Med Surg Exam 2 Flashcards
1
Q
Normal pH range
A
7.35-7.45
2
Q
Normal CO2 range
A
35-45 mmHg
3
Q
Normal HCO3 range
A
22-26 mEq/L
4
Q
Normal sodium range
A
135-145 mEq/L
5
Q
Normal potassium range
A
3.5-5.0 mEq/L
6
Q
Normal calcium range
A
8.6-10.2 mEq/L
7
Q
Normal magnesium range
A
1.3-2.3 mEq/L
8
Q
Normal phosphate range
A
2.5-4.5 mEq/L
9
Q
Normal Chloride range
A
97-107 mEq/L
10
Q
For respiratory acidosis or alkalosis, which two components are needed?
A
pH and CO2
11
Q
For metabolic acidosis or alkalosis, which two components are needed?
A
pH and BCO3
12
Q
high pH and high HCO3 equals what?
A
metabolic alkalosis
13
Q
low pH and low HCO3 equals what?
A
metabolic acidosis
14
Q
low pH and high CO2 equals what?
A
respiratory acidosis
15
Q
high pH and low CO2 equals what?
A
respiratory alkalosis
16
Q
Normal pO2 ranges
A
80-100 mmHg
17
Q
Normal O2 saturation
A
95-100%
18
Q
Example of a hypotonic IV solution? (hint: percentage)
A
0.45% sodium chloride solution
19
Q
Two examples of isotonic IV solution?
A
0.9% sodium chloride, lactated Ringer’s solution
20
Q
Three examples of hypertonic IV solution?
A
5% dextrose in 0.9% sodium chloride solution,
3% normal saline solution,
Dextrose 10% in water
21
Q
When should hypotonic solution be used? (3)
A
dehydration, gastric fluid loss, cellular dehydration from excessive diuresis
22
Q
When should isotonic solution be used? (4)
A
diabetic ketoacidosis, early treatment of burns, adrenal insufficiency, frequently used during surgical procedures
23
Q
When should hypertonic solution be used? (2)
A
Treat severe hyponatremia, provide calories for energy
24
Q
What is osmosis
A
MOVEMENT OF WATER from area of low solute concentration to area of high solute concentration
25
What is DIffusion?
MOVEMENT OF SOLUTES from area of higher concentration to lower concentration
26
What is active transport?
physiologic pump that moves fluid from area of lower concentration to higher concentration
This is movement against the concentration gradient!
27
What is hypovolemia?
fluid volume deficit
28
What is hypervolemia?
fluid volume excess
29
Manifestations of hypovolemia? (7)
rapid weight loss, decreased skin turgor, oliguria, concentrated urine, rapid weak pulse, increased temp, thirst
30
Manifestations of hypervolemia? (8)
edema, distended neck veins, abnormal lung sounds, tachycardia, increased BP, SOB, increased urine output, increased weight
31
What is chloride for?
peak muscle function
32
What is potassium for? (3)
muscle contraction, nerve transmission, glycogen formation
33
What is sodium for?
nerve transmission
34
What is magnesium for? (2)
ATP (energy), production
35
What is calcium for? (3)
bone health, nerve transmission, muscle contraction
36
Causes of hyponatremia? (6)
adrenal insufficiency, water intoxication, losses by vomiting, diarrhea, sweating, diuretics
37
Manifestations of hyponatremia? (6)
poor skin turgor, dry mucosa, HA, decreased salivation, decreased BP, nausea
38
Causes of hypernatremia? (5)
excess water loss, excess sodium administration, diabetes insipidus, heat stroke, hypertonic IV solutions
39
Manifestations of hypernatremia? (5)
thirst, elevated temp, dry swollen tongue, neurologic symptoms, weakness
40
Causes of hypokalemia? (5)
GI losses, medications, alterations of acid base balance, hyperaldosterism, poor dietary intake
41
Manifestations of hypokalemia? (8)
fatigue, anorexia, NV, dysrhythmias, muscle weakness/cramps,paresthesias, decreased bowel motility, dysrythmias
42
Causes of hyperkalemia? (5)
usually treatment related, impaired renal function, hypoaldosteronism, tissue trauma, acidosis
43
Manifestations of hyperkalemia? (5)
cardiac changes and dysrhythmias, muscle weakness, paresthesias, anxiety, GI problems
44
Use of two main medications in hyperkalemia?
Kayexalate, beta-2 agonists
45
Causes of hypocalcemia? (7)
hypoparathyroidism, malabsorption, pancreatitis, alkalosis, massive transfusion of citrated blood, renal failure, medications
46
Manifestations of hypocalcemia? (8)
tetany, circumoral numbness, paresthesias, hyperactive DTRs, Trousseau's sign, Chovstek's sign, seizures, anxiety
47
What is the Trousseau's sign?
put on BP cuff, pump up cuff, hand bends at wrist and finger distort, hand crumples-indicated hypocalcemia
48
What is Chovstek's sign?
muscle twitching when facial nerve is tapped-indicates hypocalcemia
49
What vitamins are given to hypocalemic patient?
Vitamin D and calcium
50
Causes of hypercalcemia? (5)
malignancy and hyperparathyroidism, anorexia, N/V, constipation
51
Manifestations of hypercalcemia? (4)
muscle weakness, lack of coordination, bone pain, GI upset
52
Medications for Hypercalcemia? (4)
furosemide, phosphates, calcitonin, biphosphonates
53
Causes of hypomagnesemia? (7)
alcoholism, GI losses, diet deficiency, medications, sepsis, burns, hypothermia
54
Manifestations of hypomagnesemia? (5)
neuromuscular irritability, muscle weakness, tremors, dysrhythmias, alterations in mood or LOC
55
When giving oral meds to hypomagnesemiac patient, assess what first?
swallowing ability, dysphasia is common in hypomag patients
56
Causes of hypermagnesemia? (3)
renal failure, diabetic ketoacidosis, excessive admin of magnesium
57
manifestations of hypermagnesemia? (7)
flushing, lowered BP, N/V, hypoactive reflexes, drowsiness, muscle weakness, dysrhythmias
58
causes of hypophosphatemia? (10)
alcoholism, pain, heat stroke, refeeding starved patient, hyperventilation, respiratory alkalosis, major burns, low mag, low potassium, use of diuretics
59
manifestations of hypophosphatemia? (6)
neurologic symptoms, confusion, muscle weakness, tissue hypoxia, muscle and bone pain, increased risk of infection
60
causes of hyperphosphatemia? (4)
renal failure, excess phosphorus, excessive Vit D, chemo
61
manifestations of hyperphosphatemia?
few symptoms, associated with hypocalcemia
62
causes of hypochloremia? (6)
addison's disease, GI losses, excessive sweating, fever, burns, meds
63
manifestations of hypochloremia? (6)
agitation, irritability, weakness, hyperexcitability in muscles, seizures, coma
64
causes of hyperchloremia? (7)
excess chloride infusions, head injury, hypernatremia, dehydration, respiratory alkalosis, metabolic acidosis, medications
65
manifestations of hyperchloremia? (5)
tachypnea, lethargy, weakness, rapid deep respirations, hypertension
66
In metabolic acidosis, pH is _______ and bicarbonate is ________.
low, low
67
Metabolic acidosis is most commonly due to ?
renal failure
68
manifestations of metabolic acidosis? ()
HA, confusion, drowsiness, increased respirations, shock, dysrhythmias
69
Monitor which two electrolyte levels during metabolic acidosis?
calcium and potassium
70
In metabolic alkalosis, pH is ______ and bicarbonate is _____.
high, high
71
Metabolic alkalosis is most commonly due to what?
vomiting, gastric suction, pyloric stenosis
72
Manifestations of metabolic alkalosis? (2)
respiratory depression, tachycardia
73
In respiratory acidosis, pH is ____ and CO2 is _____.
low, high
74
Respiratory acidosis is always due to what?
respiratory problem with inadequate excretion of CO2
75
Manifestations of resp acidosis? (7)
asymptomatic ususally; later: increased pulse, BP, and respirations; mental changes, feeling of fullness in head; leads to shock and cardiac arrest
76
In respiratory alkalosis, pH is ______ and CO2 is ______.
high, low
77
respiratory alkalosis is always due to what?
hyperventilationl leading to hypoxia
78
manifestations of resp alk? (4)
lightheadedness, inability to concentrate, numbness, tingling
79
Foods high in phosphate? (6)
milk, organ meats, nuts, fish, poultry, whole grains
80
Respiratory acidosis occurs in emergency situations such as...? (9)
acute pulmonary edema, aspiration of foreign objects, atelectasis, pneumothorax, overdose of sedatives, sleep apnea, administration of oxygen to a patient with chronic hypercapnea (excessive CO2 in the blood), severe pneumonia, acute respiratory distress syndrome
81
Normal BUN levels?`
7-20 mg/dL
82
Normal creatinine levels?
0.7 to 1.4 mg/dL
83
What is a hypotonic solution?
Water moves into cell to balance out solute concentration. Cell expands and eventually explodes.
84
What is a hypertonic solution?
Water moves out of cell to balance out solute concentration. Cell shrinks and eventually shrivels to nothing.
