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Pathophysiology Exam 2 > Part two: Disorders of fluid, electrolytes, and acid-base balance > Flashcards

Part two: Disorders of fluid, electrolytes, and acid-base balance Flashcards

1
Q

What are the components of sodium (Na+)?

A

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.

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2
Q

If fluid changes , then _____ changes?

A

Sodium

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3
Q

If sodium changes, then _____ changes?

A

Fluid

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4
Q

How is hyponatremia caused?

A

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

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5
Q

What are some manifestations of hyponatremia?

A

Muscle cramps

Weakness

Headache

Depression

Feeling of impending doom

Lethargy

Coma

Death

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6
Q

What is meant by symptomatic hyponatremia?

A

Symptoms are due to swelling within cells and usually occur first within the nervous system.

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7
Q

How is hypernatremia caused?

A

Watery diarrhea

Hypertonic tube feedings

Excessive sweating

Decreased water intake

Excessive sodium intake

Heart failure

Renal failure

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8
Q

What are some manifestations of hypernatremia?

A

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

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9
Q

What are the components of potassium (K+)?

A

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.

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10
Q

How is hypokalemia caused?

A

Inadequate intake

Potassium loss:
-Diuretic therapy
-GI fluid loss

Redistribution from ICF to ECF

Adrenal alteration: hyperaldosteronism

Corticosteroid therapy

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11
Q

What are the manifestations of hypokalemia?

A

Impaired urine concentration

GI symptoms
-Nausea, vomiting, constipation

Neuromuscular alterations
-Muscle weakness, paresthesia, and muscle cramps

Postural hypotension

Cardiac dysrhythmias

Confusion

Depression

Metabolic alkalosis

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12
Q

How is hyperkalemia caused?

A

Decreased renal elimination

Excessive rapid administration

Tissue trauma

Muscle injury

Severe exercise

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13
Q

What are some manifestations of hyperkalemia?

A

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

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14
Q

What are the components of calcium (Ca++)?

A

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.

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15
Q

How is hypocalcemia caused?

A

Vitamin D deficiency

Intestinal malabsorption

Liver disease

Kidney disease

Hyperphosphatemia

Too rapid blood transfusion

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16
Q

What are some manifestations of hypocalcemia?

A

Numbness and tingling

Skeletal muscle cramps

Abdominal spasms and cramps

Hyperactive reflexes

Hypotension

Signs of cardiac insufficiency

Positive Chvostek and Trousseau signs

17
Q

What is Chvostek sign?

A

Poking the cheek and inhibiting a twitch

18
Q

What is Trousseau sign?

A

Causes a tremor

19
Q

How is hypercalcemia caused?

A

Increased vitamin D absorption

Excessive calcium in diet

Increased levels of parathyroid hormone (PTH)

Prolonged immobilization

Drugs that cause decreased elimination

20
Q

What are some manifestations of hypercalcemia?

A

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

21
Q

What are the components of phosphorus (Phos)?

A

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

22
Q

How is hypophosphatemia caused?

A

Lack of vitamin D

Severe diarrhea

Malnutrition

Alcohol dependence

Hyperparathyroidism

23
Q

What are some manifestations of hypophosphatemia?

A

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

24
Q

How is hyperphosphatemia caused?

A

Impaired renal function: most common cause

Compensatory mechanism that increases parathyroid hormone (PTH) in renal failure

25
Q

What are some manifestations of hyperphosphatemia?

A

Numbness and Tingling (calcium decreased)

Tetany (calcium decrease)

Hypotension

Cardiac arrhythmias

26
Q

What are the components of magnesium (Mg++)?

A

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

27
Q

How is hypomagnesemia caused?

A

Alcoholism

Excess intake of calcium without magnesium support

Diuretic therapy

Hyperparathyroidism

Hyperaldosteronism

Malnutrition or starvation (small bowel bypass surgery)

28
Q

What are some manifestations of hypomagnesemia?

A

Personality change

Involuntary movements

Nystagmus crossing of the eyes

Tetany

Positive Babinski, Chvostek, trousseau signs

Hypertension

Tachycardia

Cardiac dysrhythmias

29
Q

How is hypermagnesemia caused?

A

Kidney disease

Excess intake of medication containing magnesium such as Laxatives

Excess magnesium administration during preeclampsia

30
Q

What are some manifestations of hypermagnesemia?

A

Lethargy

Hyporeflexia

Confusion

Coma

Hypotension

Cardiac arrhythmias

Cardiac arrest

Pathophysiology Exam 2 (8 decks)

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