whole grains
_____ can be a consequence of renal failure, Addison’s disease, excessive use of antacids or laxatives and hyperparathyroidism
Hypermagnesemia
____ is excessive accumulation of bases or loss of acid in body fluids
Alkalosis
cardiac arrest and lactic acid evaluation means acidosis
Know
_____ symptoms are flushing, hypotension, bradycardia, decreased RR
Hypermagnesemia
_____ ____ is a compensatory mechanism to rid the body of CO2 and this orebent carbonic acid from forming
Kussmauls breathing
The major chemical regulator of plasma Ph is bicarbonate carbonic acid buffer system
Know
___ is a life threatening condition that occurs when arterial blood flow and oxygen delivery to tissues and cels are inadequate.
Causes
1. Blood volume decreases
2. The heart fails as an effective pump
3. Peripheral blood vessels massively dilate
Shock
____ is most common type of shock the volume of extracellular fluid is significantly diminished primarily because of loss of blood or plasma
Hypovolemic hemorrhage shock
___ shock is sometimes called normovolemic shock Bc the amount of fluid in the circulatory system is not reduced yet the fluid doesn’t permit effective tissue perfusion
Distributive shock
___ shock is the rarest type of shock, results from injury that affect the vasomotor center in the medulla of the brain or the peripheral nerves they extent from spinal cord to blood vessels
Neurogenic shock
_____ shock is the highest mortality rate. Associated with overwhelming bacteria infections
Septic shock
____ _____ ___ ____ an Inflammatory state without proven source of infection
Systemic inflammatory response syndrome
____ ____ ____ ____ is a complication of overwhelming inflammation that results in massive cellular, tissue, and organ injury
Multiple organ dysfunction syndrome
Septic shock occurs mostly in clients with gram neg bacteria, E. coli, species of pseudomonas and gram positive resistant staphylococcus and strep species
Know
____ are harmful chemicals released by bacterial cells. Prob major cause of septic shock
Endotoxins
____ shock is a severe allergic reaction
Anaphylactic shock
___ shock is when there is interference with the circulation of blood into and out of the heart, compromising the volume of blood that enters and leaves the heart an route to the lungs and tissue
Obstructive shock
____ shock is heart contraction is ineffective and reduces cardiac output
Cardiogenic shock
WhT is the leading cause of cardiogenic shock
MI
