Mid-term Flashcards
F&E: what is crucial to the maintenance of homeostasis?
regulation of the concentration of oxygen, carbon dioxide, organic nutrients, wastes and inorganic ions
F&E: intracellular components
40% total body weight
most found in skeletal muscle cells
F&E: extracellular components
20% total body weight
compartments: interstitial [cells outside vessels], intravascular [cells w/i the blood vessel], transcellular [cells everywhere else]
F&E: 1 L of water= ___ lbs=___ kg
2.2
1
this allows for fluid loss/gain to be monitored via weight change
F&E: Na+
sodium
135-145 mEq/L
for fluid retention, neuromuscular and enzymatic functioning
F&E: Cl-
chloride
96-106 mEq/L
works w/ Na to provide hydration with a role in hydrochloric acid
F&E: K+
potassium
3.5-5.0 mEq/L
for contraction of muscles [esp/ heart muscles]
F&E: Ca+
calcium
8.6-10.2 mg/dL
most abundant mineral in the body
for muscle contraction, blood coagulation, and bone structure [as 99% of Ca+ is stored in the bones]
F&E: PO4-
phosphorous
2.4-4.4 mg/dL
combined w/ Ca+ in the crystals of bones and teeth
2nd most abundant mineral in the body
for acid-base balance as a buffer [phosphoric acid]
F&E: Mg+
magnesium
1.5-2.5 mEq/L
for neuromuscular functioning
F&E: HCO3
bicarbonate
22-26 mEq/L
for acid-base regulation
F&E: hydrostatic pressure
influenced by blood pressure and volume
arteries have a high hydrostatic pressure
it pushes fluid out of the vessel into the interstitial space
as it leaves, the H.P. decreases
as the H.P. decreases, it will fall below the colloidal osmotic pressure
F&E: colloidal osmotic pressure
exerted by plasma proteins
once the fluid is in the interstitial areas and the hydrostatic pressure is decreased, blood draws back into the vessels to be brought back into the heart
- at this point the O-carrying blood has perfused O to the tissue, so it enters the bloodstream to get oxygenated once more
in cases of malnutrition, the colloidal osmotic pressure couldn’t do its purpose in bringing blood back into the vessels b/c of the lack of essential plasma proteins
F&E: how much urine should be excreted?
1-2 mL/kg/hr
F&E: protein deficiency
causes: inadequate protein intake, protein loss, decreased protein synthesis
s/s: poor wound healing, edema [disturbance in colloidal osmotic pressure], anemia [protein carries O], fatigue, weight loss, muscle wasting [builds up muscle]
tx: diet high in amino acids, CHO [CHO used for energy leaving protein to be used for muscle gain and not energy] and protein
F&E: plasma-to-interstitial fluid shift
fluid shift from vascular compartment to interstitial compartment
causes: increased capillary hydrostatic pressure, decreased plasma protein, increased capillary permeability
s/s: increased heart rate [decrease in blood volume makes heart work harder to get blood to the major organs], decrease in B.P., decrease urine output, edema
tx: replace F and E, cautiously
F&E: types of edema
pitting dependent - upon gravity and position weeping - fluid seeps out through the skin anascara - edema throughout the body other - edema of a specific system [i.e. ascites, pleural effusion]
F&E: interstitial-to-plasma fluid shift
shift of fluid from interstitial to intravascular compartment
causes: decrease in capillary hydrostatic pressure, increases in colloidal osmotic pressure, remobilization of fluid following burns and trauma
s/s: increased B.P., large amounts of diluted urine, bounding heart beats, pleural edema, restlessness [2o to pleural edema]
tx: fluid is excreted naturally is pt. has healthy heart and kidneys, if not, use of diuretics or dialysis may be needed
F&E: what are primary and secondary sx of respiratory distress?
primary
- restlessness>increased heart rate
secondary
- crackles in the lungs, altered mental status, drop in pulse ox., use of accessory muscles
F&E: hyper-osmolarity
too many particles [of Na] or too little water which results in cell-shrinking
causes: decreased water intake, extracellular solute excess
s/s: dehydration [evidenced by increase in heart rate, thirst, poor skin turgor, dry mucous membranes/skin, decreased/concentrated urine], cell shrinkage [evidenced by altered mental status]
tx: replace water [PO or IV]
F&E: hypo-osmolarity
or water intoxication
too few particles or too much water which results in cell swelling
causes: replacing H2O and Na loss w/ only H2O, inability to excrete urine [seen in chronic renaal failure]
s/s: cerebral edema, diluted urine, increased B.P.
tx: replace loss w/ Na ad H2O [isotonic solution], utilize oral liquids w/ electrolytes
F&E: isotonic deficit
Na and H2O loss in equal proportions which do not cause size change in cells but decreases the volume of the ECF
tx: treat underlying cause, administer isotonic solution, carefully
F&E: what are s/s of hemorrhaging?
increase in heart rate, altered mental status, hypoxia, decrease in urine output
F&E: isotonic excess
Na and H2O gain in equal proportions which do not cause size change in cells but increases the volume of the ECF
s/s: pulmonary edema [causing restlessness, tachycardia, crackles in the lungs]
tx: restrict fluids, monitor fluids, diuretics/dialysis
F&E: hypernatremia
an excess of Na
s/s: results from cell shrinkage and fluid shifting [i.e. brain cell shrinkage causing altered mental status]
tx: restrict Na intake, gradual lowering of Na to prevent cerebral edema, monitor changes in behavior
F&E: hyponatremia
a deficit of Na
s/s: cerebral edema, diluted urine, increased B.P.
tx: isotonic or hypertonic solution, restriction of water
F&E: hyperkalemia
an excess of K
causes: pseudohyperkalemia, chronic renal failure, use of salt substitutes [major ingredient: K], K sparing diuretics, metabolic acidosis, burns [destroy K-containing blood cells]
tx: K-restricted diet, calcium gluconate [does not affect K levels, used for cardiac arrhythmia’s, dialysis, med.’s to reduce K [i.e. kayexalate]
F&E: pseudohyperkalemia
this occurs during a blood draw where the syringe hemolized [destroyed the blood cell] RBC’s which caused its contents to come out the cell causing an K increase in that area
the K levels in the blood would :. be high, but falsely
F&E: hypercalcemia
excess of Ca
causes: hyperparathyroidism, immobilization, overuse of calcium products, malignancies
tx: loop diuretics [promotes excretion of Ca], fluids, encourage activity, med.’s [d/o cause of condition], low Ca diet, vit. D [helps GI tract absorb Ca]
F&E: fluid spacing
1st- normal distribution of body water
2nd- abnormal accumulation in interstitial space [edema]
3rd- fluid is trapped and essentially unavailable and cannot go back to where it came from
- it is a distributional shift in fluid in a space that does not easily exchange w. the ECF [i.e. peritonitis]
F&E: hypocalcemia
deficit of Ca+
causes: hypoparathyroidism, inadequate vit. D, chronic renal failure
s/s: + Trousseau sign, + Chvostek sign
tx: IV calcium [regularly check IV bag for calcium precipitation; flush ac and pc Ca administration], Vit. D
F&E: trousseaau sign
muscular contraction including flexion of the wrist and metacarpophalangeal joints, hyper-extension of the fingers, and flexion of the thumb on the palm, when a sphygmomanometer cuff is inflating to above systolic pressure for several minutes
suggest neuromuscular excitability caused by hypocalcemia
