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Pharm Exam 2 > Patho CH 8: Fluid and electrolyte imbalance > Flashcards

Patho CH 8: Fluid and electrolyte imbalance Flashcards

1
Q

cations

A

ions with a positive charge

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2
Q

anions

A

ions with a negative charge

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3
Q

Na+ value

A

135-145

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4
Q

K+values

A

3.5-5

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5
Q

Cl-

A

98-106

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6
Q

extracellular ions

A

sodium and potassium
outside of cell

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7
Q

plasma in extracellular compartment are high in ___ , low in ____ and moderate in ___

A

high: sodium, chloride, calcium
low: potassium, magnesium, phosphate
moderate: bicarbonate

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8
Q

extracellular compartment further divided into 2 parts

A
  1. fluid in plasma or intravascular space
  2. fluid in interstitial spaces between cells
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9
Q

intracellular ions

A

chloride, calcium, bicarbonate
inside of cell

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10
Q

water composes ___% of body weight

A

60

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11
Q

two fluid compartments and percentages of water

A

intracellular = 40%
extracellular = 20%

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12
Q

fluid balance: fluid transport

A

Compartments = intravascular and interstitial
processes = osmosis, reabsorption, flitration

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13
Q

fluid balance: forces

A

hydrostatic and osmotic

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14
Q

most abundant cation in extracellular compartment
primary determinant of blood osmolality

A

sodium

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15
Q

fluid balance: regulation

A

thirst
RAAS
ADH
diuretics

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16
Q

hypovolemia causes

A

hemorrhage
dehydration

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17
Q

hypervolemia causes

A

water intoxication (decreased sodium concentration)
edema

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18
Q

mechanisms of edema

A

increased hydrostatic pressure
decreased colloid osmotic pressure
increased permeability
lymphatic obstruction

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19
Q

cirrhosis pathophysiology

A

liver disease characterized by interference of local blood flow and hepatocyte damage

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20
Q

causes of cirrhosis

A

hepatitis and alcohol damage

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21
Q

side effects of cirrhosis

A

altered fluid balance
reduced local blood flow
portal hypertension
hepatocyte damage

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22
Q

cirrhosis clinical manifestations

A

portal hypertension!!!
ascites
abdominal discomfort
increased weight
sodium retention
hyponatremia
renal failure

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23
Q

cirrhosis diagnostic criteria

A

physical exam
body weight
abdominal girth measurement
lab analysis

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24
Q

cirrhosis labs

A

ascitic fluid analysis
liver and renal function
cardiac function

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25
Q

cirrhosis treatment

A

paracentesis - body fluid sampling procedure
diuresis
intravenous albumin

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26
Q

dehydration pathophysiology

A

alteration in fluid and electrolyte balance
sodium imbalance and negative fluid balance

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27
Q

dehydration causes

A

decreased fluid intake
increased fluid output (diarrhea)
fluid shift between compartments (ascites)

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28
Q

dehydrations categories

A

hyponatremic
isonatremic
hypernatremic

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29
Q

dehydration clinical manifestations

A

decreased LOC
prolonged capillary refill time
dry mucous membranes
decreased or absent tears
change in vital signs
depressed fontanel, sunken eyes
decreased or absent urine output

30
Q

dehydration diagnostic criteria

A

H and P (fluid, urine, stools, emesis, sweat)
nutrition
lab analyses

31
Q

dehydration labs

A

electrolytes
bicarbonate
BUN
creatinine
specific gravity (high means dehydration)

32
Q

dehydration treatment

A

rehydration (oral/IV)
correct electrolyte imbalance

33
Q

hypoparathyroidism patho

A

altered calcium balance
negative feedback regulation by parathyroid glands

34
Q

hypoparathyroidism clinical manifestations

A

tetany!!!
hair dryness and loss
nail ridges and breakage
skin dryness
bone loss
tingling in extremities
visual changes
muscle cramps
seizures
fatigue

35
Q

negative feedback regulation by parathyroid glands

A
  1. production of P hormone when Ca is low
  2. P hormone mobilizes Ca
  3. Ca levels rise - hormone production stops
  4. impaired P function lead to decreased Ca
36
Q

hypoparathyroidism diagnostic criteria

A

med and surgical(thyroid) history
physical exam
lab tests

37
Q

lab tests for hypoparathyroidism

A

parathyroid hormone
blood calcium, phosphorus, magnesium
urinary calcium

38
Q

hypoparathyroidism treatment

A

supplementation (calcium and vitamin D)
vitamin D reabsorbs calcium
recombinant parathyroid hormone

39
Q

excess volume can lead to __

A

hypertension, heart failure, peripheral edema

40
Q

hyponatremia due to:

A

vomiting, diarrhea, sweating

41
Q

hypernatremia may result in

A

thirst, hypertension, tachycardia, edema, weight gain

42
Q

most abundant intracellular cation

A

potassium

43
Q

hypocalcemia lead to

A

neuromuscular irritability

44
Q

hypocalcemia clinical manifestations

A

anxiety
irritability
muscle twitching
cramps
spasms
tetany!!!
laryngospasm
seizure

45
Q

causes on low magnesium

A

malnutrition
burns
alcohol

46
Q

common cause of hypermagnesemia

A

end stage renal disease

47
Q

clinical manifestations of sodium imbalance

A

hypotension
altered LOC
oliguria

48
Q

clinical manifestations of potassium imbalance

A

arrhythmias
hypotension
polyuria

49
Q

osmolality

A

measure of the number of dissolved particles, or solutes, in 1 kg (1 L) of water.

50
Q

tonicity

A

ability of a solution to cause a change in water movement across a membrane due to osmotic forces.

51
Q

three solutes determining osmolality

A

sodium
glucose
urea

52
Q

isotonic solutions

A

same concentration of solutes as plasma

53
Q

hypertonic solution

A

greater concentration of solutes in plasma
water goes into vascularity

54
Q

hypotonic solution

A

lesser concentration of solutes than plasma
water going into the cell

55
Q

universal solute

A

water

56
Q

water moving from low to high concentration

A

osmosis

57
Q

can promote movement of fluid based on pressure gradient

A

hydrostatic/filtration pressure

58
Q

tell body to conserve water

A

ADH

59
Q

tell body to conserve sodium

A

aldosterone

60
Q

mechanisms promoting fluid excretion

A

diuretic
kidneys

loss of potassium

61
Q

too much water diluting sodium causing hyponatremia - can cause death

A

dilutional

62
Q

causes of hypovolemia

A

body fluid loss
reduction of fluid intake
loss of fluid to a third space

63
Q

clinical manifestations of hypovolemia

A

Thirst
Dry mucous membranes
Weight loss
Flattened neck veins
Diminished skin turgor (fullness)
Prolonged time (more than 3 seconds)
Decreased urine output
Increased heart rate
Decreased blood pressure
Altered level of consciousness

64
Q

activates the RAAS

A

decreased blood flow to the kidneys

65
Q

decreased blood pressure stimulates ___

A

sympathetic nervous system to increase heart rate, constrict arteries, and increase contractibility

66
Q

ADH and aldosterone work together to decrease

A

urine output and increase fluid intake by stimulating thirst

67
Q

lab changes from hemorrhage

A

decreased hematocrit and hemoglobin
increase BUN

68
Q

causes of hypervolemia

A

Heart failure
Liver cirrhosis
Kidney failure
Excessive fluid replacement
Administration of osmotically active fluids (hypertonic)

69
Q

clinical manifestations of hypervolemia

A

increased urinary sodium
increased water elimination

70
Q

clinical manifestations of hyponatremia

A

muscle cramps
switching
weakness
volume deficit
hypotension
oliguria
HA
anxiety
altered consciousness

Pharm Exam 2 (7 decks)

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