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ANATOMY AND PHYSIOLOGY > Module 05: Fluids, Electrolytes, and Acid Base > Flashcards

Module 05: Fluids, Electrolytes, and Acid Base Flashcards

1
Q

This is a state of equilibrium stabilization of body functions to maintain normal status.

A

Homeostasis

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2
Q

This pertains to extracellular fluid volume deficit.

A

Dehydration

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3
Q

This pertains to extracellular fluid volume excess.

A

Fluid Overload

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4
Q

This pertains to the absorption back to the
bloodstream, which retained in the body

A

Reabsorption

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5
Q

This pertains to the tonicity.

A

Osmolality

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6
Q

What is fluid content of infants?

A

70% - 80%

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7
Q

What is fluid content of an adult male?

A

50% - 70 %

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8
Q

What is fluid content of an adult female?

A

50% - 60 %

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9
Q

What is fluid content of an old adult and obesity?

A

45% - 55%

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10
Q

How much intercellular fluid (ICF) is in the body?

A

2/3 of fluid within the cell

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11
Q

How much extracellular fluid (ECF) is in the body?

A

1/3 of Fluid outside cells

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12
Q

This pertains to the fluid in between cells (lymph)

A

Interstitial Fluid

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13
Q

This pertains to the Fluid within the blood vessels

A

Intravascular Fluid

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14
Q

This pertains to the fluid in small and specialized
cavities (synovium, CSF, pleura and peritoneum).

A

Transcellular fluid

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15
Q

How much plasma is in the body?

A

3L

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16
Q

How much interstitial fluid is in the body?

A

10L

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17
Q

How much intracellular fluid is in the body?

A

28L

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18
Q

What are the functions of body water?

A

(1) Stabilizes body temperature
(2) Protection
(3) Chemical Reactions
(4) Transport

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19
Q

This function of body water pertains to the high heat capacity of water allows it to absorb and release large amounts of heat before changing temperature

A

Stabilizes body temperature

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20
Q

This function of the body water pertains to how it acts as a lubricant or cushion.

A

Protection

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21
Q

This function of body water pertains to its polar solvent properties: dissolves ionic substances, forms hydration layers around large charged molecules, and serves as the body’s major
transport medium

A

Transport

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22
Q

What is the percentage by volume of plasma and formed elements from blood?

A

55% - Plasma
45% - formed elements from Blood

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23
Q

What constitutes the plasma?

A

7% - proteins 2% - other solutes
91% - water

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24
Q

What constitutes the formed elements (number per cubic mm)?

A

(1) Platelets (250-400,000)
(2) White blood cells (5,000 - 9,000)
(3) Red blood cells (4.2 million - 6.2 million)

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25
Q

What constitutes proteins?

A

(1) Albumins ( 58%)
(2) Globulins (38%)
(3) Fibrinogen (4%)

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26
Q

This is a substance capable of dissolving a solute. Its dissolves medium is H2O. It may be in form of gas or liquid

A

Solvent

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27
Q

This is a substance that is dissolved in a solvent. It may be in the form of gas, liquid or solid

A

Solute

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28
Q

This is a mixture of 2 or more particles that are exceedingly small

A

Solutions

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29
Q

This is a mixture of 2 or more components; particles are fairly large

A

Suspension

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30
Q

This is a translucent mixtures with solute particles of intermediate size

A

Colloids

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31
Q

This pertains to the movement of solute and
water across a semipermeable membrane

A

Filtration

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32
Q

This is a use of a machine and a “filtration membrane”

A

Dialysis

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33
Q

This is the the movement of a solute from an area of higher concentration to an area of lower concentration within a solvent nor a membrane. It transpires at equilibrium, there is a uniform distribution of molecules

A

Diffusion

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34
Q

These transports are important for ATP, which is the source and transport of energy.

A

(1) Passive Transport
(2) Active Transport

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35
Q

This stores and provides energy. Moreover, this is the source of immediately usable energy for the cell

A

Adenosine Triphosphate (ATP)

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36
Q

This is required for energy to be assimilated in our muscles.

A

Insulin

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37
Q

In this, the three sodium ions (Na ++) and adenosine triphosphate (ATP) bind to the Na K pump (where potassium and sodium is exchanged), which is an ATP powered pump.

A

Facilitated transport though Sodium Potassium Pump

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38
Q

How does Facilitated transport though Sodium Potassium Pump control fluid and electrolyte movement?

A

As sodium (Na ++) diffuses into the cell and potassium (K ++) diffuses out of the cell, an active transport system supplied with energy delivers Na back to the extracellular compartment and K to the intracellular compartment.

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39
Q

This is the diffusion of a solvent (water ) across a
selectively (semi) permeable membrane from an area of low solute concentration to an area of high solute concentration.

A

Osmosis

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40
Q

The measurement of osmosis depends on the __________ and __________ of fluids.

A

osmolality and osmotic pressure

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41
Q

This is used to describe the tonicity of the blood plasma/serum

A

Osmolality (275 - 300 umol/L)

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42
Q

This pertains to osmolality higher than normal

A

Hyperosmolality

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43
Q

This pertains to osmolality lower than normal

A

Hypoosmolality

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44
Q

Osmolarity is used to describe all other fluids based on the content of what in a solution?

A

Salt and Sugar

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45
Q

What is the osmolarity of IV Fluids - D5%W?

A

Normal Saline, Isotonic

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46
Q

What is the osmolarity of drinks like soda, gatorade, and juice as well as tube feeding (ensure)?

A

Hyperosmolar

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47
Q

What is the osmolarity of food and plain water?

A

Hypotonic

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48
Q

This is the osmotic pressure between two compartments.

A

Tonicity

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49
Q

This is the pressure that needs to be applied to a solution to move through a semi permeable membrane, commonly called “concentration of a solution.”

A

Osmotic pressure

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50
Q

This pertains to your blood pressure.

A

Hydrostatic Pressure.

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51
Q

This is contingent on proteins and is equal to pi. This retains the fluid within the interstitial space

A

Oncotic Pressure

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52
Q

Explain “Starling’s Law of Fluids”

A

Dynamics of fluid exchange between a capillary and tissue. An equilibrium exists between forces filtering
fluid out of the capillary and forces absorbing fluid back into the capillary. Note that the hydrostatic pressure is greater at the arterial end of the capillary than at the venous end. The net effect of pressures at the arterial end of the capillary causes a movement of fluid into the tissue. At the venous end of the capillary, there is net movement
of fluid back into the capillary.

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53
Q

How much pressure is in the arterial end?

A

40 mmHg

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54
Q

How much pressure is in the venous end?

A

1 0 mmHg

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55
Q

These are shifts of plasma fluid to interstitial
space/compartment

A

Edema

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56
Q

What causes edema?

A

(1) Elevation of venous hydrostatic pressure
(2) Decrease in plasma oncotic pressure
(3) Elevation of interstitial oncotic pressure

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57
Q

What are the different types of regulation of water balance?

A

(1) Hypothalamic Regulation
(2) Pituitary Regulation
(3) Adrenal Cortical Regulation

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58
Q

What is the effect plasma osmolality on water intake?

A

An increased osmolality (caused by sugar or salt intake) or large decrease on blood pressure causes an increased thirst

Polyurea - excessive urinating
Polydipsia - excessive thirst
Polyphagia - excessive hunger

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59
Q

What are the effects of the increase extracellular fluid osmolality?

A

This stimulates thirst and ADH secretion
(1) Increased fluid intake
(2) Increased water reabsorption in the kidneys

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60
Q

What are the effects of the decrease extracellular fluid osmolality?

A

A decrease in extracellular osmolality inhibits thirst
and decreases ADH secretion
(1) Decreased fluid intake
(2) Decreased water reabsorption in the kidneys

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61
Q

This is produced by the heart when blood pressure
increases. Moreover, it inhibits Na+ reabsorption in the kidneys, resulting in increased urine volume and
decreased blood volume and blood pressure. It also inhibits ADH secretion and dilates arteries and veins

A

Atrial Natriuretic Hormone (ANH)

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62
Q

How does Atrial Natriuretic Hormone (ANH) regulate Na and Water?

A

When there is an increase in blood pressure in the right atrium, there is also an increase ADH, thus resulting to Na excretion and increased water loss and decreased BP.

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63
Q

This type of regulation is stimulated by the renin-angiotensin-aldosterone system

A

Renal Regulation

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64
Q

This type of regulation is stimulated by the Antidiuretic hormone (ADH) .

A

Cardiac Regulation

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65
Q

This type of regulation is tsimulated by 90% intake; 10% metabolism (Absorption and reabsorption)

A

Gastrointestinal Regulation

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66
Q

In terms of dehydration, how does it increase plasma volume?

A

(1) Stimulation of Thirst
(2) Brain (hypothalamus) release ADH
(3) Water reabsorption transpires in the collecting ducts
(4) This results to a decrease in Urination along with the conservation of body water which leads to an increase in plasma volume

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67
Q

In terms of hyperosmolality, how does it increase plasma volume?

A

(1) The kidney stimulates renin the gastrointestinal tract
(2) Renin converts to angiotensin I to angiotensin II
(3) This results to the release of aldosterone by the adrenal cortex, which then conserves Na+ and H2O
(4) Thus resulting to an increase in plasma volume

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68
Q

Where does insensible water loss happen?

A

Lungs, GI tract, skin

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69
Q

How much volume of water is loss in high fluid volume loss?

A

900mL

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70
Q

What is the average volume of water loss per day?

A

600 mL

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71
Q

How do you compute water loss in children?

A

300 mL x BSA

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72
Q

This is the major ion in the extracellular fluid.

A

Sodium (135 - 145 mEq/L)

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73
Q

What is the route of excretion of sodium?

A

Urine and Sweat

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74
Q

How is sodium regulated?

A

It is regulated by the efferent and afferent arterioles in the kidney. It decreases BP and relaxes Afferent
arteriole of the kidney to stimulate Renin

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75
Q

What affects the excretion of sodium?

A

Atrial natriuretic hormone (ANH) and Antidiuretic hormone (ADH)

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76
Q

What is the major roles of sodium?

A

(1) ECF volume and concentration
(2) Generation and transmission of nerve impulses
(3) Acid-base

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77
Q

What are the food rich in sodium?

A

*All cured meats
*All canned Foods
*All Junk food
*All condiments

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78
Q

This pertains to the condition on the increased intake of salt or near drowning or nephrogenic diabetes or insipidus. It is manifested by headache, thirst, lethargy, agitation, seizures, and coma. It also impairs the level of consciousness.

A

Hypernatremia

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79
Q

What is the critical value of hypernatremia?

A

CNS changes>155 mEq/L

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80
Q

How does a nurse diagnose hypernatremia?

A
  • Risk for injury/falls related to CNS excitability and orthostatic hypotension
  • Potential complications: seizures, coma
  • Impaired skin Integrity related to dehydration: cracked and parched oral mucous membranes or skin irritation from diarrhea
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81
Q

This condition pertain to the loss of sodium containing fluids or from water excess (fluid restriction).

A

Hyponatremia

82
Q

What is the symptoms of hyponatremia?

A
  • Headache
  • Confusion
  • Dizziness
  • Personality changes
  • Tremors
  • Seizures, coma (giver hypertonic saline solution 3%
83
Q

What is the serious and critical value of hyponatremia

A

125 and 115 mEq/L respectively

84
Q

How does a nurse diagnose hyponatremia?

A
  • Potential risk for injury related to postural
    hypotension, dizziness and neuro changes
  • Potential complications: falls, seizure
85
Q

The diet is the major source of this. The normal route of excretion transpires within the kidneys. The normal Mg level is required for the normal function of the Na+ and K pump.

A

Potassium

86
Q

What is the normal values of potassium?

A

3.5 - 4.5 mEq/L

87
Q

Where is potassium found?

A

96% intracellular and 4% intravascular

88
Q

What is the critical value of potassium?

A

> 8 (cardiac arrest)

89
Q

What is the role of potassium?

A

(1) Transmission and conduction of nerve and muscle impulses
(2) Cellular growth
(3) maintenance of cardia rhythms
(4) Acid-base balance

90
Q

This pertains to the increase intake, impaired renal excretion, adrenal insufficiency, and shift from ICF to ECF from high serum potassium

A

Hyperkalemia (caused by increased intake, wrong medication, Kidney Failure, Adrenal Insufficiency, Drug Induced (side effect)

91
Q

What are the symptoms of hyperkalemia?

A

(1) Muscle weakness (legs)
(2) Paresthesia (weak or paralyzed skeletal muscles)
(3) Abdominal cramps or diarrhea
(4) Cardiac: irregular pulse, EKG changes (tall peaked T waves, prolonged PR interval and ST segment depression (ventricular fibrillation or cardiac standstill)

92
Q

In ECG Changes, how is hyperkalemia manifested?

A

Tall PT waves

93
Q

How do nurses perceive hyperkalemia?

A
  • Risk for injury related to neuromuscular instability
  • Potential complications: falls, seizures, dysrhythmias and cardiac arrest
  • Potential Nutritional deficit
  • Skin Impairment (if present with diarrhea)
94
Q

This is a low serum potassium caused by abnormal losses of K+ via the kidneys or gastrointestinal tract (severe diarrhea), magnesium deficiency, metabolic alkalosis, and anorexia nervosa

A

Hypokalemia

95
Q

What are the symptoms of hypokalemia?

A
  • Weakness, fatigue (skeletal muscle and respiratory muscles)
  • Decreased muscle tone, leg cramps
  • Cardiac changes: Bradycardia
  • Paresthesia
96
Q

In ECG Changes, how is hypokalemia manifested?

A

ST segment depression,
flattened T wave, presence of U wave

97
Q

How does a nurse perceive hypokalemia?

A
  • Risk for injury related to neuromuscular instability
  • Potential complications: falls, seizures, dysrhythmias and cardiac arrest
  • Potential Nutritional deficit
  • Skin Impairment (if present with diarrhea
98
Q

This is a component of the skeletal system along with phosphorus that constitutes about 99% of it. It has an inverse relationship with PO4. And comes as free or ionized.

A

Calcium

99
Q

What is the normal range of calcium?

A

9 to 11 mg/dL

100
Q

Where is calcium obtained?

A

50% bound to protein (albumin) obtained from ingested foods.

101
Q

What is the role of calcium?

A

(1) Bones are readily available store
(2) Blocks sodium transport and stabilizes cell membrane (Maintains cellular permeability)
(3) Plays a role in clotting (prothrombin to thrombin) (4)Transmission of nerve impulses
(5) Myocardial contractions
(6) Muscle contractions

102
Q

What is responsible for controlling the levels of calcium?

A

(1) Parathyroid Hormone
(2) Calcitonin Thyroid Gland
(3) Synthesis or absorption of Vitamin D (Calcitriol) GI Tract

103
Q

Calcium needs to be regulated in the:

A
  • Gastrointestinal tract
  • Blood
  • Bones
104
Q

How does the parathyroid hormone help regulate calcium levels?

A

PTH helps increase Calcium reabsorption into the bones with by the mobilization of osteoclast (prevents demineralization) through negative feedback mechanism

105
Q

How does the calcitonin help regulate calcium levels?

A

Calcitonin produced by the thyroid gland helps in bone
deposition to resolve too much calcium in the bloodstream by using the osteoblasts

106
Q

This allows the absorption of Calcium.

A

Calcitriol

107
Q

This pertains to high levels of calcium in the blood.

A

Hypercalcemia

108
Q

Hypercalcemia can be caused by which factors?

A

(1) Hyperparathyroidism
(2) Prolonged Immobilization
(3) Overdose of Vitamin D
(4) Multiple Myeloma, Ca with malignancy to bone
(5) Thiazides

109
Q

What is the relationship between acidosis and calcium levels?

A

decreased pH increase ionized Ca

110
Q

How is hypercalcemia manifested?

A

(1) Weakness, lethargy, forgetful, confusion, personality changes, psychosis
(2) Depressed reflexes (Fatigue)
(3) Anorexia, Nausea, Vomiting, dehydration, polyuria
(4) Bone pain
(5) Pathologic fracture

111
Q

What is the EKG changes of hypercalcemia?

A

Shortened ST segment, shortened QT

112
Q

What is the nursing diagnosis of hypercalcemia?

A
  • Risk for injury related to neuromuscular and sensorium
    changes
  • Potential complications: Irregular HR, Bone fractures
  • Bone Pain
  • Decreased functional status
113
Q

This diseases pertains to low serum calcium levels.

A

Hypocalcemia

114
Q

What causes hypocalcemia?

A

(1) Decreased production of Parathyroid Hormone
(2) Acute pancreatitis (kidney failure)
(3) Multiple blood transfusions
(4) Alkalosis
(5) Decreased Intake of calcium
(6) Hx ETOH abuse (poor absorption of Vitamin D, PO4 and
Mg deficiency) or Abuse of diuretics

115
Q

Hypocalcemia can be manifested through:

A

(1) Hyperreflexia, muscle cramps
(2) Numbness and tingling (extremities and region around the mouth)
(3) Depression, anxiety, confusion, easily fatigability (chronic)
(4) Severe cases: Tetany, seizures
(5) Dysphagia
(6) Positive Trousseau’s (carpal spasm) and Chvostek’s sign (facial twitching)

116
Q

This is a manifestation of hypocalcemia that pertains to carpal spasm.

A

Positive Trousseau’s

117
Q

This is a manifestation of hypocalcemia that pertains to facial twitching.

A

Chvostek’s sign

118
Q

How do you observe Chvostek’s sign?

A

Tap the face and observe Twitching

119
Q

How do you observe Trousseau’s sign?

A

Observe Carpal spasms, as you inflate BP cuff above systolic pressure

120
Q

What are the cardiac signs of hypocalcemia?

A

(1) Elongation of ST segment
(2) Prolonged QT interval
(3) Ventricular Tachycardia

121
Q

What is the nursing diagnosis for hypocalcemia?

A

(1) Risk for injury related to weakness
(2) Alterations in functional status
(3) Potential complications: seizure, pathologic fracture neuromuscular changes & arrhythmias
(4) Bone Pain

122
Q

This is an intracellular fluid ion that is essential to muscle, cell membranes, and red blood cells along your neuro functions.

A

Phosphate

123
Q

What is the normal values of phosphate?

A

2.3 - 4.5 mg/dL

124
Q

How is phosphate deposited and excreted?

A

Deposited within bones and teeth and excreted by the kidneys

125
Q

What is the function of phosphate?

A

(1) Involved in acid-base buffer system, ATP production and cellular uptake of glucose
(2) Involved in metabolism of CHO (carbohydrates), fats and CHO-N (proteins)

126
Q

What is the relationship between the calcium and the phosphate?

A

Inverse relationship (reciprocal relationship)

127
Q

This is a condition caused by the high serum of PO4^3 (phosphate).

A

Hyperphosphatemia

128
Q

What causes Hyperphosphatemia?

A

(1) Acute or chronic renal failure
(2) Chemotherapy for certain malignancies
(3) Excessive ingestion of phosphate or vitamin D
(4) Hypoparathyroidism

129
Q

How is Hypoparathyroidism manifested?

A

(1) Calcified deposition in soft tissues such as joints, viscera arteries, skin, kidneys and corneas.
(2) Neuromuscular irritability and tetany

130
Q

This is a condition caused by the low serum of PO4^3 (phosphate).

A

Hypophosphatemia

131
Q

What causes Hypophosphatemia?

A

(1)Malnourishment or malabsorption
(2) Alcohol withdrawal
(3) Use of phosphate binding antacids
(4) During parenteral nutrition with inadequate replacement

132
Q

How is Hypophosphatemia manifested?

A

(1) CNS depression
(2) Confusion
(3) Muscle weakness and pain
(4) Dysrhythmias
(5) Cardiomyopathy

133
Q

This is the coenzyme in metabolism of proteins and carbohydrates, which is affected by the regulation of calcium balance.

A

Magnesium

134
Q

This is the most abundant intracellular fluid cation next to potassium.

A

Magnesium

135
Q

How is magnesium absorbed and excreted>

A

Absorbed from small distal bowel and excreted via the kidneys

136
Q

How many magnesium is bounded to protein albumin and is contained in the bone respectively?

A

1/3; 50% to 60%

137
Q

What is the relationship between potassium and magnesium?

A

directly related (proportional)

138
Q

What is the normal level of magnesium?

A

1.3 to 2.3 or 3 mEq/L

139
Q

What is the function of magnesium?

A

(1) It acts directly on myoneural junction (muscle nerves)
(2) Mg imbalance affect neuromuscular irritability and
contractility. Mg produces a sedative effect at the neuromuscular junction.
(4) Affects cardiovascular system – peripheral vasodilation of
arteries and arterioles.

140
Q

This condition pertains to high levels of magnesium (Mg).

A

hypermagnesemia

141
Q

What causes hypermagnesemia?

A

(1) Kidney failure
(2) Untreated Diabetic ketoacidosis (DKA) (catabolic state release cellular Mg)
(3) Addison’s disease, Adrenocorticotropic hormone (ACTH)insufficiency
(4) Excess intake – over replacement IV, oral intake of Mylanta and antacids with Mg as well as Lithium intoxication

142
Q

How is hypermagnesemia?

A

(1) Hyporeflexia of DTR, muscle weakness or paralysis
(2) Depressed Respiratory Rate (Mg = 10 mEq/L)
(3) Cardiac arrest
(4) Blood- platelet clumping due delayed thrombin
formation
(5) Low BP (peripheral vasodilation)
(6) Facial flushing, sensation of warmth
(7) Lethargy, difficulty speaking (dysarthria)

143
Q

This condition pertains to low levels of magnesium (Mg).

A

Hypomagnesemia

144
Q

What causes hypomagnesemia?

A

(1) Prolonged fasting or starvation
(2) Chronic alcoholism
(3) Fluid loss from gastrointestinal tract
(4) Prolonged parenteral nutrition without supplementation and deficient enteral therapy
(5) Diuretics’ ( Administration of aminoglycosides, cyclosporine, cisplatin, amphotericin, Diabetic ketoacidosis (DKA)
(6) Ethyl Alcohol Withdrawal
(7) Inflammatory Bowel Disease
(8)Sepsis, Burns and hypothermia

145
Q

How is hypomagnesemia manifested?

A

(1) Confusion
(2) Hyperactive deep tendon reflexes
(3) Tremors
(4) Seizures
(5) Cardiac Dysrhythmias

146
Q

This is a major ECF anion and assist in determining osmotic pressure. Moreover, it is found mainly in interstitial (IF) and lymph fluid compartments.

A

Chloride

147
Q

What is normal level of chloride?

A

97 – 107 mEq/L

148
Q

How does Na and Cl changes affect osmolality or dilution?

A

Na and Cl reflects change in osmolality
and/or dilution or concentration level
of ECF

149
Q

Where is chloride produced?

A

(1) produced by the stomach where it combines with
H ion to form HCl
(2) Can also contained in pancreatic juices, sweat, saliva,
bile

150
Q

What is the relationship between Bicarbonate (HCO3) and Chloride?

A

Inverse Relationship

151
Q

How does Biocarbonate assist acid-base balance?

A

Chloride shift as CL moves from the plasma into red blood cells, bicarbonate moves back to the plasma to assist acid-base balance.

152
Q

This occurs with hypernatremia and the loss of bicarbonate (HCO3) in the kidneys or gastrointestinal tract.

A

Hyperchloremia

153
Q

What causes hyperchloremia?

A

(1) Near Drowning (swimming pool)
(2) Hyperchloremic metabolic acidosis
(3) Head trauma
(4) Profuse perspiration and decreases glomerular filtration
(5) Excess Adrenocorticotropic hormone (ACTH) production

154
Q

How is hyperchloremia manifested?

A

(1) Same as metabolic acidosis and hypernatremia or hypervolemia
(2) Tachypnea, weakness, lethargy, deep rapid respirations; cognitive ability declines
(3) Could lead to dysrhythmias decreased cardiac output and coma
(elevated Cl accompanies high Na level)

155
Q

This condition pertains to low levels of chlorine and parallels Sodium level, thus resulting to water excess.

A

Hypochloremia

156
Q

What causes hypochloremia?

A

(1) Metabolic alkalosis (elevated pH and high serum bicarbonate (HCO3)
(2) Excessive Vomiting
(3) Low Salt Intake
(4) Drug interaction with Aldosterone, ACTH, bicarb replacement
(5) Volume depletion- Na and HCO3 are retained by the kidneys to balance the loss; HCO3 accumulates and leads to hyperchloremic metabolic alkalosis

157
Q

These are weak bonds that forms a “bridge” between Nitrogen or Oxygen atom and another electron-hungry atom (common between water molecules)

A

Hydrogen

158
Q

How is hydrogen important?

A

Formation of fragile bonds important to maintain structure of protein molecules and Foundation of body building materials.

159
Q

This is sour in taste and usually burns. This substances can release H ions in detectable amounts

A

Acids

160
Q

Acids are also known as “__________________”

A

Proton donors

161
Q

This is typically bitter in taste and feels slippery to touch. Hydroxide is the most common example of this.

A

Base

162
Q

Bases are also known ‘____________________”

A

Proton acceptors

163
Q

This form of acid-base balance prevents major change in pH by removing or releasing H ion.

A

Buffer Systems (Kidney)

164
Q

An increase in H ion leads to ___________. (excessive hydrogen ions)

A

acidity (lower than 7.35)

165
Q

An decrease in H ion leads to ___________. (deficient hydrogen ions)

A

alkalinity (higher than 7.45)

166
Q

This indicates the Indicates the hydrogen ion concentration in the blood. Moreover, it determines the overall state of acid-base balance but does not indicate source

A

pH

167
Q

What kind of relationship does pH and hydrogen have?

A

inverse relationship

168
Q

What are the extracellular buffer systems?

A

(1) Bicarbonate (HCO3) [alkaline, kidney] – carbonic acid (H2CO3) [lungs]
(2) Monohydrogen-dihydrogen phosphate
(3) Intracellular Proteins
(4) Plasma proteins
(5) RBC’s and hemoglobin

169
Q

What are the different fixed acids in the ph negative logarithm?

A

(1) Sulfuric acid
(2) Phosphoric Acid
(3) Keto acid
(4) Lactic Acid

170
Q

These fixed acids are produced by protein metabolism

A

(1) Sulfuric acid
(2) Phosphoric Acid

171
Q

These fixed acids are produced by incomplete lipid metabolism (observed usually in diabetic patients)

A

Keto acid

172
Q

These fixed acids are produced by anaerobic CHO metabolism (observed primarily in patients in shock)

A

Lactic Acid

173
Q

What are the three principle buffer systems in the kidney tubular fluid?

A

(1) Bicarbonate (HCO3)
(2) Ammonia (NH3)
(3) Phosphate (PO4)

174
Q

This principal buffer is generated from from hydrolysis reaction, CO2 is reabsorbed into the blood for excretion by the lungs and H2O to be eliminated by the kidneys

A

Bicarbonate (HCO3)

175
Q

This principal buffer combines with H to form the non-reabsorb able NH4 and/or combines with Chloride. This is usually seen in patients who have damaged lungs.

A

Ammonia (NH3)

176
Q

This principal buffer is formed when Na2HPO4 present in the filtrate, exchanges H ion for Na; H2PO4 is excreted in the urine whereas Na and HCO3 enter the blood

A

Phosphate (PO4)

177
Q

Explain the process of carbonic-bicarbonate buffer system

A

This process neutralizes HCl to prevent changes in blood pH. This occurs when Na (strong acid) binds with sodium hydrogen bicarbonate (NaH2CO3 - weak acid) to form NaCl (salt) and H2CO3 (carbonic acid - weak acid).

178
Q

Explain the process of hydrolysis reaction equation.

A

This process occurs when H2CO3 (carbonic acid) is disintegrated in order to generate water (H2O) and carbon dioxide (CO2)

179
Q

What is the ration of CO2 to HCO3 in normal acid base regulation?

A

1:20

180
Q

What is ph near death or indicating death in ph level in terms of acidosis and alkalosis respectively?

A

6.8 and 7.8 respectively

181
Q

How does the lungs act as a buffer system?

A

Respiratory system: Eliminates CO2
* Respiratory center in medulla controls breathing.
* Increased respirations lead to increased CO2 elimination
and decreased CO2 in blood

182
Q

How fast does the respiratory system respond?

A

Responds within minutes/hours to changes in acid/base.

183
Q

How does the kidneys act as a buffer system?

A
  • Renal system: Eliminates H+ and reabsorbs HCO3
    -Reabsorption and secretion of electrolytes
    (e.g., Na+, Cl-)
184
Q

How fast does the renal system respond?

A

Responds within hours to days

185
Q

These occur when compensatory mechanisms fail.

A

Imbalances

186
Q

These imbalances affect carbonic acid concentration

A

Respiratory imbalances

187
Q

These imbalances affect bicarbonate concentration

A

Metabolic imbalances

188
Q

Where is blood drawn for Arterial blood gas (ABG) interpretation in adults?

A

Radial Artery

189
Q

Where is blood drawn for Arterial blood gas (ABG) interpretation in children?

A

Femoral Artery

190
Q

What kind of information does the Arterial blood gas (ABG) values provide?

A

(1) Acid-base status
(2) Underlying cause of imbalance
(3) Body’s ability to regulate pH
(4) Overall oxygen status

191
Q

This condition in Arterial blood gas (ABG) pertains to carbonic acid excess.

A

Respiratory Acidosis

192
Q

What causes respiratory acidosis?

A

Hypoventilation and Respiratory Failure

193
Q

How is respiratory acidosis compensated?

A

Kidneys conserve HCO3 (bicarbonate) and secrete H+ into urine

194
Q

This condition in Arterial blood gas (ABG) pertains to carbonic acid deficit.

A

Respiratory Alkalosis

195
Q

What causes respiratory alkalosis?

A

Hyperventilation and Hypoxemia from acute pulmonary disorders

196
Q

How is respiratory alkalosis compensated?

A

Rarely occurs because of aggressive treatment of
causes of hypoxemia

197
Q

This condition pertains to base bicarbonate deficit.

A

Metabolic Acidosis

198
Q

What causes metabolic acidosis?

A

(1) Ketoacidosis
(2) Lactic acid accumulation (shock)
(3) Severe diarrhea
(4) Kidney disease

199
Q

This condition pertains to base carbonate excess.

A

Metabolic Alkalosis

200
Q

What causes metabolic alkalosis?

A

(1) Prolonged vomiting
(2) Gain of HCO3

ANATOMY AND PHYSIOLOGY (18 decks)

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