Patho 1 Test Flashcards
What is the BEST indicator of fluid status?
Serial daily weights
Hypoxic injury
Most common cellular injury
Hypoxia
Lack of oxygen
Ischemia
Reduction in the blood supply
Pressure ulcers/sores
What areas are most at risk? And who are they common in?
- result from ischemic injury
- areas most at risk are bony prominences -> greater trochanter/hips, sacrum, ischia
Common in: elderly, overweight, diabetic, immobile people, quadriplegics
Signs and symptoms of cellular injury
- Fatigue and malaise
- loss of well being
- altered appetite
- fever
- Increased pulse
- pain
- increases cellular enzymes in plasma from damaged tissue
What is necrosis?
Result of autodigestion which follows cellular death
What is apoptosis?
Cells in a suicide mission, affects scattered single cells
What is somatic death?
When the whole organism is dead
Signs and symptoms of death
- no respiration
- no circulation
- no muscle movement
- reduction in body temp (algor mortis)
- pupil dilation
- flat EEG
- sphincter relaxation
- loss of skin elasticity
- muscle stiffening (rigor mortis)
- skin discoloration (livor mortis)
- blood pooling
Essential lab values
Sodium (Na): 135-145
Potassium (K): 3.5-5.0
Calcium (Ca): 8.80-10.5
Renin Angiotensin Aldosterone System (RASS)
- Renin- secreted when total blood flow is perceived to be low by the kidneys
- Renin converts angiotensinogen from kidney to the liver
- angiotensinogen I causes some increase in blood pressure
- ACE in lungs converts it to angiotensinogen II which causes a great increase in Blood pressure
- Stimulates aldosterone secretion which saves sodium
- increased ADH released which saves water
- Increased volume = increased blood pressure from additional volume
Isotonic dehydration
Water and electrolytes lost together so lab looks normal
Signs and symptoms of dehydration
- Heart rate is weak/thready
- low blood pressure & low bloop pressure when patient stands
- flat neck and hand veins
- poor skin turgor
- dry mucous membranes
- decreased urine output
- increased thirst
Signs and symptoms of over hydration
- increased and bounding pulse
- distended neck and veins
- elevated blood pressure
- acute weight gain (more than 2lbs in a day)
- pitting edema in depending areas
- shallow respiration and moist/fine crackles if pulmonary edema occurs
Potassium
- major intercellular cation
- 80% is lost in urine daily
Hypokalemia
- Potassium levels less than 3.5
- cardiac diary this’s can occur under 3.0
Remember: K KILLS!
Causes of Hypokalemia
- medications: diuretics
- NG suctioning
Signs and symptoms of Hypokalemia
- irregular pulse, usually rapid, also thready and weak
- EKG changes
- muscle skeletal cramps or pain
Hyperkalemia
- Potassium levels above 5.0
- EKG changes when over 6.0
- makes heart work too much, thus causing tachycardia
Signs and symptoms of Hyperkalemia
- irregular pulse, usually slow
- EKG changes
- increased GI motility, hyperactive bowl sounds, explosive diarrhea
Causes of Hyperkalemia
- renal (kidney) failure
- excessive intake of Potassium in diet
Sodium
- Na is the major extra cellular cation (lives outside the cell)
- normal levels: 135-145
- regulated by kidney through Hormones: aldosterone & ADH (RASS)
Hyponatremia
- Sodium BELOW 135
