Part two: Disorders of fluid, electrolytes, and acid-base balance Flashcards
What are the components of sodium (Na+)?
Normal value 135-145 mEq/L in plasma
Regulates extracellular (ECF) volume.
Assists in regulating acid-base balance.
Contributes to nerve impulse stimulation and transmission.
Intake through gastrointestinal tract- dietary sources
Excreted by the kidneys.
If fluid changes , then _____ changes?
Sodium
If sodium changes, then _____ changes?
Fluid
How is hyponatremia caused?
Excess water or loss of bodily fluids containing sodium:
-Excess water: heart failure, renal failure, etc.
-Loss through GI tract: vomiting, diarrhea, fistula, ostomy, etc.
-Diuretics
Irrigation of body cavity with non-sodium fluid.
Fluid volume excess leads to dilutional hyponatremia.
Polydypsia psychosis
What are some manifestations of hyponatremia?
Muscle cramps
Weakness
Headache
Depression
Feeling of impending doom
Lethargy
Coma
Death
What is meant by symptomatic hyponatremia?
Symptoms are due to swelling within cells and usually occur first within the nervous system.
How is hypernatremia caused?
Watery diarrhea
Hypertonic tube feedings
Excessive sweating
Decreased water intake
Excessive sodium intake
Heart failure
Renal failure
What are some manifestations of hypernatremia?
Thirst: Polydipsia
Low urine output: Oliguria
No urine output: Anuria
Dry skin and mucous membranes
Decreased skin turgor
Decreased salivation and tearing
Headache
Agitation and restlessness
Decreased reflexes
Seizures
Coma
What are the components of potassium (K+)?
Normal serum potassium level 3.5-5.0 mEq/L
Major cation of intracellular fluid (ICF)
Regulates electrical membrane potential
Controls excitability of nerve fibers and contractility of cardiac, skeletal, and smooth muscle cells.
Potassium reabsorption and elimination is regulated by the kidneys and the blood pH level.
How is hypokalemia caused?
Inadequate intake
Potassium loss:
-Diuretic therapy
-GI fluid loss
Redistribution from ICF to ECF
Adrenal alteration: hyperaldosteronism
Corticosteroid therapy
What are the manifestations of hypokalemia?
Impaired urine concentration
GI symptoms
-Nausea, vomiting, constipation
Neuromuscular alterations
-Muscle weakness, paresthesia, and muscle cramps
Postural hypotension
Cardiac dysrhythmias
Confusion
Depression
Metabolic alkalosis
How is hyperkalemia caused?
Decreased renal elimination
Excessive rapid administration
Tissue trauma
Muscle injury
Severe exercise
What are some manifestations of hyperkalemia?
Most serious problem is abnormal cardiac rhythm with risk of cardiac arrest.
GI symptoms:
-Nausea, vomiting, and diarrhea
Neuromuscular alterations
-Muscle weakness, paresthesia, and muscle cramps
What are the components of calcium (Ca++)?
Normal serum level 8.5-10.5mg/dl
Enters the body through the GI system
Absorbed in intestine assisted by vitamin d
1% of calcium is in ICF
Remaining calcium in ECF
Cell membrane potential
Stimulation of neurons and nerve impulses transmission: cardiac, skeletal, and smooth muscle
Serves as a clotting factor for blood coagulation
Protein bound: plasma in albumin
-Complexed: citrate, phosphate, and sulfate
-Ionized: free to leave vascular compartment and help with other functions.
How is hypocalcemia caused?
Vitamin D deficiency
Intestinal malabsorption
Liver disease
Kidney disease
Hyperphosphatemia
Too rapid blood transfusion
What are some manifestations of hypocalcemia?
Numbness and tingling
Skeletal muscle cramps
Abdominal spasms and cramps
Hyperactive reflexes
Hypotension
Signs of cardiac insufficiency
Positive Chvostek and Trousseau signs
What is Chvostek sign?
Poking the cheek and inhibiting a twitch
What is Trousseau sign?
Causes a tremor
How is hypercalcemia caused?
Increased vitamin D absorption
Excessive calcium in diet
Increased levels of parathyroid hormone (PTH)
Prolonged immobilization
Drugs that cause decreased elimination
What are some manifestations of hypercalcemia?
Polyuria — increased urine output
Polydipsia - increased thirst
Anorexia
Nausea, vomiting
Constipation
Kidney stones
Muscle weakness and atrophy
Ataxia–loss of muscle tone
Hypertension
EKG changes
Personality changes
Lethargy, stupor, coma, death
What are the components of phosphorus (Phos)?
Normal serum level 2.5-4.5 mg/di
Maintain bones and teeth
Ensures cells and tissues are properly maintained
Conversion of calories and oxygen for muscle contraction heart rhythm and transmission of nerve signals
Inverse relationship with calcium
85% in bone, 14% intracellular
How is hypophosphatemia caused?
Lack of vitamin D
Severe diarrhea
Malnutrition
Alcohol dependence
Hyperparathyroidism
What are some manifestations of hypophosphatemia?
Muscle weakness with emphasis on chest muscles for breathing
Impaired release of oxygen from hemoglobin
Respiratory failure
Impaired white blood cell function
Bone pain
Fractures
Seizures
How is hyperphosphatemia caused?
Impaired renal function: most common cause
Compensatory mechanism that increases parathyroid hormone (PTH) in renal failure
What are some manifestations of hyperphosphatemia?
Numbness and Tingling (calcium decreased)
Tetany (calcium decrease)
Hypotension
Cardiac arrhythmias
What are the components of magnesium (Mg++)?
Normal serum levels 1.8-3.0 mg/di
Critical for ATP function
Glucose metabolism
Cellular cytoskeleton contraction
Skeletal and cardiac muscle
Blocks outward flow of potassium in cardiac cells
How is hypomagnesemia caused?
Alcoholism
Excess intake of calcium without magnesium support
Diuretic therapy
Hyperparathyroidism
Hyperaldosteronism
Malnutrition or starvation (small bowel bypass surgery)
What are some manifestations of hypomagnesemia?
Personality change
Involuntary movements
Nystagmus crossing of the eyes
Tetany
Positive Babinski, Chvostek, trousseau signs
Hypertension
Tachycardia
Cardiac dysrhythmias
How is hypermagnesemia caused?
Kidney disease
Excess intake of medication containing magnesium such as Laxatives
Excess magnesium administration during preeclampsia
What are some manifestations of hypermagnesemia?
Lethargy
Hyporeflexia
Confusion
Coma
Hypotension
Cardiac arrhythmias
Cardiac arrest
