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Patho (Sem 2) > Patho - Fluid & Electrolyte Balance W12/13 > Flashcards

Patho - Fluid & Electrolyte Balance W12/13 Flashcards

1
Q

What can cause dehydration

A

V/D, hemorrhaging, third-spacing

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2
Q

What are the S/S of dehydration

A

Decreased BP, OHoTN, syncope, dizziness, Liguria, dry stool, weight loss, risk hypernatremia, hyperkalemia, hypercalcemia

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3
Q

What can case fluid excess

A

Drinking too much, CHF, kidney failure, liver disease, over-secretion of ALDO and ADH

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4
Q

What are the S/S of fluid excess

A

Weight gain, edema, acites, N/V, confusion, headache

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5
Q

At what point would Na+ be in considered at a deficit in the body

A

<135mEq/L

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6
Q

What can cause hyponatremia

A

Excessive sweating, V/D, ALD deficit, excess H2O intake, renal failure

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7
Q

What are the S/S of hyponatremia

A

Poor nerve conduction, muscle cramps, fluid shift from ECF to ICF, headaches

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8
Q

At what point would Na+ be considered in abundance

A

> 142mEq/L

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9
Q

What can cause hypernatremia

A

ADH deficit, watery diarrhea, hypertonic water loss

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10
Q

What are the S/S of hypernatremia

A

Hypovolemia, fluid shifts from ICF to ECF, decreased urine output, increased thirst

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11
Q

At what point would K+ be in considered at a deficit in the body

A

<3.8mEg/L

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12
Q

What can cause hypokalemia

A

Diarrhea, decreased dietary intake, increased ALDo, thiazide/loop diuretics

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13
Q

What are the S/S of hypokalemia

A

Muscle weakness, increasing pH [hypoventilation], polyuria, sagging ST segment when <3nEg/L

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14
Q

How much urine the body should produce per hour

A

1-1.5mL per Kg per hour (anuria: less than .5)

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15
Q

At what point would K+ be considered in abundance in the body

A

> 5mEq/L

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16
Q

What can cause hyperkalemia

A

Severe burns, renal failure, decreased ALDO, K+ sparing diuretics, muscle damage, cellular damage, acidosis, increased intake (supplement), increased ALDO (Addison’s disease), ACE inhibitors/angiotensin 2 blockers

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17
Q

What are the S/S of hyperkalemia

A

Muscle weakened/fatigue, nausea, decreased pH [hyperventilation], dysrhythmias [pwave flattens and disappears], bradycardia [peaked twave, widened QRS at >5.5]

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18
Q

At what point would Ca2+ be considered at a deficit in the body

A

<2mmol/L

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19
Q

What can cause hypocalcemia

A

Decreased PTH, increased retention if phosphate, alkalosis, decreased albumin

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20
Q

What are the S/S of hypocalcemia

A

Increased neuron excitability (spasms, paresthesia, hyperreflexia), increasing BP cuff pressure can cause wrist spasms, decreased BP, negative inotropic effect

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21
Q

What is a trousseau sign

A

Increasing BP causes wrist spasms

22
Q

What is a chrostek’s sign

A

Tickling cheek by ear causes facial tics

23
Q

At what point would Ca2+ be considered in abundance in the body

A

> 2.6mmol/L

24
Q

What can cause hypercalcemia

A

Increased PTH, thiazide diuretics, prolonged immobilization, certain neoplasms, acidosis

25
Q

What are some S/S of hypercalcemia

A

Decreased neuron excitability (weakness, decreased muscle tone, hyporeflexia), positive inotropic effect, dysrhythmias, loss of bone density (related to increased PTH, immobilization), kidney stones, decreased ADH = hypovolemia, renal failure

26
Q

What can generally cause potassium issues

A

-too much in (unlikely)
-re-distribution (acidosis)
-too little of (chronic renal failure)

27
Q

What is the main issues with potassium

A

Dysrhythmias

28
Q

What are the 3 mechanisms of pH regulation

A

-buffers in blood
-respiratory system
-renal system

29
Q

How to buffers in the blood work

A

[short term]
HCO3- + H+ = H2CO3 = H20 + CO2 (wants body to blow odd CO2)
Hb [in RBC] + H+ = HHB

30
Q

How does the respiratory system help regulate pH

A

(Intermediate)
Chemoreceptors in lung detect changes in H+ which alter RR
More CO2 = increased rate and depth of breathing

31
Q

How does the renal system help regulate pH

A

(Long term)
Secretion of H+ into DCT of nephron
Reabsorption of HCO3-

32
Q

What is a normal pH

A

7.35-7.45

33
Q

What is the normal paCO2

A

45-35

34
Q

What is the normal HCO3-

A

22-26

35
Q

What can cause respiratory acidosis

A

Reduced pulmonary ventilations either by drugs/COPD/CNS damage

36
Q

What are the signs of respiratory acidosis

A

↓pH, ↑CO2, norm HCO3- (headache, confusion, anxiety, drowsiness, stupor)

37
Q

What can cause respiratory alkalosis

A

Can be caused by anything that increases pulmonary ventilation (pain/fever/seizures/hypoxia)

38
Q

What are the signs of respiratory alkalosis

A

↑pH,↓CO2, norm HCO3- (lightheadedness, syncope, confusion, parenthesis, cramps)

39
Q

What are the signs of respiratory acidosis with metabolic compensation

A

↓/= pH, ↑CO2, ↑HCO3-

40
Q

What are the signs of respiratory alkalosis with metabolic compensation

A

↑/= pH,↓CO2,↓HCO3-

41
Q

What can cause metabolic acidosis

A

Renal failure/dysfunction, DKA, lactic acidosis, hyperkalemia, excessive HCO3- though GI

42
Q

What are the signs of metabolic acidosis

A

↓pH, norm CO2,↓HCO3- (headache, confusion, anxiety, drowsiness, stupor, hypercalcemia)

43
Q

What can cause metabolic alkalosis

A

Excessive loss of hydrogen (V/D), hypokalemia, hypotonic volume loss = ALD secretion

44
Q

What are the signs of metabolic alkalosis

A

↑pH, norm CO2, ↑HCO3- (decreased ventilations, N/V, malaise)

45
Q

What are the signs of metabolic acidosis with respiratory compensation

A

↓pH, CO2, HCO3-

46
Q

What are the signs of metabolic alkalosis with respiratory compensation

A

↑pH, CO2, HCO3-

47
Q

How do you find out the pH direction, based on the three vitals

A

-find the 2 that are the same (ie too high/low)
-see what direction the last one is in (often in opposite direction)

48
Q

What is the tx for respiratory acidosis (high CO2)

A

Mechanical ventilations

49
Q

What is the tx for respiratory alkalosis (high pH, low CO2)

A

Manage primary problem

50
Q

What is the tx for metabolic acidosis (low pH & HCO3-)

A

HCO3- / hemodialysis

51
Q

What is the tx for metabolic acidosis

A

Manage the primary problem

Patho (Sem 2) (2 decks)

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